Radical Prostatectomy By Robotic Surgery: What can I expect?

Posted by oskarpr @oskarpr, Mar 28 2:42pm

I am looking into RP using robotic surgery
Want to get an idea of Where is the best place to go and best surgeon.
And if anyone can provide their own experience choosing this treatment.
Recover time
Side effects
Day to day living experience after.
Will appreciate any comments.
Thanks
Oskar

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dwb1 | @dwb1 | Mar 28 8:18pm

I am 63 and had RP on 1/11/24 here in Roanoke Va. Everyones recovery is different however I was fortunate and actually feel better now than I did before. The first week was difficult with the catheter and frequent severe bladder spasms. After a week the cath was removed and spasms stopped immediately. I had minor incontinence for the next week and full bladder control thereafter. I still suffer ED even while taking cialis but hopefully that will return in time.

michaelcharles | @michaelcharles | Mar 29 7:04am

Oskar:
Age 72 Gleason 9 had RP. Excellent surgical result and recovery.
I chose a Center of Excellence; Johns Hopkins. And a COE would be my recommendation. Others have had very good results with their local, very experienced Urological Surgeons.
Feel free to reach out for more information. Glad to share.
Best wishes.

hammer101 | @hammer101 | Mar 29 7:17am

I went with a RP in November, 2022 after biopsy confirmed Gleason 7 (4/3). I did research to ensure I was going to a center or excellence and then chose the best possible surgeon at that center of excellence. I went with Mayo-Rochester (MN) and Doctor Igor Frank. Amazing doctor, hospital, staff, and my recovery was the same. Your quality of life, for the rest of you life, will depend on your upfront work in picking the best possible COE and surgeon at that hospital. For myself, the 1 week catheter and 4-5 days of referred shoulder pain were the worse part of the recovery. I never had complete incontinence, but did have a few accidents during the nighttime, so wore a diaper for about six months to avoid issues. After this time period, full continence back. ED is non existent, but took about 12 months to recover fully. To answer your last question, overall life experience post radical prostatectomy is the same as before surgery.

From reading about others and talking with friends that have went through a RP, it is critical that you have your RP at a center of excellence, if you want to avoid complications, incontinence, impotence, etc... Also, it is extremely important that you do you part and do post surgery recovery exercises (Kegals and any other required therapy).

Best of luck and hope all goes well with your surgery!!!

Jim

tomf | @tomf | Mar 29 7:39am

I keep reading advice to got to centers of excellence and to choose the best doctors there. Can someone give me a roundabout answer on two things? How long do you have to wait to get the best doctor at a COE? And how much money do you have to save up to travel to, and stay at, a COE for the necessary time pre and post surgery?

leedawg | @leedawg | Mar 29 8:23am

Ram Pathac - Mayo Clinic Jacksonville FL - years of experience doing nerve saving robotic surgery prostate

mn281 | @mn281 | Mar 29 9:18am

I had a RP in December 2023 at the Mayo in Rochester with Dr. Mathew Tollefson. He and his staff were excellent, and I can highly recommend him as a surgeon. The recovery time went quickly. I just took Tylenol for the post-surgery pain for a couple of days. The incisions heal quickly and the pain was very minimal.

The catheter is a nuisance, but you get used to it. I had mine in for 7 days, but still had a small internal leak when they removed it, so it was extended another 5 days. I had very minimal leakage once the catheter was out. Maybe a couple of milliliters when doing a long walk. I'd wear a light pad for insurance, but by six weeks was completely pad free. I had no issues at night except for a few days of nocturia while my bladder got used to being full again. I probably got up every 90 min to urinate but had no issues making it to the bathroom and it quickly went away. As far as continence goes, ask your surgeon if they will use the hood technique as the data on regaining continence is quite good.

ED is harder to predict as I think a lot depends on whether you have nerve-sparing surgery (I did) or not so be sure to discuss this with your surgeon.

I did follow the six-week guidelines for activity (no lifting, bending, twisting, etc.), but felt ready to do those things much sooner. As soon as the six weeks was up, I was back to my original activity level and doing everything I did before. My life experience post-surgery is the same as before, though I find I urinate more like a 20-year-old now vs. a 60-something as there is no prostate squeezing that urethra!

While I wish I didn't have to go through this, it was not as bad as I feared (though not easy) and I am glad to know that the cancer is no longer inside me as best we can tell (3M PSA was undetectable, negative margins, etc.).

Best of luck with your decision!

@tomf
Getting my surgery scheduled at a COE was easy. My surgeon was ready before I was. We met for a consult in late September, and he was available for the procedure in October. I waited until December due to my schedule. I had several virtual appointments then traveled down to Mayo the night before. I stayed overnight in the hospital post-surgery, and then we drove home the next morning (about 90 min away). For us it was 2 nights in a hotel connected to the hospital via skyway (1 night for me and 2 for my spouse). Then I was back for the catheter removal and stayed an extra night to make sure it went well though I believe you can have this done locally if you are not close to a COE.

76692581119 | @76692581119 | Mar 29 9:41am

I’m looking for some advice. Age 74 , had prostate removed robotically in 2011 with radiation .Was using two pads per day when I had a UHC routine cystoscopy and they found a 15fr constriction they tried to dialate and now using at least six pads per day , need some help please

rcockerell | @rcockerell | Mar 30 6:46am

Oskar,
Late 2016: I had gleason 7 with 2A C hopefully contained.
Researched Proton Beam but closest center was 6 hr drive.
Early 2017: RP performed by my very reputable nephew, Urologist Surgeon, Dr James McIntosh, Independence, MO. Procedure excellent with margin contained from lymph node evaluation negative. Worst part was when removed the 1 week old catheter breaking the adhesion to the urethra. It was not as bad as sounds. Definitely worth getting rid of cancer. Condition prior to & post essentially the same. I've never felt like I've had C. I'm sure because they found fairly early. Kegels very important to prevent incontinence . Had minor issues but didn't wear diapers.
2020: PSA went from to undetectable to tripling 3 times quarterly. .03-.06-.12.
2022: PSA tapered off & presented a slow growth of cells in prostate pocket. Went to radiologist & he said no need for RT until reached .4. That now is .2.
2023-2024: PSA is .31 recently .39 so I'm contemplating options. PSMA PET detected no C. Until they find a way to eliminate Cancer Stem Cells its going to be difficult to eradicate.
Hope this isn't too confusing since your new to this. Advancements are made daily. My nephew explained they are really close to eradicating the genetic predisposition that some suffer contracting this insidious disease.
Good luck with your journey!

maxvt | @maxvt | Mar 30 7:24am

Hello,

I live in Austin Texas and Dr Aaron Laviana performed my surgery at Dell Seton.

Zero pain, but discomfort that waned to nothing after a few days. Catheter if for about 10 days; I slept really well with the night-time large bag - no wake-ups at all! LOL

I did, and recommend, Pelvic Floor PT at a clinic like Baylor Scott & White (Angus Rd in Austin) where there are folks with Doctorates in PT to help you learn properly. After catheter removal I did a few more weeks of PT and had NO incontinence, absolutely none.

Best of luck to you!