I want to learn more about side effects of robotic prostatectomy

If your Gleason of 3+4 shows a low percentage, tumor burden, and a 10% or less Of four, then you could be a subject for active surveillance. Were More than one 3+4 found? Were there are a number of 3+3? If you have more than six total 3+3 or 3+4 then treatment is more advisable than active surveillance.

I was diagnosed in 2010 and had surgery at 62. I was a 3+4, but after surgery, they found 4+3 in my prostate. Four days after surgery I drove to three of my clients offices and worked on their computer issues. Seven days after surgery, I went back to work full-time at my Computer consulting business going from one client to the next. I had a catheter in for two weeks after surgery, None of my clients knew I had a catheter or that I had surgery. I decided on surgery because my father died of prostate cancer and he had radiation. Genetic testing wasn’t really done at that time, If I’d had it, I would’ve also had surgery since I have BRCA2, Which I got from my mother. I mentioning this because you should get genetic testing as soon as possible, It’s covered by insurance.

I had no incontinence problems after my catheter was removed. Six years after radiation, I did start having some incontinence problems. I did have ED issues. Back when I had surgery, they didn’t offer nerve sparing. You should definitely ask your doctor if you can get your nerves spared when you have surgery. If they can do that, you can probably get an erection after. If you get radiation, you should also be able to get her an erection after, but after a few years people with radiation find that they can no longer get an erection. If you go on ADT, you will find you lose the desire for sex and you’ll also lose the ability to get an erection, until you stop ADT and your testosterone recovers. There are multiple solutions to ED. You can get an implant which people have been quite pleased with or you can bimix Or trimix injections to get an erection, Something that works quite well.

3 1/2 years after surgery, my PSA started rising and I had salvage radiation, which was good for 2 1/2 years before I had to go on ADT full-time. I’ve had three more reoccurrences and have been on ADT for eight years now. Even though I’ve had prostate cancer for 16 years and nobody has any idea. At 78 I run on the track 1 mile twice a day and go to the gym three days a week to do weight exercises.

I’m glad I saw your post! I too was diagnosed with prostate cancer in 2023 as well as an enlarged prostate. I began taking finestride to shrink my prostate hoping to shrink my prostate enough to be able to have proton therapy treatments in order to avoid a radical prostatectomy! I too heard about the side effects of incontinence erectile disfunction.
Unfortunately, the information I will provide you with will cause you to be even more concerned! I have lived through the surgery now and suffered the side effects and it is tough!
With my experience I became convinced to provide details to guys facing this surgery so that you can prepare yourself for what you will face!
First, regardless of the side effects I am glad to be rid of prostate cancer and extent my years even though it has been tough! Remember that! Even with the problems it brings, sometime a radical prostatectomy ( using nerve saving robotic surgery) is necessary!
I took meds to shrink my prostate for 1.5 years. It did shrink my prostate by lowering my testosterone which in turn eliminated my ability to have an erection, and my penis shrank 50%! Lack of testosterone and lack of use makes it shrink! It was scary at first! It seemed so strange that my normally 6 inch penis when not erect became a three inch penis! Do to all the extra skin on my smaller penis, my circumcised penis looked uncircumcised after it shrank. It was concerning of course but I had no option. After 1.5 years of observation hoping to avoid surgery the cancer grew and I was told I must have a prostatectomy! My worse fear! But again life cancer free was more important.
Awaiting the surgery I began reading everything I could on what to expect and I found a lot of help on this web site! Good, frank discussions from guys who had gone throng this. I was told that the removal of the prostate involves ( very simply put) cutting the urethra tube, removing the prostate, then sewing the Uriah’s tube back together. Unfortunately, when that occurs the urethra tube is shorter by whatever length you prostate was before it was removed. As I said earlier I had a very large prostate before the surgery. She the shorter urethan tube is sown back together it pulls you penis back into your body which makes you penis shorter! I read that this fact is called “ the last humiliation” because after all the other things you have gone thorough ( there is no such thing as going through this with out feeling some embarrassing moments) now you wake up after surgery and you penis is about 1 inch shorter that it was before surgery! You will have a catheter after surgery but by the time it is removed, about a week later, that is the point you can really see your new, shorter penis! They say the day after the catheter is removed is the day your penis has become the smallest, due to the trauma your penal nerves have been through. I had read that and was prepared. That day I measured and I had a 2 inch penis!
Do not despair! You will regain some length as healing occurs! There are things you can do for “ penal rehab”and it does help!
After all the finasteride got out of my system and I did penal rehab, my penis did get longer but I am one in shorter that I was pre surgery and that will not change.
Taking Cialis increased blood flow and helps. Using a penis pump to cause it to be hard due to vacuum pressure, helps as well. I am 4 months lost surgery now. Pre surgery my penis was 7.5 long erect. Post surgery I am 6.5 inches erect ( with the help of a penis pump). I cannot get an erection naturally.
The incontinence continues and requires depends. I’m going to a physical therapy it strengthen my pelvic floor muscles in the hope of ending my incontinence.
Guys, it a struggle to experience this but your life is worth it! Keep your sense of humor, be optimistic, and face it as a short inconvenience in your life! I’m expecting to recover completely to controlling my bladder, and returning to an active sex life! You will too! It just takes a lot of patience and some time!
I hope this help you! If you need more detail or have questions just ask!

