Question you wished you had asked before your Prostatectomy

Excellent idea writing out questions.
I had a bunch of them on my phone.

But first... some answers.
Orgasms... dry. Forever.
The seminal vesicles are removed as part of the operation.
In terms of orgasms, the feeling is there, but nothing comes out.
Erectile function may return, but it depends on things like whether or not the nerve bundles that run along the sides of the prostate can be safely peeled away during surgery.
Incontinence... it varies. Some of us are good, some not so much.
Pelvic floor exercises before & after surgery should help.

Hospital stay - 1 or 2 days. You'll wake up with a urinary catheter & that can stay in for up to 2 weeks.

I've still got my original list of surgeon questions on my phone.

Biopsy - how many cores indicated cancer?
Will nerves or lymph nodes be removed?
Did the biopsy show cancer beyond the prostate surface, or contained within the prostate?
How often are follow-up PSA blood tests done?
At what point would you consider follow-up radiation treatment? When PSA gets beyond 0.2?
Will there be any dietary restrictions post-op?

I had no questions that were unanswered. I did significant research and wrote down every question in Apple Notes so I could ask my doctors. I did the same thing post surgery, while I was in the hospital, I kept punching in questions to ask my doctor when he checked up on me.

I learned one thing, a takeaway from a video shared on here. The video nearly caused a total meltdown for me because the doctor was all doom and gloom mostly, but one thing he said that I did: "If your sexual health is important to you, tell you surgeon when you are being prepped and right before surgery. It might not make any difference but it might also mean that they take a little more care to help preserve it for you".

Not only did I ask that question but my wife was under instruction that if I forgot to do that then she was to do it for me. It may not have made a single bit of difference, but then again it may have.

Also, I didn't have to ask this because my doctor told me he was going to do it: URETHROPEXY. My insurance denied this procedure because it's generally only performed when you have demonstrated stress incontinence, but my doctor does this automatically and even said that it didn't matter if insurance denied it, he was doing it regardless. I think this was an outstanding bonus I got that is an uncommon procedure. It's 95%+ effective for fixing stress incontinence, so I knew that getting it upfront meant I had a better chance of being dry.

And while not a question, also start getting all your supplies ordered and ready for recovery. While I didn't need diapers, I got two kinds to be safe, plus pads and just all kinds of stuff. I wanted for nothing because I thought of everything, even to a fault!

I will make sure to address the sexual health part. I'm 60 and really want a sex life after this.

Survivor... this is why we love having you here.
Even now, I'm still learning things from you.
What's the difference between a urethropexy (never heard of it) and a sling?

Yes. Pads. Of course.
Buy a few... try them out before surgery, to see which ones are most comfortable.

I had NS RARP at Mayo Phoenix 06/2024 at age 70. Here's some questions to consider asking:
-- will I have nerve sparing RARP? Said another way, will you be able to spare my nerves?
-- for my specific case, what are my odd's of incontinence and ED, immediately and 1 year after surgery?
-- how many of these surgeries have you done and what are your numbers for incontinence & ED?
-- After surgery am I a candidate for penile rehab med's such as low dose (5 mg) daily Cialis? When would it start?
-- Is there any benefit to my outcomes if I lose some weight and/or exercise before the surgery?
-- What will be my physical restrictions and how long before I can resume normal activities after surgery?
One thing I want to mention is that during my pre-surgery meeting with the nurse practitioner she discussed various post-surgery stuff like what supplies to get, avoiding constipation after surgery, etc. I got the non-stimulative laxative she recommended and then I tried it a week before surgery to see how I tolerated it. That really paid dividends as I used it (with confidence) after surgery, strictly followed their diet recommendations, and never had any constipation after surgery. You really want to avoid straining during bowel movements right after surgery while the stitches are healing. If they don't mention this, be sure to ask. Best wishes.

Honestly, that was my #2 concern because I knew that in the absolute worst case, I could get an implant. Incontinence was my #1, and I'm blessed that I didn't end up with that one.

That's my order #1 Incontinence and #2 erections.

Thanks for that heads up about constipation and stiches ..... ouch, just ouch.

It's a more effective procedure than a sling, 95%+ success rate.
https://www.myupchar.com/en/surgery/urethropexy

Want to know how experienced at Da Vinci your surgeon is?
https://www.intuitive.com/en-us/physician-locator
I used that in combo with:
https://health.usnews.com/doctors
To determine, to my own ability, which doctor was my best bet.

Constipation isn't terrible, you just have to take some stool softener and let gravity to the work - NO STRESSING. They will remind you of this repeatedly. They also gave my Miralax in the hospital to get things moving.