Prostate cancer surgery: What can I expect & prepare for?

Posted by justmike74 @justmike74, Nov 19, 2022

48 about to have prostate removal surgery
Just needing some advice or experiences of survivors of this, what to expect and what to prepare for.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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retireditguy makes a very good point. No matter how much you read, or how many patient videos you watch, listen to your urologist/surgeon. They know best what your situation is & what YOUR body is doing. Don't waste time worrying about issues that may not apply to you. You may find all sorts of information online, telling you that you might experience this or that - but a lot of things won't happen to you. So listen to the doctors above all else.

Or as I say... worry is a waste of imagination.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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If you are already exercising/working out regularly, bump it up a bit over the next ten-12 days, them recover for two before the surgery. IMO this will ramp up your body's healing powers.

If you haven't already, investigate "penile rehabilitation after prostate surgery". For me, at least, having a plan and sticking to it for return of erectile capability and utility made a big difference...at age 74, I returned to normal relations with my partner within 6-7 months.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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I agree with the previous comments: start kegals, a plastic bucket helped a lot, watch a bunch of videos, see a PT if possible, I also dropped a few pounds (although I don't know if that was necessary or not). Also velcro breakaway pants from Amazon were very convenient and well worth the money. A big disposable pad for the bed was also helpful for me in relaxing and not worrying about a little spillage if the tubing pulled apart while sleeping. Also, I modified my diet per the provider instructions and tried the non-stimulative laxative for a few days more than a week before surgery so I figured out what worked for me and how it'd affect me while I was still healthy before surgery. I think that helped me use the laxative with confidence when I needed it after surgery. Also, I religiously followed all my doctors instructions both pre and post surgery. For example, his instructions for laxative and diet after surgery worked for me as I was never constipated after surgery, but rather had easy bowel movements. Similarly, I strictly followed his instructions to me to alternate tylenol and ibuprofen after surgery and my pain level never got above a 2 on a scale of 10. But even with all that prep, the week with the catheter was still very unpleasant. Best wishes.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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Have sex every day. It may be your last chance to do it normally, if at all.

Kegels are a definite positive activity. After surgery you could have incontinence for a short time, a long time, or none at all. Just never know until you get the catheter out.

Since your cancer is isolated to the prostate. Why didn’t you consider one of the other options? With a Gleason seven you have a good chance of getting treated and being cured. When it comes to radiation, you can have SBRT which only takes around five sessions (multiple types) but you also have many other non-radiation treatments like HIFU, cryotherapy, TULSA-PRO or more.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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1 - Professional, experienced Physical Therapist for 1 - 3 sessions preop.
I could only squeeze in 1 visit preop, but I thought that it helped me immensely.
2 - And, have a plastic bucket to hold urine bag while catheter in place.
You will do great!!!
Best wishes.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

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What TJM53 said: do Kegels faithfully.
-Remember that this is YOUR life and if your conscience or gut is/are telling you something, listen to it and fight for it.
-Know you are going to beat this disease!
-Get some Depends (or a big box store alternative) and some pads. For the pads, get some boxer briefs. TEVA pads come highly recommended. I tried the BJ's pads, but they didn't stick to the boxer briefs.
-Come here for support and to get questions answered.
-Get Dr. Patrick Walsh's Guide to Surviving Prostate Cancer and read whatever section interests you.
-Know that opinions vary, and as my Momma used to say "opinions are like bellybuttons, everybody has one."
-You are NOT alone in this. This group has proven to be extremely helpful to me and after only 6 weeks I have made some good online companions in this journey.

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

Jump to this post

Do your kegels and core. It will help in bladder control recovery

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Profile picture for anosmic1 @anosmic1

My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

Jump to this post

I watched videos from both patients & nurses/urologists so I knew what to expect.
I had my surgery about 5 weeks ago.

From a hospital perspective, these nurses had useful information.


and this patient has several great videos

Over the next 2 weeks.... eat healthily - losing even a couple of pounds will help with the surgery - and go out shopping etc. You'll be stuck at home for a while when you get out.

During recovery.... keep coming back here. Lots of us who have been there, done that.

The worry is normal. It's a major surgery.
But you'll be fine. If I can do it....

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My surgery is scheduled for Nov. 11. I'm 66, Gleason 4+3. PET scan indicates no spread. From your experiences, what can or should I do over the next 14 days until the surgery? I'm confident in my prognosis and surgeon but somehow that doesn't reduce the stress as the date gets closer. I appreciate everyone's thoughts.

REPLY
Profile picture for keywestpirate @keywestpirate

I stumbled across this site recently. I had prostate cancer in 2008 and was an active participant on a number of bulletin boards,, looking for my solution. One of the things that struck me then was the lack of posts from >>> afterwards, whatever that turned out to be. It would have been nice to hear from someone well after the fact.

