What is a Prostatectomy Like?

That about nails it, except...your urologist/surgeon may tell you that the cancer is gone forever, but that is the lie. We here are a large subset of men...the majority?...whose cancer keeps coming back, or we are told that it will eventually come back. We likely do not have contributions here from the men who were Gleason 3+3=6 and who had fully membrane/capsule-contained cancer with no perineural invasion, no extraprostatic extension ("EPE"), no surgical margins, no cribriform glands, no seminal vesicle invasion, no lymph node involvement, and no bone metastases. Those men were lucky and had their radical prostatectomy, and will likely go on to lead perfect, normal lives with no future recurrence. But then...there is the rest of us...the guys who were told "sorry, I didn't get all of the cancer out of you...you have surgical margins because you tumor broke through the membranous prostate capsule and caused surgical margins to include invasion into your seminal vesicles." "So...you are at minimum a pT3b whose cancer has a 25%-50% probability of recurring "within" five years."
Whenever that happens - if not before - your urologist will refer you to a radiation oncologist for a radiation therapy consult - either adjuvant (immediately after surgery within the first six months), or salvage radiation (six months or after surgery). Then if you have radiation, your bladder and urethra have likely been fried, and just when you regained full urinary continence 9-12 months after surgery - or anything close - you have now lost it for the rest of your life because your urethra is in fact fried from radiation. And...if you're really unlucky, you might fall into the 1-2% whose radiation caused bladder and/or rectal cancer later in life. Either way, when the radiation fails to have done the job thoroughly, your cancer will return yet again, and you will be put on hormone treatment and become a whining, emotionally labile woman who is unable to control your emotions and feelings, as you quite possible start developing small breasts. All this time, your doctor is just telling you that this will be your next treatment - whatever it is - all while hoping that you die of something else beforehand because prostate cancer grows slowly, because...they really do care enough that they do not want to see you go through the excruciating pain of bone metastases. That is kind of the likely reality for those of us here if you are kept alive long enough to go through all of these phases. Sorry...that was quite negative, but I have been in this blog enough to have read many stories that are subtle variations of all of the above...and that stinks. I empathize with everyone whose reality is any of the above or worse. I hope that you find peace and a pain-free existence for as long as possible.

@jeffmarc

Same - 12 years since surgery never a discussion of or performance of kagles, catheter was easy, no urinary problems (only problems I don't have though). Sorry to say after reading the incontinence probabilities from good old fashioned knife prostate, seminal vesical, and bladder neck lesion surgery I feel lucky. My surgeon was ecstatic that I didn't/don't leak or have problems.

I have problems with bowels with all the above plus 39 salvage and 2 photon treatments though.

I had no pain, but had to keep the catheter for two weeks. When it finally came out, complete incontinence but it improved over the following weeks.

Now, 6.5 months post-RARP. Only occasional stress incontinence, but still complete ED and only very partial erections with Cialis. Also, still having climacturia.

Hi all,

I am scheduled to get RARP in the next 2 months. I am not sure how my experience will be after the OP, but having the catheter in for 7-10 days is a piece of cake. I kind of look forward to it.

I am 45 now, but when I was 28 I had urethra stricture and underwent surgery (Buco-urethra-plastopy, 12 hours surgery back in 2008). This is where they harvest tissue from your mouth (the inner cheek) and graph it onto the lengthwise-spliced urethra, to be able to open it up so you can urinate again.
Trust me, leaking is much better than not being able to empty at all. After that surgery I had a catheter for almost 3 months. On top of that I would go to work every day, and guess what, I was in the military during that time.
So please, to all of you that may think catheter for 7-10 days is bad and leaking afterwards sucks, let us all stay strong for few days with the catheter and leaking afterwards.
I would take leaking anytime to not be able to leak at all for days.

Also, as it has probably already been mentioned in this trend, there are many clamping options available on the market.
Also, let us count ourselves lucky and blessed that we get to live another day with the ones dear to us!
To all out there that have gone through or are about to go into surgery, BE STRONG and STAY POSITIVE!

Best regards,
Dinu

@jeffreyg
I got driven home in a big car, But sitting in the front seat was painful. I got into the back and laid across the whole backseat. It was not real comfortable since I had no pillows, but better than sitting in the front seat. I’m 6’4” so seats are always a little crowded And laying across the backseat required lots of bending.

I’ve never heard of anybody having the catheter that long. I had surgery 16 years ago and had it for two weeks. It was never a problem or a pain, and I was working every day after the first week. It could be, they put in too thick a catheter, which could be uncomfortable.

My 2 cents on the ride home from the hospital: I had a friend come pick me up in his small car that sat only a few inches off of the ground. If I'd known, I'd have had someone else pick me up. The bending at the knee and hip to get seated was very difficult with the catheter and having only just gotten out of the bed. Suggestion would be to get driven home in a big car. And just for comparison, I had the catheter for 20+ days. That was easily the most painful days of my life. There was definitely something wrong. Best wishes.

@jeffmarc Agree that everybody is different.

@kjacko
I never did kagles Before or after surgery. 16 years ago, when I had the surgery, they never even discussed the issue. I had no incontinence after they took out the catheter. Results may vary.

I had my RP a little over two years ago. One month prior to my surgery, I did Kegels religiously. After the surgery, the only problem I had was terrible pain as I was coming out of the anesthesia. I wore my catheter for seven days. After removal, I did Kegels every hour on the hour. Never had one drop of incontinence. My surgeon said I was one of the lucky 10% who have zero problems. If you do choose RP, I hope you are one of the 10%. 🤞

I had ZERO pain, & no incontinence. I had ED, but that was because I chose "non-nerve-sparing" as a surgical option. I chose non-nerve-sparing because the cancer had already reached the surface of the prostate, so the nerves were probably already compromised.

I drove the day after, & walked my usual two miles a day after that. At the ten day mark, my catheter & drain tubes were removed without incident. Before they removed the catheter, the PA poured a measured amount of saline fluid INTO the bladder via the catheter. He then removed the catheter & measured how much I could then urinate, to verify that I could empty the bladder.