Right to meet the consultant surgeon?

I think so via NHS choices if specified. Might need to hang about a bit or maybe just book a private appointment for ~£250 for reassurance. If their track record is high volume and top notch should only be an incidental. I met mine for 10mins several weeks before surgery having gone to him for a second opinion. Put all my concerns and questions to bed.

Edited by member 02 Aug 2025 at 16:10  | Reason: Not specified

Hi PD123,

I'm sorry that you've had to join the Club, but welcome to the forum, mate.

If I remember correctly, I was given a date for RARP about a month prior to the op and I had my preassessment about 2 weeks before.

Whenever I've had any questions for my surgeon, pre op or post op, I've emailed them to his secretary. She's contacted him and emailed his replies back to me.

When I had my surgery, my wife and I were caring for my 93 year old mum. I mentioned this at the pre-assessment. They promised to try and get me first on the list, on the scheduled day, and kept to their word.

Best of luck and please keep us updated.

PD, my daughter is going through a similar situation with her breast cancer and feels a little concerned about the situation. We have booked her an appointment to see her consultant surgeon. The appointment is within a week and costs around,£200. I first saw my consultant surgeon at my diagnosis meeting and never saw anyone else, it was always him. We did meet for a few minutes on the morning of the surgery just to go through the consent form.

I think seeing your surgeon before the day is a wise decision to discuss the catheter situation . The Retzius version of the surgery often utilises the spc and I have seen guys mention having an spc with conventional RARP. Has already mentioned I also thought the urethral catheter was utilized to protect the joint,but I am not a urology surgeon 😀. 

Hope all goes well.

Thanks Chris 

I've never heard of people going private to see their NHS consultant, except to have cataract operations although I think outsourcing has got rid of the waits.

My experience, 9yrs ago, was I saw the consultant surgeon when I said I wanted surgery but I never saw him again for business.  

Consent was done by a doctor and when I queried if the Consultant was doing the op he said yes but there are 4 doctors as well, or was it 3, but he seemed a bit offended so I felt a bit uncomfortable.  It was a pre-robot op, I wonder how many do a robot op?

My first 2 post op clinics were done by a locum consultant.  Then it went to a doctor. Then to a nurse, where it's remained for 9yrs.

Oh, and I have a date for RALP now - 9th Sept.

Thank you ☺️

The reasons why he said he'd use a urethral catheter, rather than suprapubic......

He said that during the operation they need to pass a catheter through the urethra multiple times, whether or not the catheter they finally leave in is suprapubic or urethral.  I guess this makes sense, because not only do they need to be sure the urine has somewhere to go once they've removed the prostate, but they need something to support the eventual joint between the urethra and bladder (the anastomosis).  So, even if I ended up with suprapubic, there would be no way of totally avoiding putting a tube through the urethra during the procedure.

He also said that problems with healing/stricture at the anastomosis are greater with suprapubic.  I suppose due to no catheter to support the anastomosis during the first week or so of healing.

Added to that, he said in the past he had done suprapubic quite a few times and, in his experience, outcomes were not as good.

Another point he made was that, at the start of the procedure (with me unconscious) they will do a cystoscopy as a survey of the inside of the urethra.  This will allow them to see if there are areas of possible obstruction (due to previous strictures and surgery) where they need to be especially careful when passing the catheter through, including selecting the appropriate thickness of catheter for my anatomy.

His final point was that they have way more experience doing this procedure with a urethral catheter and departing from their standard procedure (by using suprapubic) can increase risks as they are doing things in ways they are less familiar with.

To avoid all of this, I've discussed with them before the option of radiotherapy (internal or external).  However, the risks for me from radiotherapy (as opposed to RALP) are worse from the point of view of likely disruption to the urethroplasty and/or recurring stricture.  What's more I have long history of chronic prostatitis (can be very painful), which radiotherapy can aggravate.  So really, AS or RALP are my only options and after 2 years of AS things are visibly and measurably getting worse so if I leave it, the risk of the cancer escaping the capsule keeps rising.  I'm 62 years only and in good health otherwise, so now is the time.

Hi Chris,

That’s a really good point and I think he did say something along those lines.  

Sorry that you have to live with long-term catheterisation.  Over time, have you managed to adjust to living with it?

Hi Paul(PD123)

I was told by the CNS that suprapubic catheter will increase the chances of regaining continence and it will only be used for about a week post ops before removing. And once the catheter is out, the hole punched in the bladder will self heal and it does heal quick.

Yes, I read the reason - during the surgery they need to pass catheter through the urethra a fews times and it also support the eventual joint between the urethra and bladder (anastomosis).

BDO, I would obviously bow to the greater knowledge of your CNS regarding continence recovery. Some research certainly suggest short term recovery is better, but I wonder if that is linked to the SPC being more widely used with the Retzius version of RARP, which also reports better short term recovery.

Not having the urine release mechanism kept open by the catheter could be a benefit. We will never know what caused my stricture, the main causes are cited as , over tight sutures, urine leakage through the joint and trauma at the site of the joint. My robot did not have tactile feed back and my post op urethral catheter got stuck on the way out, I also had surgical clip migration into my urethra and bladder. I was 99 percent dry 4 days after catheter removal.

My first SPC was inserted during an aborted urethral dilatation.  I seem to recall my bladder capacity was shrinking before SRT. Was it connected to having a hole punched into the bladder or me doing self dilatation. Like wise we will never know why salvage radiation had such a detrimental effect on my bladder. Was it connected to having a SPC in situ during SRT, perhaps the odd occasion when the bladder was empty during the SRT sessions.

I must point out that my situation was described as very rare.

The hole in the bladder does heal quickly, something that is drummed into those of us with long a long term SPC. We supposedly only have a thirty minute window to get it replaced if it came out. The district nurses take about 3 seconds to remove the old one and fit the new one 

Thanks Chris 

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