I had originally decided against a prostatectomy because of the difficult nature of the operation and questionable outcome (remember,, this was 2008). After several months of research,, and a month traveling around the country looking at the options, I wound up back in Boise, Idaho.

My wife's doctor suggested I take a look at Dr X, an ex boyfriend with s supposedly "terrible bedside manner". What did I have to lose at that point? I had pretty much decided on brachytherapy but knew from my research that the erectile nerves would be dead in two years.

Anyway,, Dr X did indeed turn out to be a character, brusque and a bit intimidating. St Alphonsus had just acquired the "new" Da Vinci robot,, and Dr X had moved from Portland to Boise to take advantage of the new market. He had done over 200 of the surgeries, and seemed overly confident.

I expressed by biggest fear, loss of sexual ability. He insisted that it wouldn't happen under his watch. It was supposed to be one night in the hospital,, it turned out to be two due the fact I had been a little too thorough with the GoLytely and they couldn't hear any bowel sounds.

I had no pain,, and in fact,, still have some of the Norco I was prescribed. A week after the surgery Dr X removed the catheter and I was continent the following day. It was a disappointment as I had bought this huge package of pads, based on what I had read on the boards!

Dr X had told me earlier that he wanted me to take a low does of Viagra, approximately 25Mg, daily to facilitate blood flow to the area. I managed to get a load of 100 mg tablets of sildenafil citrate from a pharmacy in India for about $1 each (remember again,, this was 2008. Viagra was unaffordable,, and my insurance had already told me,, "No Way,, Jose" are we going to fund this odd off label use.

He also had me get a penis pump, which the insurance did pay for, and he instructed me to pump daily, but avoid any climax. If this sounds strange,, so it did to me. But I followed his instructions.

Dr X had spent 2 hours and 45 minutes on the operation, working on me from a console on the other side of the room. You can view a Da Vinci prostatectomy on YourTube. Your key to your future sexual function is the surgeon's ability to tease the erectile nerves from around the prostate gland without damaging them. It takes time.

Dr X was seeing me weekly, and a month or five weeks after the operation, he said "I want to you go have sex". And so I did,, thanks to a sympathetic wife, the viagra, and the pump.
It was great. I had an uneventful recovery,, lots of sex, and am still sexually active at 78.
Of course,, I don't ejaculate,, but you can't have everything. The orgasm is still strong, and now I buy my "viagra" in Mexico (I live in Tucson) for $1 a tab,, and cut it in half.

I found this board because I want to go on HRT, specifically some form of testosterone. I stumbled across a post on Lupron. I'm right at the border of what my insurance would consider fundable for HRT, maybe 50 points too high. I was considering a month's worth of lupron just to get the number down below 200.

I had a 3 month lupron depot when the cancer was discovered. Few urologists will pass up this profit center if it's indicated. It was meant to buy me time until I discovered what I wanted to do. The Lupron lasted more than 3 months,, and after the prostatectomy I found that while I was sexually functional, I had much reduced libido.

I had a great PCP physician at the time, and in consultation with Dr X they decided that there was no reason I couldn't go on HRT. A month after starting the Androgel,, I had recovered all of my previous interest. I slept better,, was steadier, felt better,, but I discontinued HRT after three months because I just felt that I didn't need it.

So,, anyway,, my idea is to get a lupron shot, a week later get a testosterone test from my PCP, a referral to an endocrinologist , and voilá! I could get the Lupron from India,, or maybe easier,, from Mexico . I'm having my mouth rebuilt by a dentist in Nogales, so I'm down there every two weeks. When he's done,, my teeth will look like the attached photo (my wife), and I'll die with them.

To sum, for me, and I understand that everyone is different, removing my prostate was the best thing that happened to me. I had difficult to live with BHP, my life was focused on the nearest restroom; now I pee like a racehorse.

For you, the lesson is to choose your surgeon carefully. My wife is considerably younger than me, and was an OR nurse in a surgery center until a couple of years ago. Within the confines of HIPPA (naming no names), she would often comment on the highly different abilities of the surgeons she assisted. Some were talented artists,, some struggled.
My PSA remains undetectable (I still test it every year as part of my blood work). My other advice is,, do your due diligence. All the information you need is on the internet, much more available than it was in 2008. With the information you glean,, you will be able to make the decision that is right for you.

Good luck!
I remember how scary it was.

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Thank you for your post. I'm 59, and I will have the surgery next month. I've been sexually active since I was a teenager and wasn't looking forward to losing my ability to perform. Your post gives me hope. I also appreciate the fact that you reached back to us newbies. I'll make sure I do the same, good or bad.

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