RALP by Vipul Patel planned for March ... but still undecided??

 

Can anyone give me more insight as to what to expect if I go to Patel in March

I have liked a lot of what I have discovered so far .... yet still have some reservations.

Patel has a great reputation and his results are very good. A few people here have shared their experience with him.

No guarantees, of course, but of you decide on surgery an you are in Florida or around there, it's a sound if not logical choice.

You'll be fine.

Tom,

All this agreement is making my contrary patch itch. Patel is, by all accounts, one of the best. But nevertheless I find fairwind's description of the surgery and recovery to be a bit on the optimistic side, even with so renowned a surgeon.

Prostate surgery is a walk in the park. But it is more of a backpacking in Yellowstone type walk in the park than a stroll though the botanical gardens. It is worth doing but one should be clear about the contingency plans for dangerous terrain, bad weather, twisted ankles, and bears.

Tom,

Are your reservations related to Dr. Patel in particular, or to your decision to proceed with surgery?

Based upon my husband's experience with having his RALP done by Dr. Patel, I would be very comfortable recommending him as your surgeon IF you've definitely decided to have surgery.

Wow, you guys have a REALLY different idea of a "walk in the park" than I do. Granted, I had an unusually bad experience, but seriously...you woke up feeling great, hung around til the next day when you popped out of bed and strolled home where you resumed your life as if nothing happened? No catheter coming out of your penis, no drain hole, no blood thinner shots, no sore nuts, etc? You lucky boys.

Tom, if youre traveling from that far away you could theoretically shop around for a guy who's as good but closer. Menon in Michigan, Samadi in NYC, Tehwari in NYC and more.

These guys all have thousands under their belt. I think the most important quetion to ask them is if they perform the entire surgery themselves or if they have multiple surgeries going on simultaneously. I've heard that some of these do.

Phenom - I wouldn't chose to go on that walk on a daily or weekly basis, but all things considered it wasn't that bad compared to having cancer and dealing with that reality. Suppose I'm just trying to say that.

iSpark,

There are guys for whom the surgery goes perfectly and their recovery is easy and their side effects minor. The surgeons don't just make them up. There are others who don't have as easy a time of it. In my case, my urologist found a lot more than he was expecting and had to fiddle with more of my bits and, as a predictable result, I had a bit slower recovery and a few more side effects. I'm still glad I had my surgery and I think... eventually ... I will do fine.

But there are a lot more guys who do great than ones like Phenom or me who have more trouble. I'm sure you will be fine and the odds are good that it will be easy, especially with your being a wet-behind-the-ears infant and all.

Although I said unsettling, it is (the stories) that I want to hear and read about. For sure it's no walk in the park.
I think I'll fair better going into surgery knowing as much as I possibly can, even if that means some unpleasant experiences. The better equipped knowledge wise, with what can happen, I'll be better able to handle it.

I like the saying, "You can HURT me with the TRUTH, but NEVER comfort me with a LIE"

Thanks guys, I didn't mean to imply anything.

i wish someone had told me about the 4-6 hours of pain right after surgery related to the bladder being reattached to urethra. I felt like it was exploding and had no idea what it was until a nurse told me in my room.

I too, think its very misleading statement, "a walk in the park". I would not advise anyone going prostate surgery to ever had that thought in their head ahead of time.

Prostate surgery, whether it be open surgery, or robotic, is considered on the more complex and serious surgeries out there.

I think your surgeon choice is excellent too, but we have men here at HW, that went to "top notch" surgeons, and still walked away with a lot of bad issues. It may increase your odds of that not happening, but there's no guarantees in the prostate surgery business.

I spent 4 1/2 days in the hospital, then found out, instead of 10 days with a catheter, due to complications, had to have it in for 30 days, then 3 stricture issues later, that 30 days turned to 63 days.

The real gamble, and the outcomes all over the board, is how you will end up with either incontinence issues, ED issues, or both. For many, incontinence is a short path, for others, life changing. And almost all men have moderate to serious ED issues, some resolve over time, others don't. And a remote few, myself in that ultra rare club, had zero ED issues. But I was one of the really lucky ones in that department.

If your reservation is about having surgery, then think it through. Have you studied all other primary treatment options? Including regular radiation, or radiation seeds, with or without HT added in?

Until your mind and heart is 100% settled on choice, I don't believe you can you have fully decided. As you know, once done, there is no re-set or re-do button. You will have to live with the results.

Good luck, as you work your way through this critical decision, may be one of the most important medical decisions you will ever make.

david in sc

ispark,

of course prescription pain meds will help and will be available to you. Some men say they don't need them, perhaps they don't. Taking on pain needlessly is so counterproductive to sound healing, any nurse will tell you that.

when I was in the hospital, I was on morphine the first 48 hours, then switched to dilaudid.
then I was given loratabs to take at home. some worry too much about addiction or constipation. but from the short time most men need the meds, those minute risks aren't worth putting up with serious pain in my opinion. I am thankful we live in an age of such good pain control.

if you need the pain meds, by all means take them as directed.

david

Luck plays into more than many would ever want to admit. Even with a great surgeon. Each person's body is unique, and each surgery is equally unique to the physiology of the patient. No doubt about that. You can have the same surgeon, one patient has zero incontinence issues, the next patient ends up needing an artificial device 2 years later. Some nerve sparing ops work as advertise, and others don't. If one doesn't like the work luck, replace it with chance, or providence, etc.

When you find the right surgeon/doctor, you have to put your trust/faith in him/her, and hope for the best. The rest of it is out of your hands at that point.

david

GOP - that cannot be the spirit of this forum, planting seeds of doubt. What a shame.

Tom - If you do decide on surgery, all of those guys, and many others, will do you justice. I'd just ask them up front if they perform the entire surgery themselves as sometimes the big names don't.

Yes, luck is involved I suppose, as it is in every area of our lives. But you want to stack the odds in your favor by picking an expert with significant experience. This goes for any treatment. Also, the shape you're in going into treatment will also have a significant impact on your outcome. If you already have some level of ED, don't expect to come out of treatment doing any better.

Feel free to email if you want. I have a great friend who is having surgery in a few weeks her ein NYC. He's flying over from Bologna, Italy. I told him to explore surgery, Bracy and AS and then he also looked into radiation himself on the advise of an Italian radiologist. After a few months of research he opted for surgery. I'm thankful he decided to fly to America as he will only get one shot at this and frankly, America offers better odds than Italy. I understand Canada has some great surgeons, why are you not considering them? I can put you in direct contact with Samadi if you want, can ask him to call you if you think it will help answer any questions. He also knows Patel so you could ask him about him.