Surgery Options

Hello,

Sorry to hear of your diagnosis.

My husband had Robotic assisted surgery in Dec 21. Everyone is different but he has recovered really well. He didn’t lift anything for 3 months after and still took it fairly easy and everything healed well within that time. He’s 74 now so it was expected that he may have problems with continence but he’s completely dry 5 months on and has been for some time. He ended up with the catheter in for a total of 4 weeks but didn’t cause him too many problems and we were still able to get out and about. ED is still an issue although he had 50% nerves spared. He had 6 months of HT so not much testosterone at the mo so that really doesn’t help. He also started to get fast heartbeat so we decided against using the sildenafil that was prescribed.

We ended up paying private for the surgery in the end because of wait times for our elected surgeon. (Could get NHS referral though) We had to travel to London for the op aswell (we live in Manchester). Would do it all again, no regrets.

This is obviously just our experience, and I’m sure others with come on to let you know theirs.

best of luck 

My husband had open RP on the recommendation of his urologist who is one of the leading robotic RP surgeons. In his case, open was recommended because he had had previous abdominal surgery (appendectomy), the scarring from which might potentially have impacted on the laparoscopic routes in, and because the surgeon felt that he would be able to get a cleaner, more precise cut to save the nerve bundles. Yes, it was a longer stay in hospital and more weeks off work but not a huge difference in the bigger scheme of things.

Anther reason that open is sometimes preferable - a man with heart problems may not be able to have laparoscopic because you are tipped head down for a few hours which puts a lot of strain on the heart. Also, men who have had mesh repairs (e g. for a hernia) may not be able to have laparoscopic RP.

The last time NHS data was published, open RP still had slightly better outcomes than robotic in terms of continence, erectile function and positive margins but I suspect that in the last 4 or 5 years, robotic surgery will have improved.

Edited by member 20 May 2022 at 01:25  | Reason: Not specified

Hi Paul 

I had open surgery just over 3 weeks ago.  I had the procedure on a Monday afternoon and was discharged the following Saturday.  I ended up in HDU for a night after the surgery due to blood loss and low blood pressure, so I really needed every day in hospital to recover.   My catheter is out about a week and I am incontinent, particularly when I walk, although it is still early days in that regard.  I also have a 4 inch scar down my abdomen which will take a while to heal.

My cancer was localized on every scan (inc PSMA) but was designated high risk due to my high PSA and 100% positive biopsy cores.  Therefore ORP and lymph node dissection was recommended by the MDT.  As it turns out post op histology showed my cancer was contained and all the lymph nodes were negative so I'm waiting for the PSA result in a few weeks with fingers and toes crossed.  

As I said above I had an ORP due to purely medical considerations.  I'm not sure I would willingly chose that option if RRP was offered and suitable as there does not seem to be a significant difference in outcomes.

Take care and good luck with your decision.