All these classifications of cancer levels are confusing. They haven't given me a grade score. Had 15 snips, half 4+3= 7 Gleason which they called Grade Group 3, Then the other half 3+4=7 Gleason Grade group 2. Nothing about a Stage score. Did have bad news in a couple of the snips on each side (LMM & RMM) was 4+3 Gleason 7 Grade Group 3, but on each side was also a Large Cribriform gland present. I guess that Cribriform is bad and getting PMSA Pet and Decipher Test and from what I read on here is that really raises my scores up higher in those two spots, but it don't show it on higher on report. Seems that Cribirform makes it more agressive and able to spread.
Anyway, I think I just want to get it cut out. Then I read about folks that get it cut out and then a few years later have high PSA and prostate cancer when they don't have a prostate. Maybe I am confused, had a lot to deal with and thing moving too slow.

Since you asked:

My Laparoscopic robotic radical prostatectomy at the University of Washington Medical Center was a NON-EVENT. My biopsy revealed that the cancer had probably reached the surface of the prostate, & may have invaded the nerves running to the penis. When the surgeon offered the choice of nerve-sparing vs non-nerve-sparing, it took all of three seconds to decide. If you can't figure out what my decision was, you are prioritizing sex over life.

After the surgery I woke up with NO PAIN. There were five tiny bandages across my beltline. I walked with the nurse in that hospital that night with NO PAIN. The next morning they measured my vitals, removed a couple of tubes, & told me to get dressed & go home. I asked if I could have breakfast first (they said yes). They told me to visit the pharmacy on my way out. I waited at the curb for my ride home (with NO PAIN).

The next day I drove my car (with NO PAIN). The day after that I did my usual 1.5 mile walk (with NO PAIN), & resumed my daily activities.

A week later I visited the surgeon for a follow-up, where they removed the drain tube & the urethra catheter without pain.

It was the 2nd best operation I ever had. The best were my cataract surgeries.

I don't understand why some guys fear surgery. I think some are afraid of "losing control" under the anesthetic. I have a friend who doesn't even like local (awake) surgery. Well, welcome to getting old, assuming you want to get older & not go blind (like some of my relatives).

@readandlearn Mostly agree with this post. The surgery in itself is almost a non-event. The most bothersome aspect is the catheter. I had it for two full weeks, resulting in full incontinence upon removal. This, however, resolved quickly. Now at 8 months, I still don’t have usable erections even with Cialis. I have just started using inyections and I am still experimenting with it. I also have climacturia, but it seems to be improving. I am 52.

