No, 76 is not too old! I just turned 78 and two weeks ago I had the Da Vinci Robot Assisted Radical Prostatectomy (RARP), with nerve-sparing, no lymph nodes removed. Surgeon had done 3500 RARPs and warned me that due to my age, my chances of full continence recovery drops from normal 85% to 65% and ED would similarly be more difficult. My regular urologist, had done 100, and graciously gave a referral to his more experienced colleague in their organization. I took to heart the recommendation here in this forum and in Dr Walsh's book to chose a surgeon who has done more than 1000.

Thankfully, the pathology report showed all margins negative, no cribriform, no intraductal, no extraprostatic extension, no seminal vesicle invasion.

Catheter was removed one week ago and wasn't nearly as difficult as I expected. My incontinence is improving day by day, currently at 3 pads per day with no leakage at night. ED is real and very strange but not a priority for me. I am restarting Kegels slowly because it still hurts when I do them.

Background:
Good health, mildly active- not a Mick Jagger, but I walk 2 miles most days. I have a spare tire I could probably lose 5 or 10# (BMI 23).

Had PSA of 5.9 and increasingly bothersome BPH symptoms. Had 2 MRI's, ExoDX urine test, PSMA-Pet Scan, Bone Scan, a cytoscopy, and a TRUS biopsy. Clinical T1c with Intermediate Favorable Risk GG2 (3+4=7) with 4 out of 12 cores positive. Had a genetic test (GPS) on the biopsy tissue with score of 47 indicated Active Surveillance may not be a smart option. I saw a Radiation Oncologist and second urologist before deciding on RARP.

In 6 weeks hopefully my PSA will be undetectable, then only PSA monitoring will be needed for rest of my life. If PSA is detectable and increases there are multiple avenues of treatment available so my statistical chances of surviving 15 years without dying of prostate cancer is 99% (MSK nomogram).

I wouldn't hesitate to do it again. Now I know, unequivocally, that the primary tumor no longer resides in my body. I feel like a dark cloud has been lifted after almost a year of wrestling with this complex decision making process and gnawing on it and stewing over the various test results and options.

I hope my story is helpful for you, my brethren, on your journeys.