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nerve saving on one side only question

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Posted 4/25/2014 9:04 AM (GMT 0)
Hey Guys,

Just a quick question.  Has anyone just had the nerves saved on one side?  If so, what were the effects when it cam e to ED?  Since my PCa is limited to the left side I am somewhat unsure those nerves can be saved however, I am also somewhat encouraged that the right side nerves can be spared.  I've read reports that ED can be up to 50% more likely with one side saved and the other side not, but was looking for someone who might be able to give me a more personal side to the numbers.

Thanks!

Posted 4/25/2014 10:25 AM (GMT 0)
Tc, this is not an answer but I thought I would share this with you.

I went in for a RALP mid March sparing the right hand nerve. In recovery my surgeon told me they took both nerves, I said ok, no point telling him to put it back. Later in my room when I had some more wit about me I asked why. He told me the plan was to take both before the operation due to my G9. I didn't ask but assume I wasn't told before hand to spare me some stress, I'm ok with this.

The reason I'm sharing this is twofold, one, ask your surgeons before hand if they might take both (never occurred to me) and two, be prepared as possible for any outcome. Before surgery I was somewhat prepared for 100% ED and 100% incontinence. At least I'm continent and that strange enough is/was more important to me.

In all I'm quite pleased with my surgery and would do the same again. Best of luck to you!

Cheers, Doug
Posted 4/25/2014 11:59 AM (GMT 0)
Hi tc46123,

I was also GL 7 (3+4) with a PSA of 7.6 at the time of Da Vinci surgery. I also had partial nerve sparing. The right side was removed, which left me an intact left side nerve bundle. After reading many posts from others in my same situation, I had no clear idea how my ED condition would end up, but I'm happy to report that after 2 years and 3 months I was finally able to achieve success with 100 mg Viagra. But, I've also seen a number of cases where guys had total nerve sparing and are getting no response from the blue pills.
I hope it works out well for you.
Steve
Posted 4/25/2014 1:15 PM (GMT 0)
I lost about 75% of the nerves on the right side, with the left side untouched due to my tumor only being on the right side. Like you, I was very worried how this would affect me ED wise. For 3 months following surgery it was like "shooting pool with a rope"--NOTHING! I continued to take Cialis and used a pump for blood flow purposes. Finally, the Cialis started to kick in a bit and at almost exactly a year I was able to achieve an erection without meds at all. Bottom !one is that if you had no problems before surgery and if you're in good shape, you have a reasonable chance of a good recover from ED.

Good luck,
Tom
Posted 4/25/2014 1:33 PM (GMT 0)
Hello TC,

I had similar
situation. I consulted with three surgeons, and they all said that they would take the Left Side nerve bundle because of the cancer location. Didn't much like the sound of that, coupled with my age at the time of surgery. However, as we were talking a Gleason 8, I elected for the surgery. Since then, I have never had a "true" erection. Can still achieve orgasm "part way there," but it is not by any means the same, or frankly as good. Best wishes with a difficult decision.

Newspaper Lover
Age 70
11/09 DaVinci surgery upstate NY; nerve bundle taken; clean margins, clean seminal vessels, no incontinence, alas no erections.
06/11 PSA re-emerged.
Gleason 8
Time to recurrence 18 months
Three month doubling time (summer 2011).
PSA rose from .07 on 06/11 to .17 on 11/11.
09/11 hernia surgery to repair hernia resulting from the DaVinci.
10/11 Moved management of my case to Memorial Sloan-Kettering in New York City.
12/11 Started hormones (Lupron/Casodex).
02/12 Began radiation (SRT), including pelvic lymph. 40 sessions.
03/12 Last Lupron shot.
04/12 Finished SRT.
07/12 PSA and testosterone "undetectable."
01/13 PSA “undetectable”; testosterone (T) level at 452 ng/dl.
07/13 PSA “undetectable”; testosterone (T) level at 444 ng/dl.
01/14 PSA “undetectable”; testosterone (T) level at 435 ng/dl.
Have received no treatment since spring of 2012.
Started “Paleo diet” in 2013. Only eat what I plausibly could have fished, hunted, or gathered 40,000 years ago (certainly not with current skill set). No processed food of any kind. No sugars. No starch. Feel physically strong and best in years on this diet.
Posted 4/25/2014 2:38 PM (GMT 0)
I had 100% nerves removed left side. Right side was suppose to be removed as well, but due to surgical and anatomy issues unique to my body, left side was left, "damaged and intact". It was meant to be a total non-nerve sparing op, with total ED expected.

