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Had Radical Prostatectomy last week: What are next steps?
Hi, I just had a Radical Prostatectomy on 8/4/22 and made the unfortunate decision to look at my Pathology Report before my appointment with surgeon in 2 weeks. Actually, all data looked good except one margin notation. My Gleason was still a 7 as it was during the biopsy in May. No seminal vesicles, bladder neck, or lymphovascular invasion observed. 15 lymph nodes were removed with no sign of tumor and were given a rating of pN0. The tumor itself was diagnosed as a PT2. However, in two slides of the left lateral location of the removed prostate an invasive carcinoma was present at margin. The length of this carcinoma was 1mm. My last PSA taken in March 22 was 3.46. Now I am concerned what is the next step. I was really hoping I would not require Radiation after the surgery, but not so sure now. Any thoughts. Thank You. Perry Christopher
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Wow, that’s an awesome result! By my research and numerous personal conversations with a number of men who had the RALP, you are the only person I’ve heard of with absolutely NO Incontinence issues! Every man I’ve spoken with had “Stress Incontinence” issues at the very least and most men had that coupled with pretty measurable Incontinence issues and the need to change numerous pads per day! I had my surgery performed by one of the most expert and nationally recognized surgeons in the country. I didn’t hear you comment on any “ED” issues. What has your experience been in this area.
Thanks,
Philip Snowdon
Thanks...hope you improve too....Gettin concerned about having to urinate every 30 minutes, but I suppose it's better than not being able to urinate but sure is a nuisance.
To begin, I am 72 and was already having issues with ED. A time or two during the week, I take 100 mg of Sildenafil and work on stimulating myself - and I feel I am making progress. My wife is very patient and I will ask for her help in the foreplay, which may be all that there is. But, I expect SOME fun!
Yes, there was shrinkage. I will get a vacuum pump this week. The Urologist gave my info to someone who sells these, medically, at $400 - not covered by insurance. I saw my surgeon shortly afterwards and mentioned this to him. He said to go to a sex shop and they are considerably cheaper. For the fun of it, I asked him for a recommendation. He laughed, and said "I have no direct knowledge of any." He's young with a good sense of humor, so I felt that would be good for a laugh - It was.
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1 ReactionOn the Physical Therapy, I took 4-5 weeks of Pelvic Floor PT prior to the surgery.
I had the RALP on 8/23. Catheter out on 9/1. Back in PT on 9/8. That's 16 days from surgery to a PT return.
I am no doctor, but after my experience, I don't think that waiting 7 weeks could be beneficial.
Austin Texas
Urologist Dr Michael Trotter, Midtown Urologists
Surgeon Dr Aaron Laviana, MD, MBA
Hospital Dell Seton Hospital
PT Baylor Scott and White, Angus Rd, Austin Texas
Interesting. I'm not a doctor either but was told I needed to heal before I could start PT. This included the evaluation appointment where they instrumented me to check my abdominal muscle strength.
My advice is listen to the surgeon or Urologist but DEFINITELY inquire about Pelvic PT so it's not forgotten.
What is the name of your nationally recognized surgeons?
Communication issue? I began post op Kegel PT 1 week following catheter removal.
Very helpful for my recovery.
Physical Therapist (very qualified) advised longer wait, more conservative approach, to additional physical pt, especially lifting, compared to other input.
Waited 2 - 3 months before adding any activity other than walking and Kegel specific PT. Glad I was a patient patient.
Hello there,
My nationally recognized surgeon and one of the most recognized surgeons in his field performing “RALPS” is Dr. Benjamin Chung at the STANFORD CANCER CENTER in Stanford, Palo Alto, California!
Just back from having my catheter removed and 7 days after my RALP. Two areas I'd ask others who've had this surgery. 1. Were you well trained in care and operation of your catheters? I told my doctor he needed to publish a "Catheters for Dummies" Manual. I didn't know I could open the anchor bracket and move the tube to my right leg so I could elevate my left leg, which was filling with lymph fluids. My wife and I felt like the parents of a newborn child, not knowing what we don't know. And 2. My six puncture holes from the DaVinci (5 plus a drain) got no attention at all during my visit today and I was so concerned with my continence I forgot to ask. How long before they fully heal?