Open surgery vs RARP

I probably saw the same chap - quite an ego and definitely tried to put me off the robot (probably means he couldn't master it!). I was initially being lured in by the prospect of some nerve sparing but if I go to Brum it means even more delay. I may just have to get used to the idea of being dead from the waist down.

Indeed - at first I was swayed by the willingness to spare the nerves (it's as though he would because he could) plus the high profile, but in contrast the guy who did my biopsy and would do the RARP has been nothing but brutally honest that his job is to get rid of the cancer and try to keep me continent. That's it.  Sadly I'm going into this with a pre-existing degree of ED so nerve sparing or not I don't think I'm looking at a good outcome in that department.

Don't be defeated before you have tried. My dad was left with ED after his prostatectomy at the age of 62. He has been widowed twice since then but has a new partner and is still enjoying sex. He was 84 last month. He uses a very high dose injection.

I'm not sure what's best in your case but I had open, nerve sparing surgery March last year by a well known surgeon in Birmingham. I was T2C at the time of the operation. I've been content with the outcome so far. 

Good luck

It's reassuring to know that it is at least possible - let's see if I get lucky 🍀

Thanks

So... a little update.  I'm now 2 weeks and a day past my RARP and 1 week and a day past my TWOC.

The surgeon was very pleased with the way the operation went and even though we had a recap on his reservations about nerve sparing, in my case it turned out that I was one of the fortunate ones where the neurovascular bundles just fall away from the prostate without any intervention.  One side he left intact and he took a little of the other bundle (on the side where I was 4+3).  It also helped that I used the 3-4 month wait for surgery to lose about 12-13 kg of lard and clear the way for him.

Home next day feeling like an elephant had stomped on my guts.  Lifetime supply of laxatives provided along with 2 pairs of TED socks to squeeze into for 28 days and 30 clexane pre-filled syringes to jab into what little love handle I've got left (looking like a bruised pin cushion), along with 6 night bags and a useless stand (use a bucket).

The catheter and leg bag were just grim - constantly wondering "Is it full? Has the line kinked? Is it tugging?"  I honed an excellent skill set of showering and toileting with bag and I hope never to use those skills again.  I had got myself some instillagel just in case but I'm relieved (ha!) that I didn't need to use it.  Very grateful to this forum for tipping me off about the catheter bypass that accompanies a bowel movement, at least I wasn't parked there in a panic thinking "OMG that can't be right!!".

More than anything it's the incontinence post-TWOC that gets me down.  I was dry at night from the first night - delighted to wake up in the dark and think "I need to go" rather than to find that I already had gone.  But daytime it's a different story.  I can sneeze without fear but even just relaxing at home there are odd drips and leaks at random.  If I try just a short walk outside on the flat, say just a mile, I'm leaking like crazy - drip, drip, dribble every step.  I'm probably expecting too much, but I'm not going to lie, it's really getting me down.

Between diagnosis and operation I think I've been on a pretty even keel mentally but the operation itself (it's my first ever) really woke me up to the reality that I have cancer (fingers crossed "had" but there's no guarantee) that really has brought tears.

Pain and swelling very much reduced and strength is returning.  Now it's just the wait for the verdict from histopathology.

Cheers
Upkeep

I really wouldn't worry about the day time leakage. Its perfectly normal. As soon as i got tired in the early days I had very little control. It started improving but was probably about week 10 before I felt "normal"

Edited by member 25 Jun 2021 at 13:23  | Reason: Not specified

Does anyone have experience of post-op incisional hernia?  I'm now about 6 weeks post RARP and most of the trocar wounds have healed nicely with only the tiniest "lump" underneath.  There is one trocar wound that has healed nicely in the skin but underneath it there is a firm (and somewhat tender) lump about the size of a kidney bean.  I'm wondering if it's just a bit of "angry" scar tissue or if it could be the beginnings of an incisional hernia - seems a bit small to be honest.  My out patient assessment is 2 weeks away so I can ask the surgeon in person then, but I was curious to find out if anyone had had a hernia after surgery.

Upkeep

Edited by member 23 Jul 2021 at 19:00  | Reason: Spelling (again)

Cheers, John.

Continence update... 3 months post-op and I no longer need to wear a pad in the daytime. Totally dry. I'll probably still pop one in if I go to the pub or have a few glasses with dinner (pride before a fall etc) but overall I'm pretty happy with that.

Surgeon's opinion of my lump was "fatty necrosis" and to be fair it has now completely resolved.

Only one thing remains and that's the total ED. Currently not even 100 mg sildenafil will shift it so I continue with the pump 3 times a week.  Not too discouraged though as I figured this would be the last function to return to anything like normal. At least the blue pill side effects haven't been too bad.

Post-op PSA <0.01 ng/mL next one due next week. Will need to watch this like a hawk as my stage turned out to be T3aN0M0 although Gleason went from 4+3 to 3+4. Not sure how reliable the Gleason is as I had been on 150 mg bicalutamide for 4 months or so.