My husband was diagnose with stage 2A with Gleason score 8 and perineural invasion right when he turned 47 in early 2021. All scans showed prostate was confined. He decided to choose surgery (robotic-assisted) with the chief urologist at the cancer center in Germany. He's wonderful surgeon and explained all of possible side-effects to my husband. After surgery, my husband recovered very well. He has never experienced the incontinence. He was in the hospital for 6 days because they didn't let him come home until after they took out the catheter. After weeks of recovering, he was sent to get core & pelvic physical therapy. His surgeon/urologist said it's a must even though he's continent the entire time.

However, after surgery, we also found out that very tiny trace of cancer was found in the right seminal vesicle which didn't show up on scan. This was when I learned that very microscopic cells sometimes would not show up on scan. Therefore, his stage was upgraded to 3Tb. We got 4 opinions after surgery to decide on further treatments. All 4 specialists (2 urologists and 2 radiation oncologists) had the same summary. Due to his age, they recommended to do wait & see with PSA test every 3 months. He had been undetectable for almost 5 years. Now we're dealing with biochemical recurrence on one lymph node in the right external iliac.

I had NS RARP last year at age 70. I strictly followed the instructions pre & post op and everything went very well. I had my procedure at Mayo Phoenix (which is a CCOE) in the morning and was released that afternoon. There's about 57 NCI recognized Cancer Centers of Excellence (CCOE). If it's an option, consider going to one for whichever treatment you choose. I think (especially for surgery) experience and technical expertise can make a big difference in one's outcome. Back to my experience, it's standard to do pathology on the prostate after surgery. My Gleason score didn't change, but they found Cribriform and IDC (which aren't good) that wasn't in the biopsy. The week of the catheter wasn't fun, but manageable. Catheter removal was done at Mayo and was painless and easy. After the catheter came out, things got better pretty fast for me. In fact, I had to force myself to follow my doctors instructions to not lift more than 10 lbs for 6 weeks, no small seats (like cycling) for 3 months, etc, as I was feeling pretty good fairly quickly. A proctectomy is major surgery so it's real important to follow your doctors instructions, not overdue it, and give your body time to heal. I was never incontinent, but I had numerous small urine releases as I figured out the new normal, which took several months for me. I had ED after surgery and that recovery took about 15 months to get back to normal, even though I was doing penile rehab (vacuum pump, low dose daily Cialis, on demand 100mg Viagra). I also tried to eat well, (when permitted) exercise regularly, etc, to facilitate my recovery. I also started Kegels before surgery and continued them after the catheter came out. Although I'm doing well, I continue the Kegels to this day to maintain pelvic floor conditioning. BTW, you can query this blog or click on the name of commentors to find posts on any topic. Don't hesitate to ask more questions, but I only mention the query capability because it's a great way to find material on this blog without waiting for answers. Best wishes.

@readandlearn

If non-nerve-sparing means never have sex again, I could live with that., I just want to get the additional test done and am thinking cut it out. If the best way non-nerve-sparing, so be it I am almost 79 and have had a good sex life. Would rather watch and play with my grand and great grand children and spend more years with wonderful wife. I am still in good physical shape, walk several miles a day and lift weights. Been doing that since moving off the ranch and becoming a town person. Not overweight or anything, most people can't believe I am 78.
Also, I want to do what is best that it doesn't come back! I see lots of cases hat it does. Also, I really don't want to walk around peeing my pants. I think that is my biggest concern as I am out in public a lot.
Well, I am taking off now and take wonderful wife to a valentine dinner about 30 miles away.

I did Tulsa pro for my 4+3 at age 65. I only treated 30% of my prostate so I had a very minimal risk of incontinence or ED. I had zero side effects and the procedure was painless. I am 18 months out and have no evidence of disease. It is a newer treatment so there’s not a lot of long-term data, but the three-year data looks pretty much the same as surgery or radiation. It is not necessarily apples to apples comparison though, as you have to have specific parameters to do Tulsa. I am very happy with my choice. Some say focal therapy is just kicking the can down the road, but that has yet to be determined for Tulsa. Also I was OK with that because even if I do surgery or radiation later, I have kicked those side effects further down the road also. It was win-win for me.

Hope it keep working, keep looking up!