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Robotic nerve saving surgery for prostate removal
I am 56 years old and I was diagnosed with prostate cancer in 2022. I had a biopsy in 2022 and 2024 that both confirmed cancer. I just had an MRI done this week and I got a PI‑RADS score of 5. Last year, my score was a 2. I do have prostate cancer, but my PSA levels were just checked last week and they are a 1. I am considering just having my prostate removed so that cancer will not spread, but not being able to perform sexually again is scary. Is there any insight on this. I live in St. Louis, MO and I am open to hearing anything concrete of definitive and will gladly give my phone number to anyone who can help. Thank you. 314-324-3451 Chris
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@jeffmarc Thank you so much for your help again. I am meeting with my urologist next week. I will ask about the PSMA PET scans as well. Do you suggest a list of specific questions I can bring to her ?
You mention "nerve saving" in the title of your post. I am not so sure if nerve saving means anything. My urologist wrote in his surgical summary report that "both neurovascular bundles were preserved" in my surgery, but I have not had even a "twitch" let alone a soft or hard erection in 11 months since my surgery. And, I just can't seem to achieve 100% urinary continence. I have been at 95-98% for about six months now, but still have those unexpected squirts, leaks, and dribbles, that see me still wearing "shields" which have now caused me skin rash and irritation from all of the synthetic materials used in their manufacturing. As an aside...I just posted yesterday that after searching for "men's cotton-lined shields", I found a women's product called Cora that uses organic cotton and no additives, colors/dyes, chlorine, etc. They feel great but they are narrow for women..."one" barely provides the coverage width that a man would need, so I am thinking of overlapping two letting the adhesive strips connect one to the other, in order to get wider coverage like a man's product offers. Anyway, preservation of my neurovascular bundles to aid in urinary continence and erections, does NOT seem to be working. Having been divorced literally one month before my RP surgery, and being as virile as a 35 year old (I was 70 at surgery), I am now dead in the water. I refuse to start dating knowing the humiliation of eventually having to say in a sexually heated moment: "sorry, but I can't perform." While a lot of women over 60 are not even interested in sex anymore, and even more over 70, I fortunately, and unfortunately, look young for my age and attract 45 - 55 year old women, who I would bet, still want an active sex life. So...I may be single and not dating for the rest of my life. I can't even imagine a relationship with a woman without sex. Ya...when I am 80 and older I guess it might be expected, but not at 71.
@christophers
Ask to have another biopsy. You need to find out what your last biopsy showed however, you still haven’t said anything about the results. It looks like your Gleason score will be higher So a biopsy makes a lot of sense.
How about logging into the medical system where you got treated and look up your biopsy and see what it shows. You could post the whole thing here and we could review it and comment
Ask to get a decipher test to find out how likely you are to have a reoccurrence. If you are very likely, then, you probably want to get ADT after treatment.
Tell the doctor you want to get a PSMA PET scan to see if the cancer has spread somewhere else in your body.
Ask, if you were to have surgery, can they spare the nerves? That’s important so that you’re able to get an erection after surgery.
Ask if any of these things found in the biopsy intraductal, ductal, large cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive.