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Appointment with Dr. before surgery

Posted by animate @animate, Sep 12 7:33pm

Hello,
I am scheduled for RAPL in 7 weeks from now. Since I first met the Urologist that will be performing the procedure, I have had 3 consultation appointments with him to review test results (PSA, MRI, Biopsy and CT-PSMA). During these appointments he broadly explained my situation and what outcomes we can expect from the procedure. On my last appointment, one week ago, he told me that there was no need to meet again before the procedure.

In recent days I have been reading so much information, in this forum and in several other sources, which raised the question of whether I should have had the Doctor explain to me in more detail what the odds of nerve sparing and damage to urinary functions are, based on the MRI images and biopsy report. I assume that he will be looking at all this to have “a plan” on surgery day but I wonder if I should ask him to explain to me what this plan is.

I would like to know, from experiences, did your Doctor go through the MRI images and Biopsy report details with you to explain the expected scenario and what he will be attempting? Also, did you have an appointment closer to surgery date to receive final indications before the procedure?

Thank you.

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jeff Marchi | @jeffmarc | Sep 16 11:02am
In reply to @jimgaudette "Just remember that whether you ejaculate or can get an erection capable of penetration, you can..." + (show)
Profile picture for jimgaudette @jimgaudette

Just remember that whether you ejaculate or can get an erection capable of penetration, you can still have orgasms. Anything that increases blood flow is good. If all else fails, you can have an IPP implant. I got one since ADT caused ED. Don’t worry about the future, just, eat well, exercise and heal.

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Just a note that you can still Have orgasms even if you can’t get an erection. Rubbing the right spot on your penis, can get you off, even if it’s completely shrunken.

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animate | @animate | Sep 16 2:59pm
In reply to @tj1967 "I was worried about this before my procedure too. My surgeon was very clear with me..." + (show)
Profile picture for tj1967 @tj1967

I was worried about this before my procedure too. My surgeon was very clear with me and said, “I’m going to try to spare your nerves, but once I’m in surgery, my priority is to cure you of cancer.” In the end, I lost one side of nerves.

Before surgery, to improve my chances of sexual recovery, he prescribed me tadalafil 5mg daily, which I will always remain on, just to keep blood flowing properly. If you have not already, I would ask your surgeon about starting tadalafil before surgery as well. I also made a point of doing Kegels whenever I was sitting at my desk, in the car, and so on, which I think helped with incontinence.

For ED, after surgery, I started using the Soma Therapy OTC system: https://augustams.com/product/soma-therapy-otc-manual-system/
for about 5–10 minutes daily. It’s been helpful for keeping blood flow without using bands, basically just exercising your erection. For sex, I’ve had better results with the Vacurect pump: https://anactivelife.com/products/vacurect-1002-otc-ved-pump
since it seems to hold an erection longer.

I also have a meeting scheduled next week to talk about Trimix injections. I’m still hoping for some natural recovery, but honestly, I don’t know if that’s in my future. Wishing you the best as you go through this.

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Hi @tj1967 ,

It seems like, from the results of my MRI and Biopsy and what I have researched, there are big odds of nerve sparing on one side but the other side is not too certain. Again, this is from my research but I still need my doctor to give me his qualified opinion. So, with the possibility of ending up with only one side spared, I am in a similar situation as yours.

I am already on daily 5mg Tadafil and have started Kegel exercises rigorously. Thank you for your suggestions, I am also in line with you on these.

I was actually already considering the Soma and the Vacurect pumps. From your comments it seems like I was on the right track and I might end up getting both. Thank you also for these suggestions.

May I ask how long ago was your procedure?
Thank you.

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animate | @animate | Sep 16 3:04pm
In reply to @jeffmarc "Just a note that you can still Have orgasms even if you can’t get an erection...." + (show)
Profile picture for jeff Marchi @jeffmarc

Just a note that you can still Have orgasms even if you can’t get an erection. Rubbing the right spot on your penis, can get you off, even if it’s completely shrunken.

Jump to this post

Thank you @jeffmarc ,
This is a very encouraging comment. My wife and I do not really understand what to expect, regarding my ability to continue enjoying our intimacy, regardless of my possible degree of recovery after the procedure. It is very comforting to know that we will still be able to enjoy ourselves somehow. Thank you.

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tj1967 | @tj1967 | Sep 16 3:44pm
In reply to @animate "Hi @tj1967 , It seems like, from the results of my MRI and Biopsy and what..." + (show)
Profile picture for animate @animate

Hi @tj1967 ,

It seems like, from the results of my MRI and Biopsy and what I have researched, there are big odds of nerve sparing on one side but the other side is not too certain. Again, this is from my research but I still need my doctor to give me his qualified opinion. So, with the possibility of ending up with only one side spared, I am in a similar situation as yours.

I am already on daily 5mg Tadafil and have started Kegel exercises rigorously. Thank you for your suggestions, I am also in line with you on these.

I was actually already considering the Soma and the Vacurect pumps. From your comments it seems like I was on the right track and I might end up getting both. Thank you also for these suggestions.

May I ask how long ago was your procedure?
Thank you.

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My surgery was in January of this year so I am 8 months out. PSA is at 0.15 so now I'm in the process of another PET scan followed by radiation + ADT treatment.

I've had plenty of experience with both the Soma and Vacurect pumps so if you have any questions, just let me know. Sounds like you are on the right track with everything!

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animate | @animate | Sep 17 2:34pm
In reply to @tj1967 "My surgery was in January of this year so I am 8 months out. PSA is..." + (show)
Profile picture for tj1967 @tj1967

My surgery was in January of this year so I am 8 months out. PSA is at 0.15 so now I'm in the process of another PET scan followed by radiation + ADT treatment.

I've had plenty of experience with both the Soma and Vacurect pumps so if you have any questions, just let me know. Sounds like you are on the right track with everything!

Jump to this post

hI @tj1967 ,
Thank you again. I am sure that I will be in touch, once I get my pump devices.
My Best Wishes to you in your upcoming scan and treatments.

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