Failed Radiation therapy surgery option?

Glen,surgery after radiation is a whole different ballgame. Its generally much more complicated and takes someone who is highly skilled, in part due to the scar tissue and other effects from the radiation. I'm just not sure to what extent that applies, after only a few treatments, something to ask your surgeon.

Correct me if I’m wrong, but I suspect RP is generally a multi hour process with general anesthetic and intubation, the latter precluding apnea issues.
Has anyone had RP with a regional block and “light sedation” which would imply a conscious patient?
Carl

I think I had 5 treatments out of 55
My surgeon knows what I've been through and has said he may do surgery. I ran into him because his staff wrongly scheduled me so it was a brief encounter.
I also am guessing about the epidural and mild sedation but have read about it taking place.
I Am between a rock and a hard place. My penis is slowly healing but it's still raw and my urine flow is weak
The RO said urinary retention will most likely return. Seems I have little choice.
The RO said he'd call Dr Decastro about my choice. I will call the office tomorrow and see what my next move is.
I wish there were other options.
I'm scared to death and can only pray that Dr Decastro will do the surgery

G

epidurals are used for things like fusion biopsies and TURP procedures. RALP is done under general anesthesia, with all kinds of fun things like being on a tilted table in what is called the reverse Trendelenberg position...basically at a 45 degree angle head down.

You'll be intubated, and the anesthesiologist is keeping you alive. The surgery for an uncomplicated case takes 2 hours or so...and yours likely is not uncomplicated. I don't know how much damage your relatively few zaps has caused...that is a question for your whole team to look at.

Hi theswan.
You mentioned earlier problems with being catherized. You have my great sympathy - can be terrible painful. Check with your doc on how catherisation will affect you on the surgery. You'll need it for at least a week if all goes perfect and it's key hole surgery. Maybe even longer - 10 days-2 weeks. Mine was 3 weeks but I had open surgery which requires a little longer time. If you had a problem with the catheter on a previous time, check if a smaller sized one will help this time. I had major problems with my catheter following surgery and when I went back for corrective surgery to fix the resulting stricture, the urologist used a smaller catheter.

Glen - I previous mentioned that my 93 year old father was circumcised at 85 due to continuing problems he was having that sound similar to what you experienced. You may have a potential problem that could cause future issues so maybe a repair might be required? He said it was not a big deal afterwards which is hard to imagine.

Surgery clears up a whole lot of urinary problems although the problem is that the off switch often gets damaged so you have to be careful what you wish for. I had virtually no issues with continence which seems to be unusual but not everyone takes a year to recover either. It is the big unknown after surgery followed by the ED issue so keep those in mind in your discussions with the best surgeon you can find there.

Good luck fighting your way through this difficult situation.

Up at 4:30am peed into a quart container because my wife was using the bathroom. I noticed an ammonia smell
Not overwhelming but evident. I filled the whole quart so I guess that's a good thing.
Try to go back to sleep. I am going to urinate about 15 times a day. I always seem to get the urgency part but usually do not pee too much. Still a little sore but getting better

Glen Heinsohn

Oh thankfully the pain improves after several hours and a couple of buprenorphine tabs

G

Thanks Paxton thanks a lot.
Update. I dropped off a urine sample to test for infection. It smells more normal today but still thick or dark
Been drinking green and herbal tea and some distilled water I usually use in my CPAP machine.
Ran into the RO.Dr Deutsch who said TURP may allow me to continue radiation treatment. It will allow me to keep retention at bay.
I see the surgeon tomorrow afternoon and will see which is best TURP or just remove the prostate
I do trust the surgeon. He is very well educated and has rave reviews. I lean toward TURP followed by radiation but will wait to see what Dr Decastro says

I Am grateful to be able to write here. It helps not only to educate but supports me emotionally which I really need. A positive attitude is important. Right now I feel almost but not quite depressed but gain the important quality of compassion and hope when I come here

Glen

Glen,

I'll weigh in here. From the start of your journey, with your retention issues that go way back, I was one who always felt that surgery might have been your best option. The reality is that relatively few men have the permanent leakage issues that are at the front of you mind. It's a bell curve, and the no continence group is at one end of the curve. Yes, it can happen, and it sucks if you're one of the ones at that end. It's not the end of the world, though, there are options. AUS is an option, as well as installing a sling is an option.

For men with large prostates, who already have significant issues with BPH, I think RALP should be much higher on the radar for them--because it will immediately resolve the BPH. Is there risk, of course there is, there is with any treatment plan. I just happen to think there is way too much fear-mongering anti surgery for any reason going on in this forum--at least some of the time.

Thank you both
I am scared and that makes my thoughts run to extremes. However the thought of just getting it over and done with seems more appealing. I will have much better information in a few hours.
I'm thinking why risk a possibility of two surgeries when one will remove the prostate and may be the end of the problem . Your information and concerns mean so much and lift my spirits.
My wife is supportive but does not understand what and wherefore of this decision. She just does not want to lose me. Sex is no longer an issue with either of us so that is a good thing. We have an affectionate relationship and that is more important than the actual act
Anyway God bless all of you.

Glen

Morning Swan,
For what it's worth, I had an epidural with open RP Surgery. My surgeon did not want his patients to deal with being nauseous, vomit, sore throat etc.
No issues.

Samster