Prostatectomy or Not

Thanks for the encouraging post. I hope I can achieve your results.

After a biopsy (Gleason 3+4 and 6 of 12 cores positive) and rectal exam (negative), my doctor recommended treatment but left the choice of what kind of treatment up to me. I'm currently 3 weeks post radical prostatectomy and dealing with some incontinence, total impotence, and some minor bowel issues. Fortunately my post-op pathology report indicated the cancer had not spread outside the prostate.

Feeling a bit depressed tonight but hopeful symptoms will improve with time.

@jmhabo
Stay positive. For me, things came back slowly, but they did come back. Try not to let it get you down. Don’t be shy about reaching out for support.

@jmhabo

I second what @hlieberman1 says, stay positive. I am just a month after my RP as well. Suffering from the same conditions as you are. It will improve. We are all on our own timelines, but go through many of the same hardships. My wife and I joke about the pads and incontinence. Humor helps. I believe I made the right decision with the RP and understand the challenges that follow. Keep smiling, it helps.

@jmhabo
Did the surgeon spare the nerves when he was doing the prostatectomy?. If so, you can usually get your erection back within a few months.

Having incontinence after surgery is not uncommon. It usually gets better over time and improves considerably. In my case, I had no incontinence after they remove the catheter, But most people have some.

There are many solutions to incontinence issues. You should get a penis pump, Speak to your surgeon about it. I was given one A few weeks after surgery. You should be taking Cialis regularly to keep the blood flow working. You may not get an erection right away, but it helps prepare you for it.

Things will get better. There’s no reason to get really down about what’s going on right away after surgery.

@jeffmarc

My doc proudly announced that he had saved the nerves. I’m glad he did.

Thanks for the encouraging post. I am almost 5 months post RARP and still have complete ED. Surgeon told me that he could do good nerve sparing (over 85% on each side). Incontinence is almost completely resolved.

Do you remember how long it took you to regain erections?

Mark SCHOLZ MD at the PCRI.org railed against surgeons who have not recommended post (>2 weeks?) surgery penile injections to maintain muscle tone during healing. He also mentioned that 'nervous system shock' may cause post surgical erectile dysfunction with or without direct injury to nerves. Early maintenance of muscular tone by injection is important.

@thmssllvn I saw two different ED specialists and both told me to wait six months post-surgery with injections. Even though I asked specifically for them (following the PCRI videos).

Ask again if the needle is contraindicated, versus ineffective, or unnecessary because other methods are better. Maybe they are sequentialists saving the needle as a last ditch 'salvage'? Concurrent methods unless CONTRAINDICATED may be the best approach.

@jmhabo I had radical prostatectomy 4 months ago in July (Gleason 3+4) and am recovering slowly but def getting better and so glad I chose to be aggressive. The first few months were frustrating with incontinence, def no erections. It's gotten much better, I can control my bladder most of the time with 1 pad that is usually dry each night (it wasn't that way at first). Not meaning to share TMI and I don't have full erections yet but have improving sensitivity on penis which allows improving erection with help of penis pump and orgasm (suprisingly from muscles around and below where prostate was. My body is healing itself and it may take a year to get back to where I was and want to be, but it will happen.... Like you best news was that cancer had not spread outside the prostate. Urology Oncologist says the pathology numbers are very encouraging and suggest they got all of it . I can handle and accept whatever I have to during this slow recovery. Don't form an opinion until at least 4 months....I'm much, much better after 4 mos than where I was after one month.....Your body uses A LOT of energy restoring itself and you WILL be tired.....It gets better...give yourself permission to let your body recover at it's own pace......It will get better I assure you!