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My husbands surgery and results

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Posted 9/1/2016 5:21 PM (GMT 0)
Hello All!
I just wanted to give a quick update on my husband. He did have a RALP last Wednesday. They were able to spare both nerves. He got his catheter removed and the pathology report back today. His Gleason score was upgraded to 7 (4+3). SV- and nodes were negative. The apical margin was positive. After the results we got back today I am so glad that he chose to have the surgery and not delay it.

Post Edited (Cyndiane) : 9/2/2016 3:34:41 PM (GMT-6)

Posted 9/1/2016 5:39 PM (GMT 0)
I'm glad your husband is safely on the other side. Sorry his Gleason was upgraded and there was a positive margin, but glad to hear about the nerve sparing and that the SV and nodes were negative, which is excellent news! (I recall there was some discussion about whether he should consider AS. Given the upgrade to 4+3, if he had chosen AS he likely would not have been on it for very long.)

Others here that have had surgery can give any help needed on the recuperation front. Good luck to your husband and may he have a rapid recovery on all fronts!
Posted 9/1/2016 6:03 PM (GMT 0)
Yes there was some discussion and I had tried to convince him to consider AS but he just wasn't comfortable with it. I really didn't expect it to be upgraded so it was kind of a shock. Just glad we got it taken care of. What boggles my mind is how his dad's PSA was so much higher than his yet my husbands was a higher Gleason score and occupied both sides of his prostate
Posted 9/1/2016 6:24 PM (GMT 0)
Hi Cyndiane,

Glad to hear of your of your hubby's successful RP. My husband had the same surgery 5 years ago.
If you have any questions feel free to ask. It would also be helpful if you could post your husbands stats, especially if you have info you want to share.

Best of luck!

BOOGEE
Posted 9/1/2016 6:28 PM (GMT 0)
Glad to hear surgery is over.

Now onto the healing part.

Not a bad path report, odds are they got it all.

Andrew
Posted 9/1/2016 7:47 PM (GMT 0)
Cyn, glad your husband got through it ok, and glad in he sight, that he chose to actively treat.
Encourage him to walk. A lot. And make sure he is doing the Kegels.
Any questions on the recovery, ask away, nothing is off limits.
Posted 9/1/2016 9:36 PM (GMT 0)
I updated my signature to include my husbands history and stats
Posted 9/1/2016 9:42 PM (GMT 0)
Good for you guys! Just follow post op instructions and he'll be up and at 'em quickly!
Bob
Posted 9/1/2016 11:36 PM (GMT 0)
He has been trying to walk as much as possible. He said it was uncomfortable with the catheter in though. He should be doing more of it now that that is gone. I did have a question. He is still very bruised and sore and his dr told him to try and not get any erections yet nor did she give him a timeline of when he could do these things. about how long will it be before he is given the go ahead. Also, when should he start the kegels?
Posted 9/2/2016 1:17 AM (GMT 0)
I started doing Kegels the day after the catheter came out, so two weeks after surgery. I think every Dr has a different protocol. I'd listen to whatever the surgeon or his staff instructed.

I was told ok on erections (more accurately, sex) after 4 weeks, but I waited 6 as I was afraid. Again, I think envy one is different
Posted 9/2/2016 2:21 AM (GMT 0)
Cyndiane, I also started kegals the day the catheter was gone. I had been doing time on the treadmill with the catheter in (I had my surgery in mid-winter, and we had LOTS of snow, so outside walking was out). I was night-dry almost immediately, and was only using light shields within 2 weeks or so.

I also distinctly remember (and noted it in my linked thread "my story") that I had a partial spontaneous night time erection within a week of catheter removal. My surgeon told me, on that subject, that if I felt up to playing, there wasn't any problem. And, if something developed, don't be afraid to use it (gently) at any time. In other words, Cyndiane, if he's not having discomfort from his bruising, and something happens...feel free to do whatever works...just be gentle and non-demanding.
Posted 9/2/2016 9:46 AM (GMT 0)
I too found moving around with the catheter quite awful. Once it came out, I felt so much better. Do try to encourage him to walk now and get his strength back. After seven weeks, I was given the go ahead to run and swim (still no cycling!).

I too was told to start Kegel exercises the day the catheter came out. I had appointments with a PT before the surgery - and I had my first post-surgery appointment with the PT the day after the catheter came out.

Best of luck for a speedy recovering.

Joe
Posted 9/5/2016 6:20 AM (GMT 0)

Cyndiane said...
I did have a question. He is still very bruised and sore ....

I had maybe up to 4 weeks of pelvic floor & groin soreness & swelling. It put the brakes on things for a while. Only getting dry this week, nearly 5 months after surgery.
I did an initial Pelvic Floor program (6 weeks) with PT.
I am currently following up with an 8 week "Back Pain" program as it focuses on Core Strength including the Pelvic Floor muscles (with a different PT).
Urologist started me on ED meds about 2 weeks after catheter removal.
------------------------------------------------------
Age: 66, highest PSA 8, BPH 72gm
RALP 11 April 2016
Stage T2c G7
Week 4 PSA 0.02
PSA review next week
Posted 9/5/2016 11:22 AM (GMT 0)
Glad to hear that your husband is on the other side. There is a "trick" that helped me regain bladder control. I started to ride a bike even when I was leaking bad. In a matter of weeks I went from -700 grams a day to trace. I put it up to the bicycle seat strengthen the floor pelvic muscles.
Posted 9/5/2016 9:13 PM (GMT 0)
He has been doing fairly well as far as urine leakage. He only has to wear a light guard at night. As long as he gets to the restroom as soon as he gets the urge he doesn't have a problem. I'm not trying to rush him into anything. I was just curious as a timeline for that hasn't even been mentioned in any of his appointments
Posted 9/5/2016 10:08 PM (GMT 0)
Cyndiane, the most common timeline given for sexual activity is 4-6 weeks after surgery. If he didn't get one, it's a good idea to get him a scrip for daily cialis (5 mg daily is common) to start ASAP. Don't be shocked at the price...and your insurance may not pay for it. Lots of docs have sample packs to give out.

For what it's worth, it's really about when he feels well enough to try...and when things start stirring in that area. You can help things along if he's interested.
Posted 9/6/2016 12:18 AM (GMT 0)
Cyndiane,

I'm glad your husband is safely on the other side. Let the healing begin.

It's not unusual for Gleason scores to be raised after surgical pathology. Mine went from 6 to 7 too. Not sure if that's an upgrade or a downgrade.

Also, I wouldn't be too concerned about that positive margin, although you might want to let the urologist decide how worried to be. Dr. Patrick Walsh makes a pretty good argument in his book (a pretty good book btw) that positive margins often don't mean much. I had couple positive margins and my uro wasn't really concerned. That was more than five years ago and my PSA is still undetectable. Here's hoping for a similar outcome for your husband.

Best,

Jonathan
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