Share what kind of surgery you had? Brief overview outcome?

hello and welcome to hw, martin

i had open surgery by choice. my uro/surgeon had over 400 under his belt, and at the time in my area, only 15 robotics had been done (by my uro's partner). in the end, due to something in my anatomy and due to complications, a robotic surgery would have had to have been aborted had it been started.

i spent 4 1/2 days in the hospital, my surgeon is not one to rush a person out. i didn't mind that part, had good insurance.

there's not much risk in an open over a robotic surgery these days, they had 3 units of blood banked for me, and none was needed.

i could have traveled 125-150 miles for a robotic out of area, but did not want to go that route.

sounds like your open surgeon has plenty of experience, and if you already have a trust relationship with him, that's a big plus.

good luck on your decision ahead.

david in sc

I had open radical. Dr convinced me that was my best choice, he did only open at that time. I asked about robotic and he downplayed it. Today he is doing robotic! Go figure.

Surgery for me was simple, quick, relative little pain, and could have gone home the next day. I chose to stay an extra night.

I have not leaked from the day the rubber snake was pulled. ED a problem still working on it and I am better.

I was told the ED stuff was a crap shoot about 50/50.

I know lots of guys that have met the robot and their results are about the same as mine in some cases better and other cases worse. I don't know if it makes much difference.

Cajun jeff

Martin,

I chose Da Vinci (robotic surgery) because 1) Minimally evasive = perceived better recovery, 2) Surgeon was very experienced in robotic and 3) Surgery was available at a local hospital. I'm going on four weeks recovery and I do not regret my choice. The only pain I had the first week was gas pain and currently I have some perineal soreness. Both nerve bundles were spared and based on early indications ED does not look like it will be a major issue. Incontinence is getting better. I'm currently dry at night and about 3-4 pads a day for stress related issues (cough, sneeze, etc). I was released the following morning from the hospital. No blood loss issues during surgery. My surgical pathology report was pretty favorable as you can see in my signature below.

As I understand it (not giving medical advice), the advantage of open surgery is that the surgeon has the ability to feel things with his hands which may aid in distinguishing cancerous tissue. With robotic there is no involvement of hands and the specimen is removed at the end so no ability to go back in if needed. Robotic has the ability to have more precision made possible with the technology and three dimensional magnification. Dr Patrick Walsh's Guide to Surviving Prostate Cancer book has some information on both approaches.

The choice is a personal decision, but be sure to get the best experienced surgeon as it is one of the key factors in achieving a successful outcome.

Good luck with your decision and I'm sorry you have to be here, but this is an excellent site for information from experienced PCa patients.

Welcome to HW Martin.

I lurk more than I post these days, but here’s my $.02 worth …

My Uro did only open, and had LOTS of experience. His partners did robotic, but since I liked and trusted my guy I went with the open. If not for bladder spasms, I’d have been discharged in less than 36 hours. Turned out to be a little over 48 hours.

Naturally, your mileage may vary.

Good luck

 

Martin,

Welcome to the forum no one wants to join on their own.  Other than you younger age our stats are very similar.  In my area of Birmingham, AL it is hard to find a URO who doesn't use the Davinci robot. All of the major hospitals have at least one of them. My GP referred me to my URO and he just happened to be at a hospital only 4 miles from my home and where my wife works too. She is my URO's landlord.

After I was diagnosed my URO gave me a copy of Dr Walsh's book "Surviving Prostate Cancer" and told me to read it before we had our first consult on treatment. The book discusses pretty thoroughly both open and RALP surgery and all RT as well. Since I had not found this forum at that time, the book gave me all the questions I needed to ask. MY URO has done close to 700 RALP surgeries so I knew I was not dealing with a newbie. I have to say I Was surprised at how easy and almost painless the surgery was. I am one of the lucky ones in that I was totally dry with in 2 1/2 weeks after the rubber snake came out.

My one very important peace of advice is to discuss with any potential surgeon about his protocol for treating ED. At your younger age i would think this is very important to you. My URO subscribes to a growing and popular protocol to treat ED early on rather than later. He told me before surgery what to expect and how he would treat my ED. He also did not quote any unrealistic expectations or statistics about ED either. He believes as many doctors are starting to believe that penile blood flow therapy after surgery is a key component to restoring full sexual function down the road. I was given a 30 day supply of Cialis on my 3 week follow up and after that I began injection therapy with a product a lot of men in here use successfully called TRIMIX.  He told me the goal was to get blood flowing into the penis and if I got a erection good enough for sex it was a bonus at this point. I am starting to see some signs that my nerves are healing and life to Willy is returning.

One other thing to remember when you get advice in this forum and as you make decisions on treatment there is ONLY one correct decision and that is the one you will make as you are the one who will live with it.  Good luck and keep us informed about your journey.

Terry the Water Guy

 

Like 142 said if you're going with surgery as a primary treatment go with the doc' you are comfortable with if his/her experience is up to par.

I went open at a local doc', she was young but had plenty of experience. To go robotic I would have had to travel and like most doctors she was reluctant to take on another surgeon's work for after care and it would be a year before I could do local checkups.

I was in the hospital almost exactly 36 hours, in at 0630 out the next day at 1845, cath was in for 14 days (I think I'm about the only person I've seen who didn't mind the cath) and results were beyond expectations.

As long as experience levels are equal there really is no difference in long term outcome.

Best of luck whichever way you decide to go.

I had the DaVinci surgery and was in the hospital for less than 24 hours. I walked 1 mile 3 days after my discharge from the hospital.

Thanks for the question as it is one I'm struggling with. My urologist does not do robotic but claims that the results are similar regardless of the method. However, in the prostate support group they explained how with robotic the surgeon can have a view magnified to 8 times and have the precision of operating with mechanically controlled devices. It seems to me that such magnification and control of instruments would have to allow for more precision. However, I'm told that there is definitely a learning curve with robotic and it is best to be operated on by a very experienced surgeon. Apparently the future (my guess is that it will be the near future) will be that a patient can be operated on by one of the best robotic surgeons from an entirely different city or even a different country.

That all being said, I'm still struggling with whether to go with my urologist or try to get in line for robotic. It is fairly new to Ottawa but apparently we have a well respected surgeon who just returned from a stint at the Mayo Clinic. Then again, I'm also still considering bracythearapy as well. Too many choices for my pea-brain to handle.