Newbie with question

Hi all -- I've been perusing this site since my dad was diagnosed about 2 months ago. On Monday (10/4) he had an open RP. The doctor had to take the lymph nodes and nerves on the left side, but was able to keep the right side. He still has the catheter in, but has recovered very well. The doctor said he had the lowest amount of blood loss he's every seen in 30 years of doing this!

My question is -- with nerves on one side, how likely is it that he'll return functioning in regard to continence and ED?

His stats are:

Age: 67
2009 - PSA = 6.5
2010 - PSA = 8.5
Gleason was 6 (3 + 3) on one side and 7 (3 + 4) on the other. We don't have post-op gleason or PSA yet.

Thanks!

Thanks for the quick reply Jeff. One thing to note -- I don't think his doctor's "technique" was to retain blood flow, I think it was just ironic that it worked out that way. At least that's how his reaction appeared. BUT -- I'm really glad to hear that it might help my dad! Do you have any thoughts on continence?

Thanks Ted. Perhaps I should have explained a little more. Prior to the surgery, at my dad's pre-op appt, the doctor did not think he'd be able to salvage any of the nerves (based on his expectation of the size of the tumor). My dad, who is normally a very happy-go-lucky person, was SO depressed from that point on. I had never heard his voice so lifeless. So, we were just thrilled when we learned that the doctor was able to save 1/2 the nerves. We're not trying to rush his recovery, we were just wondering what others' experiences have been when 1/2 the nerves remained intact.

Welcome to the site and glad to hear your dad is recovering.

It's a bit impossible to predict outcomes, but all I know about erections it that they need a combination nerves and blood, so if your dad had very little blood loss this should mean that there was very little damage to the blood vessels, which may be helpful in the future.
As for the nerves it is more complicated. There can be all manner of nerves around the prostate, it's not simply a case of one down the left and one down the right both of which deal with erections; there may be as many as fifteen different nerve groups.

Continence is not controlled by these nerves. The problem with continence after surgery is due to the fact that you can't remove the prostate without removing the muscle at the bottom of the bladder as well. This only leaves the muscle in the pelvic floor to squeeze things shut, something which may or may not work adequately. Kegel exercises help train and strengthen these muscles, but shouldn't be done when there's a catheter in.

I think your dad needs to do what most of us do here which is to reckon that priority number one is kicking out the cancer, priority two is getting control over the continence and three is dealing with erections. That said, the penis should not be ignored. There's no harm in giving it regular gentle reminders about what it does, anything that gets a bit of blood flowing in it will help keep the tissue supplied with oxygen and nutrients and keep it healthy. Don't expect miracles, but don't sit back and do nothing either.


Alf

Thanks to all of you who've responded. You've definitely educated me on some things that I wasn't aware of. I know with man, little is possible -- but with God, all things are possible. So I know that my dad is in good hands.

I hope and pray that all of you experience complete healing and comfort from the only One who can provide it!

Warmly,
Positive 1

<she was just getting over Strep. Could she have caused this spike in the PSA?>

Were are a bit OT for this thread ..  You will likely find many treads on this subject..

But - to your question --  From what I know - Absolutely no way !  

PSA - Prostate SPECIFIC Antigen (Check other threads), results from Prostate cells being 'angry' - you might say..  

What may have been warranted, would be to wait a few weeks and just get another PSA, but ensuring that there is no    for two days minimum.

Naturally -  ejaculation "Excites" the Prostate and can (will) raise the PSA.

Inspite of a possible repeat PSA of say  3,  you would want to start looking more closely at your situation.

A jump like you have seen, would warrant close watching

The trip to the Urologist would still be reassuring but there are some who think that unnecessary Biopsies can be hazardous, in themselves.

Moderate all choices with past family experience with PC..   If you have PC in the line, act sooner than later.

http://news.healingwell.com/index.php?p=news1&id=643036

Have a look at some of the threads at the top of the pile..  and use the(Google) SEARCH facility on the top line.

PSA values for each age group:  (I think these are still current)

1.7  +/- 1.1 ng/ml for 40–49 years

2.0  +/- 1.2 ng/ml for 50–59 years

2.9  +/- 1.7 ng/ml for 60–69 years

3.5  +/- 2.0 ng/ml for 70–79 years

   You can find the report here: http://www.springerlink.com/content/b7p26t840570q0x5/

 

 

Whatever - just understand that whilst it's YOU, that is being trialed and tested, there are a great many of us out here, and early detection of a problem can be a true   'Life-Saver'..  .... I hope that it saved MY life as it did, my Brother.

At age 60, I had NO indication of a problem, and the finger was negative, and an ultrasound (Bx) showed nothing,, BUT - viralent cancer was there.

.

PS - Don't respond - You could start a new thread if you seek more comment

.

As others have indicated, continence does not depend on nerves being spared. I had no nerves spared, and was fully continent from day one.

ED however is another matter! 2 1/2 years out, I have seen some recovery in erectile function, but nothing like it was before surgery. I now rely on a pump, and while sex is different to before it is still very enjoyable. ED is not so bad -- there are far worse things that can happen.

So even in the worst case, (no nerve function) your father should still be able to do what he enjoys. And as he has had some nerve sparing, he will very likely end up better than I am, so there is plenty to be positive about.