I had been monitoring my PSA over a ten year period and it had risen to a level that caused me concern (3.5). I got a biopsy and I had a Gleason score of 7 (3+4) in 5 out of 10 core samples. Active Surveillance was not a good option; given the Gleason levels. I decided to concentrate on external beam radiation and robotic surgery as treatment options because these appeared to be the primary, go to, options.
I met with two radiation oncologists and two robotic prostate surgeons. Each of these surgeons had performed over 1,000 of the procedures. (Make sure you are talking to experts and that they, personally, will be doing the surgery. That is, that it is not a training exercise for a resident.)
I chose a robotic prostatectomy as my treatment because I was more comfortable knowing the prostate had been removed and if the cancer was confined to the prostate, I would have a great chance of being prostate cancer free. NOTE: Later on in this story I am going to share some information which MIGHT have led me to using radiation, had I thought of it at the time.
Here is what transpired during my first two weeks at home from the hospital.
During the first week at home my abdomen was sore, but the pain was controllable with Motrin. My main activity during this first week was managing my urine bag from the catheter. At the end of the first week, I got the very good news that all of the cancer was confined to being inside the prostate.
Regarding my bladder function, I am wearing a pad, but I am peeing under my control and on a fairly normal schedule. I have some minor "dribbling", but I have had no incidences of peeing my pants or anything of that nature. Regarding sexual function, it is too early to assess the situation. I am taking 25 mgs of Viagra every night before going to bed and using a penis pump daily, but no erection to speak of.
During my second week at home, the soreness in my abdomen reduced every day; until by the end of the second week the pain was almost completely gone. As a note, the night after I had the catheter removed I experienced very painful bladder spasms, but I was able to address these using a heating pad.
It has been six weeks since my robotic prostate surgery. I got my first post-surgery PSA test back today and I am pleased to report that it was undetectable; meaning no cancer. So, how are things progressing with respect to bladder control and erection?
Continence – Progress is great here. Leaking is down to an occasional dribble; with slightly more if I exert myself (called stress incontinence). Some benefits of the surgery are that, without the prostate, my urination stream is extremely strong, my bladder empties quickly, and I am going less during the day and night.
Erection Functionality – On the erection front, I cannot yet get an erection adequate for sex. I am told that this can take a year to come around; if at all. I figure that I have about a 50/50 chance of it returning; considering my age (65) and the fact that I was experiencing some ED before the surgery.
Regarding my activity level – I have ramped it up and now try to walk one hour a day on a treadmill at the local YMCA. I have also been doing all of my weight machine exercises starting last week, BUT WITH ONLY 10 (TEN) POUNDS ON ALL OF THE MACHINES. I started swinging the golf clubs one week ago and I am comfortable swinging all of the clubs today. I will be playing my first 18 holes of golf at the seven week mark following surgery.
It has been eight weeks since my robotic prostate surgery. I am just returned from a one week vacation. I am an avid golfer and during this vacation I golfed five times and hit golf balls at a range a few times in between rounds.
I did not experience any pain or discomfort relating to the surgery while on vacation. I did have some stress incontinence while swinging the club, but I consider it minor in the bigger picture and believe that I am making good progress on the urinary front. Still wearing a small pad, all of the time, and monitoring the leakage because I get some dribbles on occasion.
Regarding erectile function – I have not made much progress. It continues to be inadequate for sex. At this point, I have tried Viagra, a penis pump, and tri-mix penis injections, but these have not worked for me.
I got abdominal infections that were directly the result of the robotic prostate surgery and was hospitalized for 11 days.
I continue to be cancer free and I have stopped wearing urine "dribble" pads, but I am not able to get an erection useful for sex.
I continue to be cancer free and the urinary function is great. However, in October, I had two hernias repaired, that were likely caused by, or accelerated by, the robotic prostate surgery.
Further, there was an error during the hernia surgery, and one of my bowels was nicked and I required an emergency bowel resection. (Hospitalization for 25 days). I mention the hernias because it has a bearing on my YANA story later.
I continue to be cancer free, urinary function is outstanding, but I have given up on the possibility of ever getting an erection again; without getting a penile implant. I have done extensive research on penile implantation over the past month and will likely move forward with this at some point.
I have found out that I need another surgery for a mid-line hernia that was caused by the multiple surgeries in that area (prostate, hernia repair, and the emergency bowel resection) They are going to have to rebuild part of my abdomen (4-5 hour operation); to minimize future hernia occurrences. I mention all of this in my YANA story for the following reason.
My father had trouble with hernias. For that matter, I had one repaired while I was in high school. Robotic prostate surgery, while less invasive that open surgery, is still very disruptive to the abdomen. Had I thought about my high school hernia and my father's trouble with hernias when making my treatment decision, I might have gone the radiation treatment route; rather than robotic prostate surgery.
As a note, my personal experience is that the invasiveness of surgery is not stressed enough in the comparisons of radiation versus surgery as a treatment alternative.
Glenn's e-mail address is: email@example.com