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Apprehensive, and asking for your advice pre RP
Hello there, in the span of a week I have had a biopsy with positive PC results and scheduling of surgery 8 days from now due to a cancellation. Feeling fortunate in that I am having the surgery in short order… and a little overwhelmed and still trying to absorb the diagnosis and what is yet to come. Telling family members now and tbh haven’t quite had (or made) the time to work this through in my own mind. Asking this wonderful group for their advice on prep for surgery, and what to expect in the immediate weeks subsequent to the surgery. I find myself of all the potential side effects etc being scared of having a catheter in for 14 days and possible incontinence afterwards…. Sure there are bigger picture things to worry about. Range of emotions for sure!!
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Good luck, you will be so glad everything is behind you after the first week. Get the catheter out and all will be good. Takes a bit for full continence, but you will do great, as long as you do the recommended therapy.
The hardest part is the waiting. The surgery was really not that bad. Never had to take even tylenol. A bit inconvient for sure, but only for a short time. Best wishes to you for a speedy recovery.
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1 ReactionWelcome to the other side of your surgery, pjw2! I hope all was amazingly successful with great post-op pathology reports because that will limit the number of things for you to consider as you move on with the rest of your life.
I found this forum to be very helpful before and after RALP (4 months post-op here). I try to focus on the things I can control or, at least, influence. For all things, I try to read and learn from others experiences - thanks to the many who post here!
Good luck with the at-times seemingly inevitable roller coaster. May your hills be few and small. and your skies, like your pathway, clear.
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2 ReactionsI had my RP this past November. I echo all the comments made so far. It really is not that bad. The catheter wasn’t as inconvenient as I thought it would be. Taking it out by my doctor was simple. Once that’s behind you the main thing is to DO YOUR KEGELS. BTW, I had NO incontinence at all. Even my doctor couldn’t believe it. My formula: doing Kegels religiously(I also had a month to do them before my surgery), an excellent surgeon, and lots of prayer and a positive attitude. Best wishes!
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4 ReactionsNewbie here, Previously diagnosed with BPH in 2017 by our family GP Dr because of nocturia – usually 2x / night increasing to 4-5x this year. Prescription for Flomax (0.4mg to start, 0.8mg now). Watched PSA over that time and when it spiked from 2 to 7, he referred me to Urologist who performed a biopsy followed by bone scan and an MRI. Result was Gleason 7 (4+3) on left and mid cores, none of the other 6. Bone scan clear and the MRI verified PIRADS 5 on left and center with no pelvic lymphadenopathy. Currently scheduled to do Robotic Assisted Laparoscopic Radical Prostatectomy with Bilateral Pelvic Lymphadenectomy – ERAS on March 28 (sorry if some of the acronyms aren’t correct).
I’m 78 years old, 140 pounds, retired and active physically – skiing, mountain biking, hiking with daily exercise. Urologist told me he normally wouldn’t do radical removal on someone my age, but he said due to the fact that I had “little visceral fat” and in good shape physically, he would recommend this route. Also had several consultations with Radiologist who also supported this surgery. So at this point, I feel confident in following this path in spite of about a (30%?) chance of incontinence, ED, or other complications. I’ve been doing Kegel and abdominal exercises under direction of a PT. I’ve never had any issues with bladder infections or leakage in the past.
For anyone willing to share their experience following the surgery plan, can you help me understand the progression (good or bad) post-surgery? How long after the catheter removal before you were able to regain urinary control? If you were doing Kegel exercises, do you use the same muscles to control your flow? How did you know if you were performing the Kegels correctly?
If there is another thread that has information on actual experiences post-surgery, please let me know. Thank you so much!
I’m 71. I had some of the same issues as you did: BPH, nocturia, etc. After learning I had prostate cancer last August, I saw a surgeon and immediately decided on RP. He told me that the old rule was to avoid surgery if 70 years or older; but now they will do surgery if the man is in excellent health. He also told me he was looking forward to operating on someone with low visceral fat. I had 5 weeks prior to my surgery. My surgeon showed me how to do Kegel exercises. I did them religiously daily until the surgery. After the surgery, I had on a catheter for 9 days. I even did Kegels during that time(I read later you’re not suppose to do them wearing the catheter). After removal, my surgeon had me do Kegels every hour; 10 fast and then 10 with a 4-5 second hold. Some days I did them the 13 hours I was awake. The result: I had ZERO incontinence issues. Even the doctor couldn’t believe it. My initial 3+4 Gleason score was changed to 4+5 after my pathology. So far, my PSA is undetectable and no new cancer. My decipher score shows a high risk of recurrence, so I continue praying and exercising daily. My recommendation to you is DO THOSE KEGELS! I hope your outcome is the same as mine. I hope this helps. Best wishes!
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4 ReactionsAt 74 I had gleason 9 CR RP with ADT and Erleada for 13 months That was 30 months ago. No meaningful problems with surgery nor the meds PSA is .01 This cancer is serious stuff and I am taking it seriously and hopeful for a good long run. In hindsight, I think that my doctors and I did the right thing Good Luck to you!
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2 ReactionsFor me, the progression has been good and bad days. Days I work out are tougher. Less active almost dry. I do Kegels 7 times a day. A set of 10 slow and a set of 10 fast. There's a good iPhone app "KPFE" to track them. Also removed all bladder irritants from my diet -- coffee, soda, spicy food to start.
And to your question, same muscles to control your flow. And to your other question, my pelvic floor pt watched me do them.
Nearly four months out almost dry at night and days are getting better.
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1 ReactionMy story is almost the same as yours. 74 y/0 @ the time of surgery 10 months ago. Weight 145#, body fat 6%, very physically active (Ironman triathlete). Gleason 4+3 in one biopsy sample. At the end of this post I include a link to a blog post I wrote seven weeks after surgery, which covers my progress up to then. The takeaways:
• Start kegel's before surgery, then continue as soon as catheter is out. Quality and consistency, not quantity, is key. Seeing a specialist physical therapist helped get me started. I regained full bladder control in less than three months.
http://bikrutz.org/triblog/?p=3487• No biking for 3 months, according to my surgeon and his mentor at the local Center of Excellence. Frustrating, but I have had NO issues biking once I re-started.
• Walk immediately after surgery, then daily. Start weight lifting within 3 weeks.
• Loss of penile erectile function was/is the most bothersome. Ability to orgasm was not lost. There is a link in the blog to a rehab program I found very useful, which included viagra daily, vacuum penis pump, and vibrator
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1 ReactionOk, here's a response from the modestly fat contingent of PCa victims.
You have much good advice already.
72 @ surgery. Very healthy "big boned" 5 11 / 235 lb guy who walks almost every day and periodically lifts light dumbells for upper body.
Professional PT instructed me 1 time preop (very fast to RP) and a few visits postop.
Very little to no continence issues. I attribute it to the surgeon's skill, the PTs assistance and good fortune.
Catheter no big deal; walked in the house carrying the bag in a plastic wash bucket (much more helpful than you would think).
Actually played a round of golf after 6 wks.
Feel free to private message if you have questions (pro tip: You will have Qs. Your surgeon's office my have patients who will share info)
Best of luck for a great result
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