Re: Things you wish you had known

[Guest guest]

,

One thing to remember is that everyone is unique when it comes to prostate surgery. If I were considering surgery again first on my check list would be is the surgeon an artist? Does he publish his incontinence and impotence rates? And I would ask to speak to some of the surgeon's other patients who have undergone RP under his knife.

Nerve sparing is not guaranteed to preserve your erections so I would make hay while the sunshines and take your wife on a romantic weekend because believe me it is more than likely that your sex life will never be quiet the same again. Oh! I hear you say 'But sex is not all that important anyway' Believe me, the reality of a diminished sex life is totally different from the perceived imagined loss of it. My wife says I have to also mention about penile shrinkage ( now I really feel inferior :-) )

Remember that there are other treatments with equally good results that are less invasive. I don't know the extent of your disease but if you have indolent PCa it may pay to look at these less invasive treatment modalities. But at the end of the day it should be your call based on strong research.

Regards

[Guest guest]

,

My Doctor was really open about the potential pitfalls of the surgery. He did conventional surgery on me and spared the nerves. My advice would be to begin kagels now as you may have to rely on them to help with incontinence for a month or so after the surgery. In my support group are two guys who had the robotic surgery done and their recovery time was about the same as mine (a couple of days in the hospital and limited mobility until the catheter was removed.)

Like all surgeries, the quicker you get up and start moving around, the better.

Enjoy the time off from work and catch up on your reading.

Jim Pryor

Things you wish you had known

Hi all,As I look down the road towards surgery in a month or so, I'm wondering: for those of you who have had surgery of any sort:Are there things you had wish you had known before the surgery? Things about the procedure or the recovery that your doctor hadn't told you about?Did you do anything to prepare for the surgery and recovery?What did you do to make your recovery speedy or tolerable? Looking back, is there anything you would have done differently?

[Guest guest]

Hi ,

If it were me, I would postpone the surgery until I had done a lot of

research. Your cancer will not kill you overnight. You have time.

Once you have had surgery, there is no going back.

I had my prostate removed in 1992- but we did not have as many

options at that time. I would not choose surgery today. I believe

that seed implants, HDR, or brachytherapy is a much better option.

No matter what therapy one chooses, there are always some side

effects, No matter who does it or how it is done, removal of the

prostate has side effects, some more pronounced and unpleasant

than others.

You are wise to do a lot of research. One reason not to have surgery

is because sex will never be the same after the prostate is removed.

It and the seminal vesicles manufacture almost all of the ejaculate.

During orgasm, the prostate squeezes down and forces the semen

out. This is a part of the pleasure of an orgasm. You may still be

able to have an orgasm, but it may take a lot more stimulation.

Many men who have surgery are impotent afterwards or have

erectile dysfunction. There are nerves on each side of the prostate

that control erectile function. These nerves are difficult to see and

quite often they are severed or severely damaged.

Another side effect of RP is that many men lose some length and

girth afterwards. Several studies have been done on this subject.

Go to www.google.com and search for Loss of Penile Length and

Radical Prostatectomy. Before my surgery, I had 7 1/4 inches. Now

I can barely manage 6 inches when using my Vacuum Erection Device

(VED)

Many men are also incontinent afterwards because the primary

bladder valve is intimately connected to the prostate. It is very

often damaged and some men are completely incontinent. Some

of these men have to have an Artificial Urinary Sphincter implanted

in order to control their urinary output. Some men learn to use

the secondary valve below the prostate by doing Kegel exercises.

But even if they do learn to control normal urinary functions with this

valve, when they try to have an erection or sex, this valve will open

and they will have leakage. This valve has always opened during

sexual activities and no amount of Kegel exercises will cause it

do otherwise. Since the primary valve is not involved in brachytherapy,

there is little or no incontinence.

The impotence rate is also very low. Some men will still have an

ejaculate, though it may be less in volume. Some men are

even able to father children after brachytherapy. After a RP, one may

be able to have sperm aspirated from the testes and used to

impregnate a woman. But it is a difficult procedure, is expensive and

may not always be successful. If a man thinks he may want to father

children after a RP, he should consider banking some of his sperm

I wish you all the bestAubrey Pilgrim, DC (Ret.)Author of A Revolutionary Approach to Prostate Cancer-Read the original book for free at: www.prostatepointers.org/prostate/lay/apilgrimRead the new edition for free at http://www.cancer.prostate-help.org/capilgr.htmDr. E. Crawford is co-author of the revision

Hi all,As I look down the road towards surgery in a month or so, I'm wondering: for those of you who have had surgery of any sort:Are there things you had wish you had known before the surgery? Things about the procedure or the recovery that your doctor hadn't told you about?Did you do anything to prepare for the surgery and recovery?What did you do to make your recovery speedy or tolerable? Looking back, is there anything you would have done differently?

[Guest guest]

Well summed up Aubrey. How I wish I had had the benefit of forums such as this upon my diagnosis in 1998. On the face of it surgery would appear to be the best option when one does not know the realities of the side effects and it is this deception that it is the 'Gold Standard' that is the true tragedy in this world of prostate cancer.

You know as well as I that when a man has made up his mind to have surgery very rarely does he change his mind. The 'Get it out' mentality has kicked in and it becomes compelling. Similarly, not many men will admit that they made a mistake having the surgery because cognitive dissonance comes into play.

