Robotic assisted simple prostatectomy

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 in the morning and was released that afternoon. 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. Although I learned the Kegels from Mayo literature and youtube videos, it's widely accepted that going to a pelvic floor physical therapist is the gold standard. 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.

We never stop learning, here. I'd never heard of a 'simple' prostatectomy.

A simple prostatectomy is a surgical procedure to remove the inner part of a severely enlarged prostate, treating benign prostatic hyperplasia (BPH) by leaving the outer prostate capsule intact. This surgery improves urinary symptoms by removing the tissue that blocks urine flow, often using a minimally invasive robotic approach through small incisions. It is different from a radical prostatectomy, which removes the entire prostate, typically for cancer.

Good information right here:
https://www.bidmc.org/centers-and-departments/urology/urologic-procedures-traditional-and-minimally-invasive/prostate-urologic-procedures/enlarged-prostate-open-surgical-resection-simple-prostatectomy

@peterj116

Thank you for your reply and information. It is appreciated. My hubby’s surgery is definitely not TURP. The doctor said TURP is not indicated in my husband’s case. Because he does have PCa in addition to BPH, she has recommended radiation to eradicate the cancer.

Taking part of the prostate seems quite different than most experiences on here involving surgery since there's no real way to know if you got all of the cancer since a biopsy only tests very small areas and is far from comprehensive. How would they know if they got all of the cancer?

@survivor5280
Hubby had been on active surveillance for the last five months. We had hoped to be on AS for a longer period, as his PCa doesn’t seem to be aggressive. However, his new urologist said she is not comfortable with continuing AS. Hubby has a Gleason score of 7, PSA 10.7, and a high Decipher. She said the biopsy focused on the Pirads 4 and 5 lesions. Because hubby’s prostate is so large, she said there could be more cancer that the biopsy didn’t capture. That is why she is addressing the BPH by RASP, and then radiation to address the cancer. Fingers crossed the doctor is right about the simple prostatectomy procedure. After radiation, she said that surgery to remove the prostate is not possible.

@lizziew That makes sense, I suppose, but if they are going to be in there anyway it's surprising they would go that route. It's not a common path, though, you may consider getting a few more consults to see if everyone is on the same page - which is good to do regardless of treatment recommendations.

@survivor5280

Thank you. I don’t quite know who to go to to get another opinion on the proposed treatment.
We do like hubby’s new urologist, she seems very qualified.
But now, I wonder if my hubby is going to be her guinea pig for this novel procedure.

Just start calling urologists, medical oncologists and radiation oncologists to get a nice, well rounded answer. If unsure, just call each hospital group around you - i.e., the university hospital, the HCA hospital, Mayo, etc. Before I decided on a treatment path, I talked to nine doctors in those fields.

@lizziew No such thing as a ‘simple’ prostatectomy…except to those who are performing the procedure!😆

I agree! Simple for the surgeon, but the patient will feel it’s not simple at all!