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

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

I am 71. When diagnosed I immediately decided on RP. I met with two different surgeons for opinions. My original urologist said, beside having experience doing RP, that you feel 100% confidence in their ability to do the job. The 5 weeks prior to my surgery last November, I focused on doing Kegel exercises. Do your Kegels. My surgery went well. No real side effects. The toughest part was learning my cancer was a higher risk that determined by my biopsy. After the catheter was removed, I was told to increase my Kegel exercises to 10 fast and 10 with a 4/5 second hold every hour. I actually set a timer on the hour so I wouldn’t forget if watching tv, etc. Some days I was up 13 hours and never missed. Do your Kegels! I had ZERO incontinence issues. I still do them periodically. I just completed my second post-operative blood test and it has remained at < 0.01. Beside keeping a positive attitude and prayer, I continue to exercise everyday and have made changes in my diet, increasing my fruit and vegetable intake. (The one thing my doctor said this week was to eliminate red meat. It was easy for me as I gave it up 20 years ago). Don’t neglect these factors. I hope this helps. Best wishes!🙏🤞

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Choose a medical center that is classified " center of excellence". Find out how many prostatectomies the surgeon does each year. We traveled to Mayo Rochester from AZ, choosing a surgeon who does robotic assisted prostatectomy again and again .... its his specialty. My husband saw Dr. Matt Tollefson and we could not be more pleased with the outcome. Agree with others, kegals are so important. We trusted the care team, our wonderful support network of family/friends and left it in God's hands. Still do, nearly 1 year post surgery.
Best of luck to you as you start this journey!

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Had RP at age 69.
Agree to get a very experienced surgeon at a COE.
Suggest getting book "Life after Prostatectomy and other Urological Procedures" bu Vanita Gagliani (available on Amazon. Very detailed. Will walk you through gaining continence week by week. Kegels are only a part. Suggest starting several months before surgery for best results and least incontinence.
Pads by Tena the best.
With the catheter in use a little vasoline on catheter by retracting the penis head to eliminate irritation produced by catheter movement.
May have hiccups the first day or two caused by the risidual CO2 gas irritating the diaphragm. Goes away. Post op is relatively painless.
The degree of incontinence and ED is multifactorial and dependent on age, surgical skill, extent of tumor and preexisting patient factors.

Good luck!

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I agree with everyone on this thread, but if you are overweight losing belly fat will also help to make the surgery easier.

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Just complete my RP (age 78, healthy, active, 140-145 pounds) on 3/28/2024. 24 hour stay at hospital, home with Catheter for 2 1/2 days. Took 3 Hydrocodone tabs over next 3 nights to help sleep with Catheter. Hydrocodone suppressed bowel movement until I took 4 oz Magnesium Citrate - within an hour, bowels returned to normal function. Since then 1 tab Acetaminophen at night to ease abdominal pain from RP. Did Kegels and other and other abdominal exercises 6 weeks prior to RP.

In addition to Gleason 4+3=7 cancer, my focus on RP route centered on notaria - up 5-6 times each night with very slow release - had to stand or sit for 1-2 minutes to empty bladder. Surgeon's notes after RP stated that my Prostate was unusually large so had to do several more "pulls' with the probe to remove it all.

Post surgery I can now empty my bladder completely in about 10 seconds probably because there is no more Prostate restriction. However, the total volume in bladder is only about 3-4 oz so frequency is still too high for restful night.

After consideration, of above, I would choose the RP option again given the minimal impact on my usually active life (skiing, hiking, lots of farm activities lifting bales, tractors, equipment, feeding critters etc.) Curious if others have found a method to increase bladder capacity post RP?

Thank you
Ron Splittgerber

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@rsplittgerber

Just complete my RP (age 78, healthy, active, 140-145 pounds) on 3/28/2024. 24 hour stay at hospital, home with Catheter for 2 1/2 days. Took 3 Hydrocodone tabs over next 3 nights to help sleep with Catheter. Hydrocodone suppressed bowel movement until I took 4 oz Magnesium Citrate - within an hour, bowels returned to normal function. Since then 1 tab Acetaminophen at night to ease abdominal pain from RP. Did Kegels and other and other abdominal exercises 6 weeks prior to RP.

In addition to Gleason 4+3=7 cancer, my focus on RP route centered on notaria - up 5-6 times each night with very slow release - had to stand or sit for 1-2 minutes to empty bladder. Surgeon's notes after RP stated that my Prostate was unusually large so had to do several more "pulls' with the probe to remove it all.

Post surgery I can now empty my bladder completely in about 10 seconds probably because there is no more Prostate restriction. However, the total volume in bladder is only about 3-4 oz so frequency is still too high for restful night.

After consideration, of above, I would choose the RP option again given the minimal impact on my usually active life (skiing, hiking, lots of farm activities lifting bales, tractors, equipment, feeding critters etc.) Curious if others have found a method to increase bladder capacity post RP?

Thank you
Ron Splittgerber

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I’ve had some of those same urinating problems post RP at night. Most of my problems now are related to my sleeping patterns. In the past, the pressure from my enlarged prostate would cause me to get up. Now, I just wake up and decide to go while I’m up. I would offer two suggestions: limit water intake and find ways to increase your sleep without awaking. It’s helped me. One other thing: my doctor said that some people’s bladder produces more urine than others, and I still might have peeing problems. Hope this helps. Good luck!

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I had my robotic surgery done 3 years ago.It was an outpatient visit.The surgeon removed the prostate and seminal vesicles as well as a few lymph nodes.Post op I was left with a very small penis and pathologist found that the cancer was beyond the prostate bed.I was put on ADT and have been on these meds ever since with their particular side effects.If I had to do it again I may have gone with brachytherapy.If the cancer is removed entirely then maybe robotic surgery is best.I’m disappointed with the resulting vestigial penis.I guess this is a male vanity thing.Hope this helps.Good luck!

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@starman

I had my robotic surgery done 3 years ago.It was an outpatient visit.The surgeon removed the prostate and seminal vesicles as well as a few lymph nodes.Post op I was left with a very small penis and pathologist found that the cancer was beyond the prostate bed.I was put on ADT and have been on these meds ever since with their particular side effects.If I had to do it again I may have gone with brachytherapy.If the cancer is removed entirely then maybe robotic surgery is best.I’m disappointed with the resulting vestigial penis.I guess this is a male vanity thing.Hope this helps.Good luck!

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Starman -- I have the same issue. I found using a vacuum pump helps with length.

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I had robotic surgery two years ago, in and out the same day. Then the rodeo started! Everyone has different expectations and outcomes. I my case, the doctor informed minutes before that he would have to “cut wide”. I’ve recover for the most part: fully continent and no erectile function. I wish you a speedy and full recovery.

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@michaelcharles

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.

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Hello: Thank you for this information. We are in the Maryland area, close to Johns Hopkins. Can you share your surgeon’s name?

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