Welcome New Member Happy121 with Questions About Removing Prostate and Bladder at the Same Time

Hi,

I'm not sure if many of us have had surgery that removed the bladder, along with the prostate, seminal vesicles, etc. I suppose there are cases like this, but I haven't seen too many discussed here.

For me, as with many others undergoing a prostatectomy, the DaVinci surgeon removed my prostate, seminal vesicles, exprostatic tissue and a number of lymph nodes. And, of course, the section of urethra passing through the prostate was also removed, along with the prostate.

The bladder neck is then rebuilt and the bladder is positioned downward to fill the space once occupied by the prostate -- and then reconnected to the penis to restore urine flow.

I am about 16 months post-op and was essentially 100% continent after just a month or so, hardly needed any pads after the first couple weeks. And I can urinate like a firehose -- which I could not do before the surgery because of BPH.

Erections are slowly beginning to come back now -- it sometimes takes the nerves several years to completely reawaken (assuming it was nerve sparing surgery).

So yes, life really does return to normal after a successful DaVinci surgery. Once my sexual function has come back a bit more things indeed will be back to normal.

Chuck

Resident of Highland, Indiana just outside of Chicago, IL.
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA Sept. 2011 was 5.7.
Local urologist DRE revealed significant BPH, but no lumps.
PCa Dx Aug. 2011 at age of 61.
Biopsy revealed adenocarcinoma in 3 of 20 cores (one 5%, two 20%). T2C.
Gleason score 3+3=6.
CT of abdomen, bone scan both negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
My surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicles, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior,
right posterior apex & left mid posterior prostate.
Right posterior apex margin involved by tumor over a 0.2 cm length, doctor says this is insignificant.
Prostate 98.3 grams, tumor 2 grams. Prostate size 5.0 x 4.7 x 4.5 cm.
Catheter out in 7 days. No incontinence, occasional minor dripping.
Post-op exams 2/13/12, 9/10/12, PSA <0.1.
Semi-firm erections now happening 14 months post-op & slowly getting a bit stronger.

Do some of you remember Andrew (Ohio State)...had a bad prognosis of PCa, catheter even stuck inside bladder and couldn't be removed (supposedly), used casodex to fight his PCa and after a month or two the catheter fell out on its own, because the cancer cells had dimished enough. He had a catheter worn for 4 months (the same one) cause it couldn't be removed easily and didn't get HT therapy until his psa was 130+ and it doubled from like 60 in one month and another month went by with no psa testing (he might have registered 200-260 level then), then at my support group he attended my onco-doc asked why he was not on HT...well the docs he saw (in Ohio) wanted to gut him and remove prostate and bladder and he had no insurance so zoladex was even denied him at one place (cash needed up front).

He went onto casodex for one years and then went off of it for over 1.5 years, psa did drop to below 1.0 not way long ago, went up some and he went back on casodex and back down, off again recently for 7 months now and just restarting it again. So he has managed 3-4 years now without surgery or radiations and has good quality of life and reasonable PCa control. So far he is a happy camper no Lupron either of which he is afraid the side effect would be too nasty, he had a scan done and the contrast solution messed him up with sickness big time although the rad-doc said it was probably the flu, my onco said it is possibly the solution reaction (which is believable). I just point this out as an interesting case and someones decision on their own pathway. No way would I judge which is wiser courses of action, but seeing results and quality of life are pleasing to know about or witness. He wishes to remain intact, so HT related therapies are his choice of actions.

Thanks for sharing the info, Zufus.

I guess in Andrew's situation, not having insurance was a life-changer in a positive way. Not something we often hear about for sure.

Again, thanks for sharing. :)

WOW...
hello everyone and thank you. sorry my posts will always be late i work till approx 9pm each day.
reading your responses you all sound like doctors..... that would mean, very intelligent.
Firstly thank you Peter for starting the thread and i am a girlie. i am assuming you have had similar problems because of your stats? how are you doing now ?
This is all new territory for me. Never been on a forum before so forgive me if i get it wrong.
to highlander you sound as if you have been through the mill but admiration for you is great you sound so positive and im so pleased to hear that your recovery is strong. we have been aware of the bladder cancer since aug2012 he has had a scrape then was scheduled for a biopsy which turned into a scrape and a biopsy in Nov2012 which we had clear biopsy results at that point. he presented with symptoms in late dec 2012 and we got in touch with hospital who said he was alright to stick to his appointed next date for end of jan2013 for a microscope procedure several visits to gp and local a and e resulted in you have a probable infection, have some anti-biotic or we cant help you here you need to go back to urology. when he finally went for microscope he was told he had the cancer again and he needed to go in to surgery asap. they took him in where he was seen by surgeon number 2 this resulted in a scrape which turned out to be of the prostate allowing the ease for urination again also bladder cant be scraped again there is too much tumor there. this lead to a scan now he is facing surgery for bladder, prostate and urethra removal.sorry have not heard of DaVinci surgery or BPH.

MS WorryWort, thank you ,
stats, Gleason score, PSA, pathology report, i dont have these but i will get them and post tomorrow.
we have not been told about hormone therapy and we do not know if the nodes or the bone have beeen affected, we have not been given the option of radiation, we do not know what his PSA readings are or what they have ever been. the only option we have had is removal sceduled for march 20 2013.
we did ask about bladder instilations back in august and we were told there was no point.
i believe from my readings that neo-bladders are not an option for cancer patients and i think that the absorption levels of the bowel tissue can cause complications for some recipients.we did ask about an artificial bladder again the answer was this is not an option for cancer patients.

i am happy that the pathway of treatment that your husband chose is working and that things look possitive for him. the inability to urinate causes you both distress and some pain its not nice so im really pleased that that has had some relief.i can tell you that the thought process of having a bag is doing my partner no good, but its early days for us we only found out last friday we thought it was relatively contained.

Pat

i believe bladder function is a problem post surgery and it is one of the most difficult things to re-invent but it is possible and from what i have heard with some serious work this can be improved, here to chat when your recovering let me know when you go for the treatment and keep physi -o - oing on that bladder function.
Thank you to everyone who had posted their info for me to help get my head round this.

Happy212& David in sc may The Lord who is most high give you peace and comfort. I will pray for y,all and ask the Holy Spirit to pay you a visit. Above all things do not have a spirit of fear, but of sound mind. I,m of the mind set not to let that s.o.b have the satisfaction, I would also think the information like psa, biopsy or Gleason score should be numbers y,all should h ave been given. Are you comfortable with the doctor or hospital your with?. The town I,m in was small, and my problem was big, so I flew to another area for better treatment, if you have reservations about the handling of things, you may want to find another place to go, with cancer cases, you really only get 1 time to get it right. God Bless us all jim

Happy121, a warm welcome to our forum. With such a serious prognosis, I would like to also encourage you to search out all of your options.

Usually, Prostate Cancer patients have time to learn about all options, the side effects and come up with a plan. In your case, it seems that you need to do this quickly. You and your partner need to put aside things that can wait and focus on exploring all of your options. You have much to learn. Seek additional opinions from a Radiation Oncologist and a Medical Oncologist to help you plan your path. Surgery may well be the best option, but find out first.

We are not doctors, but patients who want to help each other. So as you have already done, ask away any questions that you may have. Usually you will get both sides of the story to help your decision process.