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Nerve sparing and continence.
If the surgeon says he might have to go after the nerves on ine side, I know that contributes to ED, but does it also affect your return to continence? Doctor believes nerve sparing is totally possible on the left but is unsure about the right because of where the tumor is.
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i will follow this thread. But Nerve sparring does not guarantee incontinence or impotence. I am not familiar with the term two sides. I had nerve sparring and did not regain either. My cancer was in the center with clear margins.
How long ago was your surgery?
January 2020. I have had zero detectable PSA and clear Pet Scan.
And you still have incontinence now? How bad?
I started one of the threads. I think its called life after prostate cancer. I think the surgery was successful. trying to figure out now what to do next. Looking into AUS. I think I will try working on my kegle muscles first. I was surprised at how many are incontinent. Even telling me that AUS does not keep you 100% dry. One of my issues is that I have worn a condom catheter since the first week because I cannot stand to wear or smell a pad. I can sleep without any protection. On my impotence I can get about a half of one. But that also, my wife has cancer so I have no stimulation. So I dont even attempt to get arousal. I guess it can be use it or lose it so I may have lost it. But again that is very common on the threads I have been reading. LARP according to my Dr had 85% success. His numbers. I just happened to be 15% on both. No cancer and it appears I might be in the clear for any movement.
There are 2 symmetrical nerve bundles posterior and lateral to the prostate gland. In these days, all Robotic Prostatectomy is nerve sparing. All urologic surgeons attempt to preserve the nerve bundles as they are critical for spontaneous (natural) erections.
Incontinence is related to removing one (two actually) sphincters responsible for urinary continence. Most older men have the opposite problem, trouble initiating the urinary stream and completely emptying the bladder. Once the prostate is removed, we just have the pelvic floor muscles to hold in the urine, similar to women. That is why it is recommended to strengthen those muscles before and after surgery. Gaining urinary continence is more than just doing kegels. It has to do with hydration, the foods and liquids you ingest (some irritate the bladder) and training your bladder to hold the urine.
A book that was recommended to me by my urologist prior to my RP was very helpful-"Life after prostatectomy ..." by Vanity Gagliani (available on Amazon).
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2 ReactionsMy Urologist is saying he may not be able to save the nerves on the right side. But should be able to spare the left.
Do you know anything about Retzius sparing?
Retzius sparing improved the probability of full continence earlier. There is another thread on Mayo Connect that included this discussion. The following is a Weill Cornell discussion of the technique (https://youtu.be/d57oum9s_7Q?si=tjWnJvBmZ6GN0Xje).
Not all surgeons use the is technique, so it is important to request a surgeon with expertise in this technique. However, this technique and the improved results are specific to continence; not ED.
There are others that have participated in this forum who had only one side nerve spared due to the same issue, so hopefully they see your post and respond.