HealingWell
Search Close Search
☰

RALP Nerve Sparing one side

Support Forums
>
Prostate Cancer
✚ New Topic ✚ Reply
❬ ❬ Previous Thread |Next Thread ❭ ❭
Posted 6/5/2016 4:56 PM (GMT 0)
I am doing well 4 days post-op. I have been off all pain meds for two days. Walking 3 times per day 20 mins each. My surgeon wants 2 miles per day. This schedule at my pace puts me a little ahead of that. Had that first BM today at 4 days. Not bad, but I've been eating simple, oatmeal, applsauce, canned tuna, bannanas, jello, yougurt, canned soft fruit, prunes and some roasted chicken breast.

I am writing this because I had full nerve sparing on one side only. I still have not got a clear indication of how wide he went on the other side. He was somewhat cryptic, saying he just had to go 'wider' on the right side. So, either he took them all on that side or left partial. I will find out more on Tues.

Anyway, what does one side do for you? Does it help with dealing with incontinence? I assume it gives you a chance to beat ED? I saw Gemlins signature today and noticed he had nerve sparing one side and it got me thinking of him and others who had similar one side nerve sparing RALP.

Can anyone provide some info on what I can expect with one side nerve sparing?

Thanks.

J
Posted 6/5/2016 5:04 PM (GMT 0)
Hi J, glad to here you are doing well so far. Good luck on the recovery. -JR
Posted 6/5/2016 5:23 PM (GMT 0)
I had one side sparing...took 2 1/2 years to get full erections. I used the VED for most of that time for whatever that is supposed to do... never used for for sex...I currently take 50mg viagra daily for BP and some xtra kick at the gym{ammino acids}....use 100mg for functional intercourse Provides erections visually without the need for manual stimulation...tho that of course is provided in sex. It is NOT the same as preop...I was 66 at op am currently 73 and extremely fit...{evidence of knowledge and a bit of fame as well...} Wish you a speedy recovery...exercise as your body allows...you can push the envelope...no guts...no glory as is said...
Posted 6/5/2016 5:26 PM (GMT 0)
Jay, I had nerve sparing on the left and our Dr. was a bit 'cryptic' also when he originally told my girlfriend immediately after surgery while I was still out that he was not able to save the right side nerves. However while discussing it later with another Doc that was present for surgery he said they took about 50% of the right side so technically it wasn't considered nerve sparing because they didn't save 100%. Regardless of the confusion my understanding is the nerves have nothing to do with incontinence and only affect the erections. They told us that while it may be best to totally save all the nerves on both sides that there are men who have complete recovery with only one side saved and men who have total nerve sparing on both sides who have permanent ED problems so for us not to worry too much, that he felt my prognosis for ED recovery to still be good....Jim
BTW...my incontinence recovery has been great so far, just an occasional surprise little squirt which is nothing more then a little dribble. I just started no pads at all except for work where I am physically active and am more cautious. But in a week or so I will try to go without as the occasional squirt hasn't happened for days now.
Posted 6/5/2016 6:02 PM (GMT 0)
Hey J-Man! Continence comes from functionality and control of the urethral sphincter muscle that is below where your prostate used to be.
The surgery and subsequent re-sectioning of the urethra to the bladder neck has knocked it out of whack. Your mission, if you choose to accept it, is to keagle yourself a few hundred times a day to regain your control of said sphincter muscle to regain your continence. It is not directly related to nerve sparing.
This message will self-destruct in 15 seconds.
Posted 6/5/2016 6:10 PM (GMT 0)
Jay, At this point, the focus needs to be on recovering from the surgery. Keep walking, it sounds like you're eating right, and everything else is right on schedule. In a few days, you have your consult for your pathology report and catheter removal. That's when I got my staples out as well.

Frequently, after the cath is out is when the docs will start you on daily viagra or cialis to help with the blood flow--which is definitely part of healing. Who knows, you might be surprised. I was. about a week after catheter out, while I was still wearing a heavy pad at night, I had a partial and woke up in pain cuz willie was tucked down by the pad.

Some guys with partial nerve sparing have no problems, and some with total sparing have problems. It's a crap shoot. All you have to do for the next week or so is get stronger.
Posted 6/5/2016 7:01 PM (GMT 0)
Hey,
I lost about 75% on one side, but have full elections with no meds today. I was on Cialis right after the catheter was removed. It took about 6 months for me to achieve a "useable" election, but at almost exactly one year I didn't need meds at all. My wife takes full credit for my recovery yeah

Tom
Posted 6/5/2016 7:04 PM (GMT 0)
At this point, worrying about future erections, if any, is the least of your concerns. The surgeons job was to CURE you of your prostate cancer. Focus on how well he did that when you meet and go over the pathology report...."Nerve sparing" I'm afraid is a secondary issue ..
Posted 6/5/2016 7:47 PM (GMT 0)
Fairwind,

I actually could not agree more. However, it appears that regardless of the pathology report, I need to learn how to live rather than just survive. That thought process, at times, has been overwhelming. I figured the best way to get back to living was to try to get back to who I was, or as close as i can, before this started. That started for me in the shower yesterday morning, I looked down at myself. I saw a weakened shell of myself. I looked at how far I still needed to go, not at how far I've gotten.

