Decided on nerve sparing surgery

Yes the urologist didn't recommend I just wanted it for sbrt without adt if
it came in low but unfortunately it didn't but my low volume 3+4 atleast
was favorable for the time being anyway.

@ginger38314 seems like you have a lot of the information you needed and if there is no EPE and nerve sparing odds are good, surgery sounds like the right option. Did Dr. Amling give you the probability of successful nerve sparing?

I specifically asked him that question and he said because my lesion was
relatively small and just in the peripheral zone away from the seminal
vessels he said I had a very good chance of saving those, I guess alot
depends on where the lesion is located.

@ginger38314, I hope it all goes well. Cancer control is the main goal but then again so is quality of life. My biopsy is in a few weeks and I’ve spent countless hours researching treatment options and like you hope to make the best decision possible.

I hate to be a downer here, but I have been impotent ever since my RALP almost four years ago. In my pre-surgery conference I was assured the nerves would be spared "But there is a chance they won't be". I think he put that chance at 20-25%. Upon waking in the recovery room, one of my first questions asked if they were able to spare those nerves. I was told yes. I started ED pill therapy as soon as possible to keep blood flowing to my penis, and I purchased a VED and have used it religiously to help with the therapy. Every appointment I was asked about my erections and always said not yet. After two years the surgeon/urologist admitted they weren't likely to ever return, and so far, he has been proven correct. Yes, Trimix works. Yes, the VED works, but they are obviously different. It's a psychological thing knowing I will never experience a natural erection again. I don't know what I might have decided about the prostatectomy if I had been told this was my future. The cancer is gone and that is great. I will try my best to believe it was a fair trade.

I hate to be a downer here, but I have been impotent ever since my RALP almost four years ago. In my pre-surgery conference I was assured the nerves would be spared "But there is a chance they won't be". I think he put that chance at 20-25%. Upon waking in the recovery room, one of my first questions asked if they were able to spare those nerves. I was told yes. I started ED pill therapy as soon as possible to keep blood flowing to my penis, and I purchased a VED and have used it religiously to help with the therapy. Every appointment I was asked about my erections and always said not yet. After two years the surgeon/urologist admitted they weren't likely to ever return, and so far, he has been proven correct. Yes, Trimix works. Yes, the VED works, but they are obviously different. It's a psychological thing knowing I will never experience a natural erection again. I don't know what I might have decided about the prostatectomy if I had been told this was my future. The cancer is gone and that is great. I will try my best to believe it was a fair trade.

ginger38314 Congrats on your decision. I’m not there yet but heard it’s a relief and been told to focus on moving forward without any regret.
Did surgeon provide any opinion on possibly requiring additional treatment or just wait for post pathology?
Testing for Brca2 may be helpful if not done already.
Good luck my friend

Thanks. No he didn't mention any additional treatment With my low volume of
cancer I wouldn't think that would be necessary but the high decipher does
raise adverse pathology to 40%, hopefully that's not the case surgery is a
ways off they are supposed to call me in 3 weeks to schedule. It's been a
week since meeting so probably will call office this week to check and get
on cancelation list.