If surgery were in fact the only option then I don't think we would have these debates, but it isn't the only option and it certainly isn't the 'Gold Standard'

Regards

[Guest guest]

Thanks - You are right about people just wanting it out- They

panic- I know I did- sure wish I had it to do over. Wish this forum had

been around in 1992.

Aubrey

Well summed up Aubrey. How I wish I had had the benefit of forums such as this upon my diagnosis in 1998. On the face of it surgery would appear to be the best option when one does not know the realities of the side effects and it is this deception that it is the 'Gold Standard' that is the true tragedy in this world of prostate cancer. You know as well as I that when a man has made up his mind to have surgery very rarely does he change his mind. The 'Get it out' mentality has kicked in and it becomes compelling. Similarly, not many men will admit that they made a mistake having the surgery because cognitive dissonance comes into play.If surgery were in fact the only option then I don't think we would have these debates, but it isn't the only option and it certainly isn't the 'Gold Standard'Regards

[Guest guest]

One point is the healing of the rejoin between the uretha and the bladder

depends on the

catheter,ensure the catheter is well strapped down.Mine came out overnight on

the first night,I

had to go back in the theatre and be opened up again.The surgeon sad it was a

very rare

occurrence,so dont worry.Personally I wish I had had brachytherapy or the new

HIFU,the guys in our

support group who had these remain potent and continent

--- Handelman wrote:

> Hi all,

>

> As I look down the road towards surgery in a month or so, I'm wondering:

> for those of you who have had surgery of any sort:

>

> Are there things you had wish you had known before the surgery? Things

> about the procedure or the recovery that your doctor hadn't told you about?

>

> Did you do anything to prepare for the surgery and recovery?

>

> What did you do to make your recovery speedy or tolerable? Looking back, is

> there anything you would have done differently?

>

>

>

>

__________________________________

Start your day with Yahoo! - Make it your home page!

http://www.yahoo.com/r/hs

[Guest guest]

A LazyBoy recliner or at least a soft chair with a footstool will be nice

to have. Also a bucket to carry the catheter bag once you get home. The

bucket keeps the urine bag upright and contains any accidental spill. Hope

you have someone to help you up from your chair and help you out of bed in

the morning the first couple of days after surgery---you don't want to

stress the abdomen so soon after surgery if you can avoid it. Good wishes to

you...

RJ

Things you wish you had known

> Hi all,

>

> As I look down the road towards surgery in a month or so, I'm wondering:

> for those of you who have had surgery of any sort:

>

> Are there things you had wish you had known before the surgery? Things

> about the procedure or the recovery that your doctor hadn't told you

> about?

>

> Did you do anything to prepare for the surgery and recovery?

>

> What did you do to make your recovery speedy or tolerable? Looking back,

> is

> there anything you would have done differently?

>

>

>

>

>

>

>

>

[Guest guest]

Hi .

I will add my 2 cents about issues that patients felt bad after their

radical prostatectomy.

Please make sure that you did all the possible tests to answer the

question: Is my prostate cancer localized only to the prostate?

There is nothing more disappointing than finding out after surgery

that your disease was not localized (in spite of the statistics) to

the prostate. The tests done after surgery to find where is the

cancer, do them before surgery. The results of these tests may change

your mind about your choice of treatment or may cause you to add other

treatments to the radical prostatectomy.

Ask your doctor what he would do if your lymph nodes are involved. Is

he going to leave the prostate in? Is he going to take it out?

Dont leave the decision of aborting surgery to the surgeon only.

Discuss with him before the procedure. There are options to be

discussed how to deal with this situation.

The last thing I want to mention and it is the most important point in my mind:

If you do not feel comfortable with having surgery, then please don't

have it. I found out that patients who belief instinctively that

whatever they chose is the right treatment are always doing better and

have less problems. Not to be afraid is half of the battle won.

Those who really did not want to have the surgery, at the first sight

of failure start blaming the whole world. If the patient really felt

that it was his own decision and he felt good about it, the first

thing if something goes wrong is the question popping up: Ok it did

not work so well, what do I do now. The attitude of keeping going

versus blaming everyone is determined by the fact whether you decided

or someone else decided for you. It is easier to keep going when you

really were convinced that it was the right decision and now it is

time to make more decision and keep going. If you don't really feel

that surgery is your choice out of self conviction than it can be

detrimental to you health later.

With best wishes for success.

I will cross my blistered fingers for you.

Yours

Israel

> Hi all,

>

> As I look down the road towards surgery in a month or so, I'm wondering:

> for those of you who have had surgery of any sort:

>

> Are there things you had wish you had known before the surgery? Things

> about the procedure or the recovery that your doctor hadn't told you about?

>

> Did you do anything to prepare for the surgery and recovery?

>

> What did you do to make your recovery speedy or tolerable? Looking back, is

> there anything you would have done differently?

>

>

>

>

>

>

>

>

[Guest guest]

Good sound advice from Dr. Barken.

Many thanks for this input

Bob

>

>

[Guest guest]

,

I should have mentioned that upon opening me up, the surgeon discovered the cancer had left my prostate. Had I not had the surgery, I would have not known about it's leaving the prostate and also showing up in one lymph node. The surgeon got clean margins and I am currently on HT (Zolodex and Casodex.) My PSA is <0.1 both before the HT started and after six months.

Jim Pryor

Re: Things you wish you had known

Good sound advice from Dr. Barken.Many thanks for this inputBob>>