Upcoming Surgery

My RALP is now scheduled for January 11. I am on a waiting list. It may happen even sooner.

Now I wonder what life will be like afterward. I know it won't be the same. I have never had problems with pain, urgency or sleeping through the night due to numerous bathroom trips (maybe a few times). I have had no problems except the biopsy indicating that it is better to be safe.

I have a couple of friends who had surgery and they said that I will be fine. However, one still has problems with urgency. He is still constantly looking for a bathroom a year after his RALP. And he hasn't had sex since. The other says that he rarely has any sex years after. For me, I would miss the intimacy, the warmth and closeness of my wife. Will that all be gone? Will I just be a shell of myself?

Sorry for the ramblings. Sometimes I just wonder.

Depov

Well, it varies. That's all that can be said. I'm one of the fortunate ones--I was continent almost immediately--but urgency is a different animal. I go from "soon" to "NOW" in a lot less time than before. And that appears to be pretty much universal.

Sexual function? I'd propose that wherever you are on the scale (be honest) now, you will likely move down at least one or two notches....or maybe loose it altogether. It's just not predictable. Closeness, etc? That will happen if you want it to. You won't loose your hormones--at least just with surgery--so the 'shell of yourself' is going to be about what happens between your ears, not between your legs.

you have a much better chance of having ED, incontinence and a shorter penis with surgery.

Depov, sounds like second thoughts to me. But please don't accept anecdotal evidence from your friends either in person or here at HW. Do your own research. I cannot recall from your other threads whether or not you investigated other treatment options but, if not, you should. Your diagnosis is such that almost any of the mainstream options should cure you, i.e. surgery, LDR Brachy, HDR Brachy, SBRT, IMRT. What most of us advise - whether we had surgery or radiation - is to make sure you have spoken with multiple experts. Your diagnosis is barely a month old. Make sure you do your homework -- you get one chance to do this right the first time. Treatment regret is real, especially among men who have not explored all of their options.

Jim

Hi Depov, I agree with the others that you have a concern with the side effects. I was fortunate that I also was almost fully continent a couple of weeks after surgery. I do have "I gotta go now" urge sometimes, almost a year later. But I also had SRT so my bladder is still recovering from that.
I started kegels right after my Dx, and I still do them. I would strongly urge you to talk to your urologist to make sure you are doing them properly, and doing the correct amount each day.
With regards to sex, I can achieve about 60% - 65% erection, with help from my wife. I had one nerve spared, and part of the other. The skill of the surgeon has a lot to do with this. With regards to intimacy, my wife has been the best. We have not lost any of that, and we both enjoy our quiet times together in bed. We have not tried intercourse yet but I am planning on starting Sildenafil in January and we will see how that works.

Last, I made an effort to lose about 10 - 12 pounds, and to exercise regularly before and after surgery. I really believe it helped with my recovery and my overall mental state. Good luck and keep us posted!

Jan 11 is around the corner. Do kaegels, get heathy and have fun now. Hope you have chosen a very experienced surgeon. That’s critical.

Living with ED is a high possibility. Incontinence is possible but less of a risk.

With your stats you can definitely hope for a cure with surgeory as well as with other radiation options.

Hi Depov - Your mileage may vary, but I completed RALP on August 2nd and it wasn't too bad. The first month was mostly home bound with some incontinence. I had been told not to worry about incontinence as it would take care of itself, and sure enough thats what happened. After 2 months it was nearly gone, and now at about 4 months after I am ~99% good. Desire is still fine, but on ED your doctors will probably offer Viagra and I recommend taking it. A little bit seems to do the trick and I was back at about 6-8 weeks after surgery. Almost certainly your surgery will go well and that will be it, although alas in my case the journey continues so I'm waiting to see the side effects from ADT + RT. Good luck!

I have an upcoming surgery on January 15 to have a prostatectomy. I've talked to at least a half a dozen friends and acquaintances who have had the surgery and everyone generally says the same thing. They are incontinent at first and most of them have recovered their continents within a month or two. My surgeon tells me that only a few of his patients are incontinent after six months.
As far as erections go, I was having problems years ago and received a penile implant in 2013. My doctor is a trauma urologist that specializes in reconstruction stemming from a stent in the U.S. Army putting our boys back together after getting blown up. I could not be happier with my erections now and was told in 2013 by my doctor that, if I got prostate cancer, I have taken care of an important part.
Nonetheless, having something wrong with your genital urinary system is a little bit humiliating. I have a fiancé that is 12 years my junior and we have been dating for over four years. Nonetheless I am still embarrassed that I have to have my prostate taken out and wear a catheter for a week to 10 days.
I am extremely nervous about my surgery but have extensively surveyed the landscape and determined that, in my case, I will use radiation as a backup to surgery.
At the hospital where I will have my surgery, the head physician's assistant told me that a 53-year-old patient decided on radiation for fear of incontinence and erection problems. His cancer returned and he is trying to find a doctor that can successfully pull off a post radiation prostate removal.

Depov,
Had my ED consult today for my January 15th RALP. Doc told me to start 20mg Sildenifil once daily, then start using a vacuum erection pump 14 days post op for best results down the road.

HF5280

Depov said...
The other says that he rarely has any sex years after. For me, I would miss the intimacy, the warmth and closeness of my wife. Will that all be gone? Will I just be a shell of myself?

Doesn't have to be. I had surgery 10-years ago. Personally, I'm having (considerably) more sex today than back 15-years ago when the kids were young and life was more hectic. I've also embraced the fact that I've been taking tadalafil (cialis active ingredient) for nearly 10-years...

You'll be fine.
best wishes...!

It’s been about a year and a half for me. With 20mg of Viagra my erections are up to 90% or so. The surgery and early recovery is touch no doubt. The interesting thing for me and my wife is we both believe our sex lives are better because we have had to be more creative. We now relie less on intercourse which weirdly has been more satisfying for both of us. Healing is slow, be patient.

normal changes.
the new normal will become normal.
and the old a fond memory.

spontaneity becomes longer - "Hey, want to, in say an hour?",

Depov:
I'm scheduled for surgery on January 4 and chose surgery over radiation because of the fact that I would have to be on hormone therapy for two years with proton and one year with general radiation. Also I'd like to have a backup in case I have a recurrence. With that said, I was suffering from ED years ago and for many years having tried pills and shots. I had a Titan Coloplast implant inserted in 2013 and could not be happier. My surgeon is pretty cocksure of himself in that he said that he's only had one patient in the past three years that has been incontinent past six months. He continued to say that he was a Gleason nine and had metastatic issues.
Despite the fact that I'm implanted, he is going to try to spare the nerves because I do get a semi sometimes and further said that the nerves that provide feeling to the glands and penis are not the same that create an erection. I'm telling you all this because you should consider an implant by one of the 4 or 5 leading implant surgeons. You can go on Frank talk.org and read all about it. This whole ordeal sucks and I'm joining a club that I did not apply for. Nonetheless I'm doing my best to pick the right treatment for me at this point in my life. Best to you.