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RARP Scheduled After Transperineal Biopsy

Posted by hogeye1909 @hogeye1909, Oct 14 11:26pm

Started my PC journey in Feb 2025 and so grateful for finding this support group and reading your stories/insights. My story (Age 56): following an MRI in February & TRUS biopsy in March after some symptoms and slightly high PSA (4.5), I began AS with one TRUS biopsy sample in Right Apex at Gleason 3+3=6. Had 6-month follow-up with transperineal biopsy which showed an upgrade to intermediate-favorable PC:

Specimen 4) RIGHT ANTERIOR MEDIAL: Prostatic adenocarcinoma, Gleason score 3+3=6 (grade group 1), involving 2/3 cores (20%, 15%).
Specimen 5) RIGHT ANTERIOR LATERAL: High-grade prostatic intraepithelial neoplasia.
Specimen 8) LEFT BASE: Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, 5% pattern 4), involving 1/2 cores (10%). - Perineural invasion is present.
Specimen 9) LEFT ANTERIOR MEDIAL: Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, < 5% pattern 4), involving 2/2 cores (60%, 30%).
Specimen 10) LEFT ANTERIOR LATERAL: Prostatic adenocarcinoma, Gleason score 3+3=6 (grade group 1), involving 1/2 cores (20%).
Specimen 11) REGION OF INTEREST 1 LEFT ANTERIOR MID PZ: Prostatic adenocarcinoma, Gleason score 3+4=7 (grade group 2, 5% pattern 4), involving 3/3 cores (70% of entire cores).

Met with urology team in mid-September to discuss treatment options: Robot-Assisted Radical Prostatectomy (RARP), EBRT, & SBRT. After weighing the options and pros/cons, I scheduled my RARP at Vanderbilt Medical Center for Oct 22. Been working for past 3 weeks with PT on pelvic floor exercises (Kegels). Hopefully this help with the recovery. Sometimes the waiting has been the hardest part, but I am trying to stay positive and focused on preparing for the recovery period as much as I can with family support. I hope my story is helpful in some way as your stories have helped me, and I would appreciate any insights/comments as I prepare for my RARP next week.

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hogeye1909 | @hogeye1909 | Oct 15 10:32pm
In reply to @jpbossert209 "I had RARP two years ago at age 70. No pain after surgery. I didn't even..." + (show)
Profile picture for jpbossert209 @jpbossert209

I had RARP two years ago at age 70. No pain after surgery. I didn't even take OTC pain medications. I found that recovery can be broken down into several stages. First, what I would call the catheter stage. My catheter was in for 10 days. Not pleasant, but tolerable. I found medical supplies online that were superior to what the hospital sent me home with. Rather inexpensive. I didn't want to bother with cleaning the bags, Etc. During this period, make sure you are following all instructions, including walking. The next phase was dealing with side effects. I took me longer than some of the stories to regain continence. This can be very depressing, but stick with your routine. I used depends and found them to be very reliable. Never had leaks outside them. I walked regularly and did my pelvic floor exercises religiously, but after a couple of months I started using a Concept II rower and that proved to be a fantastic decision. Phase 3 is the follow up. Even after two years of undetectable PSA, I get nervous before each follow up test. Just normal I guess, but know it's going to be there.

Best of luck.

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@jpbossert209

Thank you for your good wishes and for sharing your experiences/insights with me! I'm glad you are doing well 2 years out from your RARP, and I wish you the very best with your follow-up tests. I like the idea of breaking down the recovery into stages. This approach will really help me focus on recovering one step at a time instead of getting so overwhelmed by all of it (which I have to be on-guard against at times). I plan to be diligent in following the instructions of my medical team and will also try to be patient and persistent with my recovery exercises. I'm glad the rowing machine has proven helpful to your recovery. I will look for one at our local gym or may even try to purchase a Concept II for home use.

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hogeye1909 | @hogeye1909 | Oct 15 10:45pm
In reply to @surftohealth88 "I am wishing you the best of luck 🍀, complete eradication of cancer and zero side..." + (show)
Profile picture for surftohealth88 @surftohealth88

I am wishing you the best of luck 🍀, complete eradication of cancer and zero side effects 👍😃 ! You are doing it at the right time when the best results are expected.

My husband had RP mid August and his recovery was very fast and he also had zero problems with catheter or anything else. His incontinence is negligible at this point (25 milliliters a day and improving). ED also on the mend. He just wishes he had procedure sooner, but not our fault.

Keep us posted 😊🌺

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@surftohealth88

Thank you for your good wishes and encouragement! I've struggled a bit about whether this is the right time for surgery, and my wife said virtually the same thing earlier tonight as you did about this being the right time to have the best chance for success. Thanks also for sharing about your husband's RP in mid-August. I'm glad he is doing so well with his recovery just 2 months out, and I hope he continues to make great strides over the coming weeks. His recovery is certainly encouraging to me. Thanks again for your good wishes and will be sure to keep the forum updated on my procedure and recovery.

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davederousseau | @davederousseau | Oct 17 1:21pm

Had my RARP on 3 Oct. Just had the catheter removed after 14 days. Little to no post-op pain. Discomfort where the prostate was removed. And that continues somewhat today. As others have said, the catheter stage was uncomfortable, had some burning sensations and a couple of scares seeing small clots and white material in hose and pee after empty. Nurse said all good, as long as flow continued. Waiting now to see how the incontinence goes. Not much leakage yet, but prepared with pads and depends. Did my exercises before the procedure and now. Lymph biopsies and margins results not back yet. These discussions definately help. I too started all this in FEB 2025.

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hogeye1909 | @hogeye1909 | Oct 19 9:27pm
In reply to @davederousseau "Had my RARP on 3 Oct. Just had the catheter removed after 14 days. Little to..." + (show)
Profile picture for davederousseau @davederousseau

Had my RARP on 3 Oct. Just had the catheter removed after 14 days. Little to no post-op pain. Discomfort where the prostate was removed. And that continues somewhat today. As others have said, the catheter stage was uncomfortable, had some burning sensations and a couple of scares seeing small clots and white material in hose and pee after empty. Nurse said all good, as long as flow continued. Waiting now to see how the incontinence goes. Not much leakage yet, but prepared with pads and depends. Did my exercises before the procedure and now. Lymph biopsies and margins results not back yet. These discussions definately help. I too started all this in FEB 2025.

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@davederousseau

Thank you for sharing your experience, and I am glad you are making good progress on your recovery following RARP on 3 October. I do hope the incontinence issues are minimal, and I also hope you receive some good news on the results. The journey since February has been a ‘roller coaster’ at times. Best wishes with your recovery.

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davederousseau | @davederousseau | Oct 20 10:18am
In reply to @hogeye1909 "@davederousseau Thank you for sharing your experience, and I am glad you are making good progress..." + (show)
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@davederousseau

Thank you for sharing your experience, and I am glad you are making good progress on your recovery following RARP on 3 October. I do hope the incontinence issues are minimal, and I also hope you receive some good news on the results. The journey since February has been a ‘roller coaster’ at times. Best wishes with your recovery.

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@hogeye1909

Thank you. And to you all the best on your journey. I certainly did not imagine my self here a year ago. And yet here we are, with family, friends, and an online support community along for the ride.

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