My thoughts turned to the next steps I needed to take. First thought was catheter removal. So, the natural next thought process was working on incontinence. I'm wondering, will that take weeks, months, maybe never? Does any nerve sparing affect that?

Then my thought process turned to ED. Will the nerves taken on the right affect that? How long could it take? Never?

Then, the biggest and all consuming thought gripped me. Oh, yeah, I have cancer, and regardless of a good pathology report or bad pathology report, I will always have to deal with this. It will never go away. A good report just means I will forever be living PSA test to PSA test. A bad pathology report means moving on to the next couse of treatment and hoping the 'bad' isn't 'really bad'.

So, yes, cancer control is my primary concern. But it shouldn't mean I do not have secondary quality of life concerns. How I deal with them, if I can deal with them at all, may indeed be determined by the pathology report.

J
Posted 6/5/2016 8:35 PM (GMT 0)
Hey Jay, you hit the nail on the head. Catheter out is one of your milestones, and then continence.
Doing kegals with your catheter in is not advisable apparently, so don't start doing em till the cath is out.
Posted 6/5/2016 10:12 PM (GMT 0)
Jay, keep on plugging. What's running through your head is absolutely NORMAL. And, in time, what will develop for you is a new normal, which will be different from the old normal. How different will it be? Who knows?
Posted 6/5/2016 10:36 PM (GMT 0)
JayMot, about your initial question about ED and nerve sparing. I read somewhere that the difference between unilateral and bilateral nerve sparing is about 10%, two years after surgery. That means that about 60% have full erections instead of 70% for your age.
These nerves have nothing to do with incontinence. These nerves control the relaxation of muscles in the penis - to let blood enter - to give the erection. Viagra helps with the relaxation if the nerve impulse is weak. I have regained about 80% of my pre-surgery erections (w/o Viagra).
Posted 6/5/2016 11:52 PM (GMT 0)
Jay, I agree with you 100%..But for now, focus on survival..The other stuff will take care of itself..Incontinence and impotence are things that can be dealt with and overcome..Keep in mind, I'm a stage 4 Gleason 9 Brother so my advise and opinions are coming from a different place...Impotence and incontinence are minor issues to guys like me..Staying alive is front and center..Your date with the surgeon, his explanation of the pathology report, (be sure to get a copy) is top priority right now..The goal of surgery is to remove ALL the cancer and produce a CURE. Did your surgeon do that? or did the Pathologist rain on his parade? This is the ballpark you are playing in now...
Posted 6/6/2016 2:15 AM (GMT 0)
Jay,
You're about 6 weeks behind me in recovery from surgery. I know you have a lot of time to sit around and think. When I was where you are I had very similar thoughts to those that you are describing. Remember like the others said...one step at a time. I was in very good physical shape prior to my surgery. I worked out 5-6 days a week with heavy weights and did plyometrics as well. I am very active and don't spend much time sitting in the house. It was hard for me to sit around and wait for my body to heal but it did a little each day. I lost about 22 pounds in the first 3 weeks after surgery...mostly muscle mass. Like you I would look in the mirror and I could see my muscles dissolving away and see my bones showing more than ever before. Once the catheter came out I started getting better and I started feeling more "normal". Next I was fearful of incontinence but after about 2 or 3 days I was not leaking so I felt very fortunate about that. I also was eating more as my appetite was kicking back in and I started to gain a little weight back. I definitely have some ED but that is already getting a little better....I had bilateral nerve sparing. I got my pathology report and first PSA last week and I feel very fortunate. Like you said I will still be living test to test but I know I am lucky compared to many on this forum. I started working out again about 3 weeks ago and I'm starting to feel stronger and my energy level is back to normal now. I was focusing on healing, eating better, continence and now finally ED. If I never get another good erection I will feel blessed and never complain because my situation could be much worse than it is.

Hang in there Jay and remember one day at a time and be patient. It sounds like you are doing great and you are on schedule.
Posted 6/6/2016 5:00 AM (GMT 0)
I say this to folks at the gym who have lost fitness for one reason or another and are now back at it and say to me...I'm trying to fet back to where I was.. Oh yeah what I say to them... You don't want to get back where you was... You really want to get to where you are going... Clever...and meant to be{sigh}..but there really is some real truth in that statement...the statement applies neatly into the ed recovery conundrum...

Age has a lot to do with it,as well as presurgery ED if any... I think we all identify with your thought process...you plan ahead and, to my view, the fact that you are thinking ahead indicates an active mind.

