What is a Prostatectomy Like?

I had prostatectomy two years ago. The surgery was no problem and I recovered quickly. I had a second surgery to have a penile implant that has a tube and a pump that gives me an erection. As long as it is pumped up the erection lasts as long as I want it. I wish I had had this when I was 40!

It makes me think of Airplane where they inflate the auto pilot.

My urologist was 100% upfront with me about the side effects and recovery. He also talked about other treatment options. In fact, he all but guaranteed some measure of ED at the minimum and certain incontinence. I didn't get a dog and pony show from him - but I didn't get one the first time I used him either and I trusted him enough to have him do this.

I know a lot of folks are down on their doctors for their outcome. My outcome was positive, but I was told up front that it would be negative. He told me that, based on the MRI, I would lose at least half my nerve bundles, if not more. I lost a couple nerve endings and kept most of the nerves on one side and all on the other.

Just before I went in for surgery someone here posted a Sloan doctor's presentation that depressed the living hell out of me. The guy backed up what my doctor said about the vast majority of men experiencing ED and/or incontinence. But there was one take-away from that video that stuck with me, he said that if your sexual function is important to you that it doesn't hurt to remind your surgeon of that right before surgery so that when he's in there he's thinking about it and maybe take a few extra minutes to examine the nerves a little more thoroughly before just cutting them out. I did that very thing, and I even told my wife that if I forgot to say it that I wanted her to remind him. I don't know if that made any difference, but I didn't lose half my nerves due to the protrusion on my prostate.

The point being that not all experiences are the same. I saw 9 different doctors before making my decision, not a single one of them recommended their specialty, they all recommended surgery, every one. Now I'm only 54 and that was a huge factor because they all prefaced with "at your age", but my experience wasn't "surgeons want to cut and oncologists want to radiate".

I think whoever told you that it was a walk in the park and you'd be back to work right away was irresponsible for saying those things.

It makes me think of Airplane where they inflate the auto pilot.

I reckon he had a midget standing just off-camera, turning water on & off.
🙂

Yes, the doctors you saw were all telling you that surgery was the answer. After attending weekly advanced prostate cancer meetings at Ancan.org we heard where surgery was recommended for people that it just didn’t make sense to do. They were either too old or their cancer had spread too much.

Not all urologists are the same. One of the doctors who comes to almost every meeting is in his 80s and his urologist kept telling him he was fine as his PSA kept rising. He ended up very high risk because his urologist didn’t pay attention to his results. Not all urologists are equal.

I ran a computer consulting business. I had no real backup. I really did go to the office of some of my clients four days after surgery. By a week after surgery, the only issue was the catheter, the bag for which I had in my pants leg. No one ever knew I had surgery. I was 62 at the time and I just didn’t have any pain from the surgery, so I went to work. I didn’t do any heavy lifting for a couple of weeks.

I believe I’m in a position to finally provide my own input into this. While I’ve not quite completed the entire process, I’ve experienced enough of it, and it’s fresh enough in my mind, that I can comment.

This is my second robot assisted surgery and, in fact, the exact same surgeon did my prostatectomy and he used almost all the same incision points and, in the end, the recovery from surgery itself is almost identical.

I keep relatively fit, with an emphasis on my core strength (think abs, etc), so having incisions to my abs became very painful to recuperate from both times.

So, what was it like? I just had it out a few days ago. No part of it is fun, but for me the worst part is the ab pain. I take the walking seriously and, like last time, I use a couple of canes to help stabilize me as I walk a bit more each day. Yesterday I pushed probably a bit hard and my abs were absolute murder for about an hour after, I mean more agony than I can remember in a long time. I had the option to take Oxy for this but skipped it because I only use that if the Tylenol doesn’t do the trick.

The second worse part, and it’s far worse this time, is dealing with the gas they pump into you for the surgery. It rises to the high points of your body, shoulders mostly, but if you favor one side while in bed then that entire side gets saturated and the pain is extremely intense. It dissipates over time but takes a few days, it’s already about 1/2 what it was before and that 1/2 is still pretty painful..

Getting used to a catheter for a week is an adjustment. While it generally doesn’t “hurt” (sometimes it does a little), it’s a constant annoyance that varies between you simply always being aware of it there or it actively reminding you that it’s there. I’m counting the days until it comes out - 4 days and change now.

Losing the ability to encourage the relief of your bowels is a huge adjustment. You just can’t do it. For one, you have a surgical zone to worry about breaking open and irritating, a urethra that is just barely stitched on and healing and your muscles are shot. For this reason they give you Gas X and a stool softener to help, but this entire process is pretty not fun. On top of all of this, Oxy constipates you so then you have to deal with that too. Once healed up you can operate in a similar fashion but have to remember that you no longer have independent control of bladder and bowel, so it’s a new “normal” to get used to.

Would I do it again? Probably. It sucks, but that little sucker is gone and so far the doctor is very optimistic that the cancer is taken care of for now. I could have opted for the other primary treatment, radiation, but since the side effects could be the same and then some, I opted out of that (plus every doctor said that at my age it wasn’t recommended, since I’m pretty young for this). There are also the outlier treatments that some have reported success with, maybe those would be better but they just weren’t for my case.

If you get RARP then just know you are NOT going to be back to normal in a few days. You could probably hobble around and try to get back to normal life but you are risking serious injury or even death if you tear something. Even sitting in my recliner doing very little, I thought I would be able to fire up my laptop and work more than I’ve actually been able to. Healing zaps your energy, your whole body is tired and it’s hard to keep up - add to that the bevy of pharmaceuticals and you have a recipe for resting rather than returning to normal.

That’s my $0.02 on my third day post-op.