@ireland1964
You are so right about nerve sparing. Definitely be aware that may or may not be possible depending on the severity of cancer spread and the cancer being out of the capsule. There are two nerve bundles, one on each side. Again depending on circumstances a skilled surgeon can avoid and save the bundles 100% or sometimes 50% or more. He might save both sides 100%, one side 100%, one side 50%, one side 100%, one side 0%, 50% each side, none at all. This is all depending. What is important is just because you hear the Surgeon say “I will do nerve sparing”, you need to ask to what extent or percent he expects to save of the bundles from his review of your MRI and biopsies. He generally has an idea based on the MRI and biopsy. Don’t just believe by his statement regarding the surgery you are in the clear and then be terribly disappointed afterwards with the results. It is better to know upfront what can be possibly saved. This depends if the tumor is deep in prostate or was on just one side or tumors on each side. The point is that there are limits due to the extent of your cancer in what surgeon’s are able to do regarding this and be prepared regarding nerve sparing and your expectations when you hear they will do nerve sparing. Some patients hear nerve sparing and just believe that keeps them from ED issues.

Also I am a believer in real time pathology while you are in surgery. It’s true they have no idea until they really get in their and unless they have your margins checked while in Surgery you could have positive margins when you get your post pathology report. The more margin they delicately try to get rid of takes time, real pathology takes time, lymph node dissections take time. I think many surgeons want in and out as quickly as they can.