That was in October of 2008, and I have never had a day of ED. Not post surgery. Not post radiation. None. I was getting full errections while still on the catheter (I was on the original cath for 63 days due to complications).

I have never used any ED meds, no pumps, no injections. All natural and full errections. Rare? Perhaps, but shows it can happen, and one never knows how they will end up.

We have men here who had nerve sparing ops and still ended up with long term ED. No promises or guarantees when it comes to the results of PC surgery.

Good luck to you in your case.

David
Posted 4/26/2014 6:46 AM (GMT 0)
TC,
I have read all your posts regarding decision making and don't believe that you have made one yet; therefore, I will enter this dogfight since most of reputable posters have already responded in your previous thread. You have asked a question and have received responses; please realize that they represent only a small number of men who have surgery. The statistics are that there are larger numbers of men who suffer serious side effects of surgery vs radiation when the cure rate is about the same. With your stats a form of bracky will probably do the job best. Tud or Yoop can give you the address of the best practioner in the Chicago area which should be doable for you; if you desire to utilize your medical facility they should have experienced personnel.
I guess that I am responding to your previous thread mostly, but I don't understand why you would consider surgery when the odds of ED and incontinence are stacked against you. It's a shame that at an initial consult both a uro and RO aren't present so the patient is provided the best solution. Sorry for my rant and I wish you the best. Keep us informed.
Bill idea
Posted 4/26/2014 12:19 PM (GMT 0)
TC,
My biopsy was 7 out of 12 positive, all 6 on one side and 1 on the other. I was told there would be a good chance of sparing one nerve bundle -- until after the surgery when he said he "had to cut wide to get it all."
He did get it all. At 5 years out I'm confident he got all the PCa and all my erectile function.
I feel great. I'm fit, and have no other issues. Life is good! And I can still talk.

A word of advice!!!
When your wife starts jiggling her car keys, slapping her thighs and saying "Come on boy! Want to go for ice cream?! Want to go in the car?! Come on boy!", Don't get in the car !!! It's a trick! She is really taking you to the Vet's Uro's office.
You will not be licking ice cream on the ride home!

(I still have not forgiven her.)

Jeff
Posted 4/26/2014 2:13 PM (GMT 0)
Jeff,

You should forgive her. After all she has forgiven you for digging up her garden and peeing all over it.
Posted 4/26/2014 6:20 PM (GMT 0)
I had open RP and both nerves were spared but I had partial ED pre op due to meds and now have total ED but I'm totally continent. I had Gleason 9 and had ten nodes resected, all negative. My surgeon preferred to perform open RP because he wanted to be able to feel the nerves and the nodes in that, with gl9 , the chance of PCa having spread beyond the capsule was high. It had indeed spread as I had EPE, margin plus at base where EPE existed, and SVI. The blue pill did nothing so I'm using a VED for now. ED is far from being my biggest problem with very high risk PCa .
Bob
Posted 4/28/2014 3:51 AM (GMT 0)
I had all nerves removed. I have been fully continent since the removal of the catheter on the fifth day. I take Trimix injections, because no other options are available to me. More -- what word goes here....its a family show --- than I have had in a long time. Satisfies those who need to be satisfied; others don't matter. The worst it can be (at least in my mind as it relates to impotence) is still tolerable. Orgasms are different, but still very pleasurable.

I don't know how I would feel if I leaked alot; incontinence is a much bigger deal in my opinion than impotence.
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