Surgeon appointment for Robotic Prostatectomy: Questions to ask?

You are asking very good questions. I had my proctectomy at age 59 with a Gleason 3+4=7 (one core) and three 3+3=6 cores. I met with two surgeons, an RO, and a focal expert before deciding on surgery.

I strongly believe the quality and experience of your surgeon is one of the most important factors in maintaining the same quality of life you had before the surgery (specifically, continence and the ability to have an erection). The other important factor is your health going into the surgery (healthy BMI, Kegels before the surgery and an active lifestyle). Dr. Walsh's book on prostate cancer has a section on questions to ask. It would be a good start.

I would ask the following:
1. How many procedures have they done (you want a high number, more than 300 and preferably in the 1000's at a center of excellence IMO)?
2. What is their post-surgery follow up plan and how do they track their patients progress?
3. What is their continence and ED "success rate" (time to regain full function)?
4. Will they utilize the Hood Technique (for continence) and nerve sparing (for ED)?

It can be a scary and confusing time, but a great surgeon will be more than happy to answer any and all questions you have.

Good luck with the appointment!

Welcome to our group. Before I weigh in with questions that I’d ask may ask a few things?

1. Are you seeking care at a local community hospital or a center of excellence that utilizes a multi-discipline Tumor Board to review each case?
2. Was an MRI performed before the Biopsy?
3. Was the Biopsy a random 12 core or was it a MRI guided Fusion biopsy?
4. Was there any discussion of having a decipher test or similar genetic test run on the sample to assess the aggressiveness of the cancer?

The reason I ask is because each of these things can make a big difference in outcome, treatment options and quality of life issues like sexual health and urinary continence.

Great comment!

my condition was very similar. gleason 3+3 , one of twelve with cancer, but my PSA was 1.2. Margins were clear. Mine was not considered immediate. I elected for the Robotic nerve sparring surgery. My doctor was with local hospital with his own practice. I started a thread "life after prostate cancer" and many have asked me why the surgery. My Dr said his numbers were 85% success both incontinence and impotence. I had no other issues and active. I fell into the 15% on both. Four and half years later I think maybe I stopped the cancer but I need to figure out the future. so asking now is a good idea. My Dr was a typical I am smarter than you type of guy and bristled at the fact I googled my information. That should have been a clue. I think all the suggestions on here are great ones. I did watch about 5 full surgeries on the internet. I thought it was interesting.

Thanks Robert
To answer your questions:
All procedures through College of Medicine/Urology/Oncology Dept University of Florida
MRI before Biopsy Multiple parametric.
Biopsy guided fusion
13 cores,12 normal, 1with 3+4 lesson.
Decipher test= low risk

Thanks for the details. Mn281 had great suggestions of what to ask the surgeon. I suggest you check them out if you haven’t already done so.

I’m glad to see that you’re getting care through a center of excellence and that they’ve been thorough and pragmatic with their diagnostic approach. From all appearances, you’ve got what many people would characterize as low risk disease and have a number of possible treatment options besides RP available through UF. These include HIFU and TULSA-PRO. It is my understanding as a layman that both of these procedures carry a lower risk of ED and incontinence than RP yet both leave the door open to multiple salvage treatments such as RP, RT, ADT, and Chemotherapy should the primary treatment fail. You’re a young man and if your sexual health is important to you you’d do well to consider asking your surgeon if either of these treatments would be appropriate for you.

Best wishes for success on your journey to be cancer free.

I am 71 yo. Just completed RP currently day 9 post op. I had a urologist I had great confidence in and who had 12 years experience in robotic surgery. For good measure I also got a RO consult. Journey started when I was
Having BPH symptoms but PSA was 30. Biopsy showed G 4+5=9 and MRI and PET scans negative for Mets. Just got
My pathology back and clear margins, negative seminal vesicles and nodes. I feel
I made
The right decision as now I know and don’t have to wonder about
Microscopic spread. Will see how my PSA does and take it as it comes. Good luck!

why i decided for the same procedure with same results. I too am clean 4 1/2 yrs now. Hoping no reoccurrence. But I have been reaching out. I had nerve sparring robotic surgery but I am incontinent and impotent. Although I dont work at either. I am following this site. Good luck.

If you don't mind my asking, what is the Hood technique?

Praying for a very speedy recovery and complete healing and NO more cancer! Hugs to you!