Recovery after Robotic Prostatectomy

Thank you JeffMarc, you just basically summarize the MAIN
Principle of PCa:
EVERYONE journey is completely different even when procedures for treatment are the same, everything will depend on how we deal with it, in order to move forward and make progress continuously!
Best wishes

Thanks Michaelcharles:
I did start the kegels routine prior surgery, I was surprised I was able to do it right after surgery, will wait for PT appointment for more recommendations.
The cleaning and doing it twice
A day due shower and in the morning.
Good vibes to you

Hey Steve, It’s a rough patch for sure but you seem to be managing it. I’ve found that ‘management’ is my new normal and over time it’s easier.
One question: If your surgeon states that your cancer will recur, are you scheduled for post op radiation/ADT?
If your surgical pathology was clean you can probably wait. I recently read that immediate radiation or radiation 5 years down the line - with monitoring of course- shows no statistical difference in outcomes.
So hopefully you can catch a break and concentrate on your urinary issues for now. Much love and support on your recovery.

Phil, thanks for the reply. No, I do not have any adjuvant treatments like radiation or ADT scheduled. The doctors told me that in the past, they started adjuvant treatments immediately, or soon after, primary treatment in agressive cases, however, studies showed no improved outcomes so now they wait for reoccurance and react appropriately; Hence the ultra-sensitive PSA tests every 3 months. This is good, especially since I was told that once radiation occurs post RARP, your level of incontinence will likely be permanently frozen in what ever state it was at the time radiation is started - so I'm happy to wait! Who knows, maybe I'll defy the odds and not ever experience reoccurance. That too would make me happy. I will say the waiting around for less than desirable PSA results is not helpful to one's mental state, so I'm working hard to focus on more positive things, otherwise one could get pretty depressed. Good luck to you!

Sounds like your doing well so far . Any blood in urine ? any fever ? I walked as much as I could even in hospital , get blood and body moving . Helps with constipation. Drink lots of fluids . Oxy's do work well , but if pain is really bad you can ask for some codeine in there too . No need for this pain at all these days . Watch the bag for blood. Dont leave hospital with any sort of fever ( like I had ) shows a slight infection if you do have fever . get those laps in at the hospital . Cathider removal should go no problem . How old are you ? 3+4 Gleason? What did the biopsy say ? The younger you are the quicker you heal .... Dont eat too much and take gas-x if your too gassy ! . God Bless you . think positive . James on Vancouver Island .

Hi James:
Thanks for your reply.
To answer your questions:
No blood in the urine since day 2 after surgery.
I am at home walking around and taking naps.
Just got back from catheter removal.
Before the catheter was removed they filled up my bladder with sterile saline.
Then catheter removed, allow me few minutes to pee/empty bladder,
It was uncomfortable but not painful. I felt more pain while removing the tape that was keeping the catheter attached to my thigh( Brazilian wax without the wax😕) even when they used alcohol to dissolve the glue, I guess,too much hair on that area, and amount of time having that attached was the reason for the pain.
I am 59 years old, prior surgery
Glenson score 3+4, one lesson
1.6cm, BPH, PSA 5.4, Decipher test low risk, PSA scan : no
Metastasis, confined to the prostate.
Pending, post pathology results.
Dr. Prescribed Tadafil daily for maintenance of blood flow to penis, also continue with kegel exercises.
Next appointment from 1st PSA reading post surgery, and general evaluation, for in continence or ED.
I will keep you posted
Keep in touch
Wish you Health Blessings
Oscar

Your well on your way Oscar . Sounds like great progress ! I had to stay in hospital for observation after my surgery March 31, 2021 , for about 6-7 days . Surgery went well but I had a low grade fever , so they just kept me in there . Pain control was good in hospital and nursing care . Food was actually good as well ... but for some reason I did not have my normal hunger 🙂 . My PSA did not go to 0.008 which is 'unreadable' here on Vancouver Island . It was like 0.030 for a while then started a very slow climb . Hence at 0.14 I got radiation, 1 year ago roughly . At 7 months level PSA started down quick . As they pull away prostate from Bladder neck always some noncancerous cells are left behind . Kind of normal with surgery . Let us know what son the pathology and your recover . You are in my prayer Bud ! God Bless . James on Vancouver Island .

Don't be in a rush and expect to regain full continence for, at least, many months. Everyone is different of course but I've seen so many videos on Youtube where it's claimed "No problem! I was continent within weeks!".

In my case, I was religious in my Kegels and was becoming frustrated that it seemed to be taking so long to improve. At about the 8 month mark, I realized, HEY! I'm not leaking so much.

I'm now at 19 months since my surgery and go through 1 light pad per day and, even then, the pad is nowhere near full. It doesn't stop me from being active, enjoying life and doing the activities I was before the surgery

Be patient, do your Kegels and you'll get there

Take the Tadalafil!! I did not since I thought the surgeon gave it to me so I could have sex - NO ONE explained to me that it was vital to maintain blood flow to the penis. I’ve paid the price with shriveling at the base and nothing really works now.
But I’m here to bitch about it - and THAT, my friend is what it’s all about! Wishing you a smooth recovery.

One more comment for the guys who are just beginning to deal with this issue, or those that will, but have not yet been confronted with incontinence, especially related to RARP. At first, I was leaking like a fountain - the first few days I just wanted to stay in the shower all day. Later, the urine leakage was not like a baby who holds and then releases it all at once, rather, it is just a slow uncontrolled drip or dribble, supplemented by stress leakage when standing, walking, laughing, lifting, etc. The absorbant products deal with this well. While I carry a daypack with all my products, and am prepared for overwhelming leaks, that has not been an issue. The main issue is leakage from a overly saturated absorbant pad or underwear - and that is much slower and more manageable! If you are going to recover continence, it was/is a slow but steady process for me, i.e., After a few weeks, I began staying pretty dry at night, followed by improvements when sitting, and finally, increased urinary control during active periods. During the day, I urinate frequently at the first sensation. Early on I wouldn't even get a drip. This slowly evolved to a few drips, then a small short stream, and now I can control maybe 75%. I weigh my products and was leaking 2+ cups during the day, but after 10 weeks, that is down to 1/2 to 1 cup. So, my optimism for regaining control and needing no pad, or at least a light pad that lasts all day, is increasing! 7 weeks in, I wanted faster improvement so I connected with a PT who specializes in male pelvic floor/incontinence issues. I'm exceedingly pleased with how much she is helping me! Do your Kegals as well as the other exercises for core strengthening! One issue that I found when wearing an absorbant product is to change them frequently enough such that you don't stay damp all day. I cleaned myself often as I didn't want to get a fungus infection or smell too bad. It is a long road and there isn't a lot written about the details of the process. I'm sure it varies for most people, but if you pay attention to what's going on with your body and figure out a system you will get through it. After an RARP,
many of the nerves, signals and controls change, are numb, or just don't work and relearning is required - and this takes time. Good luck to all of you dealing with this issue!