Any time we, as humans, interact we have a propensity to try get into someones head...especially if we speak the same language...I did it with this post...so it goes.
I did post a bit ago that that propensity disappears a lot when we are in a foreign culture interacting with people of same...{languwage barrier}...tho having just said that and always having the "other" thrust into my mind, even then when my wife and i ,who were recently in Japan visiting our eldest son...I and my non english stranger who was trying to help us find dis or dat...tried...and always succeded to get into each others head{intent}, hence the needed help was made manifest...good fun... Oh these were times when we were not with our son...who speaks reads and writes japanese fluently... the last part of that sentence was 100% evidence of fame...emotican of pride...unabashedly.. roll with the punches as you recover....
Posted 6/6/2016 6:24 AM (GMT 0)
J,

I had "partial" nerve sparing surgery. See my story below, focus on the ED bit.

All the best, mate!
Posted 6/6/2016 3:46 PM (GMT 0)
Jay - patience is the key.

Continence was a two steps forward and one step back kind of thing. I'm a glass half full kind of guy and I got dismayed many times along the road to no pads.

ED is another story. Nerves were spared but I still need the daily Cialis to get to 100%.

As others have noted everyone is different, realize recovery isn't linear and you will do great.

Go out and have that first beer once your cath is out but be sure to bring extra pads and even a change of clothes. I had poor alignment, soaked my jeans and didn't know it before I got through half of the happy-hour large beer at Buffalo Wild Wings.

Laugh, no worries. I never thought I would need to have a pee-pad in my golf bag but I did.

Jon
Posted 6/6/2016 10:21 PM (GMT 0)

Graytech said...
I had poor alignment, soaked my jeans ...

Got caught by that last night (in bed).
At week 8 (post T2c) now.
Mornings good, afternoons still leaky. Coffee may not be helping.

Post Edited (shudderingThud) : 6/6/2016 4:24:00 PM (GMT-6)

Posted 6/7/2016 1:46 AM (GMT 0)

JamesE said...
Jay, I had nerve sparing on the left and our Dr. was a bit 'cryptic' also when he originally told my girlfriend immediately after surgery while I was still out that he was not able to save the right side nerves. However while discussing it later with another Doc that was present for surgery he said they took about 50% of the right side so technically it wasn't considered nerve sparing because they didn't save 100%. Regardless of the confusion my understanding is the nerves have nothing to do with incontinence and only affect the erections. They told us that while it may be best to totally save all the nerves on both sides that there are men who have complete recovery with only one side saved and men who have total nerve sparing on both sides who have permanent ED problems so for us not to worry too much, that he felt my prognosis for ED recovery to still be good....Jim
BTW...my incontinence recovery has been great so far, just an occasional surprise little squirt which is nothing more then a little dribble. I just started no pads at all except for work where I am physically active and am more cautious. But in a week or so I will try to go without as the occasional squirt hasn't happened for days now.

Jay,

As others have said, the nerve sparing really doesnt have anything to do with urinary control. As newton said... kegels kegels kegels. I too have had one side fully spared, and "about half" of the other side. Still working on the ED thing, but there are some good signs at times. James, you and I look to be about in the same boat. My doc says erections will come back (with PED5's). Using trimix now as a "bridge". Also doing the low dose thing too. Plus VED's. Good luck & keep at those kegels.
Posted 6/7/2016 11:39 AM (GMT 0)
Jay-

7 weeks post RP tomorrow- one pair of Depends underwear gets me through the day - no extra pad. Keep doing the Kegels, as they do help. Of course, since my surgery failed to get all the cancer I want to be continent before starting RT. Meet with the RO today and will receive my first pot op uPSA result.

I had non-nerve sparing, so can't comment on the ED. Although, I may at some point consider a penile implant.

Bobby Mac
Posted 6/7/2016 10:43 PM (GMT 0)

Bobby Mac said...
Jay-

7 weeks post RP tomorrow- one pair of Depends underwear gets me through the day - no extra pad. Keep doing the Kegels, as they do help. Of course, since my surgery failed to get all the cancer I want to be continent before starting RT. Meet with the RO today and will receive my first pot op uPSA result.

I had non-nerve sparing, so can't comment on the ED. Although, I may at some point consider a penile implant.

Bobby Mac

Age: 69, 69 at PC dx, PSA 6.7 Avodart (6.7 x 2.3 = 15.5)
Biopsy: 2/16 13 of 14 Positive, 2-99%, GL 8, 2nd look GL 7 (4+3)
RALP 4/20/16
Post OP Pathology:
Non-Focal EPE, 2 positive margins, Gleason 4+3=7, involving 50% of gland, prostate weight 31.5 g, Stage pT3a N1 Lymph node involvement: 2/10, right side positive, Diameter of largest N Metastisis 2 mm

Bobby Mac,
So as not to hijack this thread about results with nerve sparing, if you don't mind I am going to copy this post, mainly for your signature, to another thread I will start which I think I'll call "Is surgery every the best choice even with aggressive PC". I think your case makes for a potentially interesting discussion.
Posted 6/12/2016 6:59 AM (GMT 0)
Hi Jay,

Thanks for the post. I think you are days ahead of me in this journey. I too had nerve-sparing on one-side only. We'll get through this.

Best, Joe
✚ New Topic ✚ Reply