Prostate Surgery With Bilateral Lymph node dissection

I believe they punched my biopsy 3+4 numbers into a nomogram and used the result to decide if lymph nodes should be removed. I was very confident in my doctor and trusted his judgement. I didn't really ask but believe node removal, for my case, was mostly diagnostic for staging. Thankfully, all 13 were negative. I had confirmed cancer in my prostate and it looked contained from the MRI images. Didn't have a PSMA pet scan. I did do a Prolaris test it indicated that I was on the borderline for treat or active surviellance. Looks like the biopsy missed the bad stuff because
my surgical pathology gleason grade was upgraded to 4+3, tertiery 5, cribriform, PNI. The margins were negative and so were the 13 nodes. I've been < .1 for 22 months. I was never incontinent but it took about 7-8 months for erections with the help of viagra. I hate cialis and viagra but still need it to this day.

I had a RARP in May and they removed some of Lymph nodes on both sides. My surgeon explained that this was a necessary step as they send the Lymph nodes to be tested for Cancer in those cells to help determine Metastitis. Ask your surgeon if that's why they are being removed. I had swelling in those areas and some pain but nothing major.

Okay, so I admit to some confusion here.
Is lymphodectomy and dissection generally a routine part of prostatectomy?
I'm getting RARP at UC San Diego in a month for capsular contained Gleason 8, PSMA showing no spread, and I see that my surgeon is also planning on doing that as well.

The majority of people I have heard from that had prostatectomy did not have lymph nodes removed unless it had spread. None were removed in my case.

I suspect if you’re Gleason eight or nine, there’s a lot higher chance of them wanting to do that As precautionary measures.

Thak you Jeff. I appreciate your input.

Yes, my GPS score of 47 shows my cancer DNA is the aggressive type, but currently it is Gleason 3+4, and only one out of 18 cores. Also a recent PSMA PET scan showed no metastitis. That is why I am questioning why we need to remove the lymph nodes. I have emailed my concerns to my Urologist, and hopefully he will answer my questions possbly when I see him just before the surgery.

My husband had his RARP in early June. His surgeon wanted to remove the six closest lymph nodes because one of them lit up on the PSMA he had done in March. We asked why the six instead of the just the one and he said there could be cancerous lymph nodes that didn’t show up on the PSMA and this concerned him because my husband is a Gleason 9. Sure enough TWO of the six removed were cancerous. It is my understanding that it is not unusual to remove the closest nodes if the docs have any concerns and also there are generally no lingering complications. My husband hasn’t noticed any problems so far. Consequently his treatment plan is more aggressive now and it all makes sense to us.