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For Those Who've Had Prostatectomies

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Prostate Cancer
Before surgery, which of the following possible downsides did your surgeon fail to mention? If more than one, please check the most egregious omission
Erectile disfunction - 2.9% - 1 votes
Incontinence - 0.0% - 0 votes
Bladder neck stricture - 25.7% - 9 votes
Catheter - 2.9% - 1 votes
Urinary leakage during sex - 57.1% - 20 votes
Bladder spasms - 11.4% - 4 votes
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Posted 5/27/2012 5:37 PM (GMT 0)
The post about orgasms after prostatectomy got me wondering how well informed the average guy is before agreeing to this procedure.

I'll be interested to see how the poll comes out.
Posted 5/27/2012 5:53 PM (GMT 0)
My surgeon did not meant two of the items as posted but I didn't have them as SE's. There are more possibilities you didn't list such as defining ED ~ does their patient not have ED because of VED drugs, pumps shots, etc. Also kegel exercising the correct way with perhaps a recommendation for coaching.

I did good here and I believe it was my age and surgeon quality at the time of my RP.

Tony
Posted 5/27/2012 6:04 PM (GMT 0)
My doctor didn't mention bladder neck stricture. I didn't have it. Is that a common side effect for prostatectomy? I knew it was for radiation. I marked it on the poll as number 1, because that's a SE that would have freaked me out the most, and he said zilch about it.

He also didn't mention urine leakage during sex. That would have been nice. We talked about the other stuff.
Posted 5/27/2012 6:37 PM (GMT 0)
I think bladder neck stricture after surgery is a pretty uncommon side complication, but a nasty one. My doc said the odds were four percent, I believe.
Posted 5/27/2012 6:45 PM (GMT 0)
These and more were mentioned to me as possibilities. But I was told that because of my age, health, sexual health and surgeon skill (they all said that) heading into the surgery I would most probably not get any of these.

Luck or not, today apart form dry orgasms I am exactly where I was pre surgery. Continence was perfect as soon as catheter was removed, sexual function returned within a month with pills and gradually over the course of months required less and less pill use. Unlike continence issues, which were under complete control form get go essentially, sexual function was a process with improvements on a monthly basis until things got back to normal.

sorry, didn't see bladder spasms in your list. That wasn't mentioned to me until my surgeon visited my a few hours after surgery. When I woke up from surgery in the recovery room I thought something was seriously wrong with me. Turns out it was just bladder spasms and/or the feeling from having my bladder attached to urethra. Kind of wish they would have prepared me for it but frankly given my groggy state at the time not sure it would have helped. If I recall correctly that awful sensation lasted less than 24 hours and Tylenol helped.

Post Edited (davidg) : 5/27/2012 12:48:31 PM (GMT-6)

Posted 5/28/2012 3:21 AM (GMT 0)
Only one not mentioned to me, was about urinating during sex afterward, don't remember that ever coming up.

Know we discussed bladder neck strictures beforehand, and after the surgical difficulties that were encountered, my surgeon warned my wife while I was in recovery - that due to the bladder neck/urethra connection area - that I was likely to encounter strictures. And boy did I, remembering fondly my 21 catheters, a total of 1 1/2 years cath time, and the 6 corrective surgeries to deal with them. It may only effect 2-4% of men post surgery, but if you are in that exclusive club - it really sucks.

david in sc
Posted 5/28/2012 3:46 AM (GMT 0)
Other than that it was a breeze, huh David? :-)
Posted 5/28/2012 3:59 AM (GMT 0)
Can't take the survey because it does not have "none of the above".  My doctors advised me of all these possible SE's, and spent considerable time on ED and Incontinence.  Though being young for this crappy disease they were mostly focusing on the belief that I would have no problem with continence (they were right, I'm dry) and ED will subside over time and I'll be fully functional again in a year (partially at 4 months, sufficient with meds) though the surgeon had to take 30% of the nerve bundle on each side, so that may change things.

Only SE none of the doctors mentioned was the high pressure urination during orgasm.  Though I had seen that on the forum so was clued into the possibility.  Have not experienced that one thankfully.

I found I have been very lucky (or chosen wisely) as my Uro was pretty good in discussion, and the surgeon I chose was exceedingly thorough pre-op.  Be him and his PA's, we went through all the SE's, complications, the whole pre and post treatment, what to expect, how to handle it, etc..  I went into the surgery incredibly well prepared.  Then the nurses went through all the post hospitalization care in depth before release.  I've been surprised by how many men have not been given the benefit of this knowledge up front and it's a shame.  I feel quite lucky on how I was cared for and my outcome so far. 

Posted 5/28/2012 4:10 AM (GMT 0)
Actually, jazz, from the open RP point of view, no. As I only had the most minimal issue with very short term incontinence, perhaps a week or two? And was one of the rare lucky ones that didn't experience any ED. But I kind of think the rest of it more than made up for it, lol.
Posted 5/28/2012 11:21 AM (GMT 0)
The surgeon was very thorough but I did a lot of research prior to surgery.

The stricture would be the only one since it may or may happen. 

The stricture for me was due to scar tissue and I think a nasty staph infection while in the hospital may have contributed to the problem.

Posted 5/28/2012 11:04 PM (GMT 0)
Mine said "I am cutting a wide path." apparently, I was supposed to know from that comment that he was removing nerve bundles. His mention of incontinence was that it was minor and short lived. He never mentioned bladder stricture or spasms. Now, 2 plus years later, still with total impotence, constant leakage, bladder stricture ( 2 percent open RP, .2 percent Da Vinci) I think he could have been a little more forthcoming.
Posted 5/28/2012 11:07 PM (GMT 0)
And while I think of it, maybe penis shrinkage should have been in the poll. Now that was awell kept secret!
Posted 5/28/2012 11:57 PM (GMT 0)
yup, I missed a couple possible items, but they only allow you six questions.

Sounds like you got the drive-thru orientation from your doc, fertree. They really need to train these guys on patient communications.
Posted 5/29/2012 5:56 AM (GMT 0)
I’m not sure. Prior to surgery, I read a lot and got a lot of good information from HW. But I’d have to say “urinary leakage during sex” probably did not come up at the consult. Btw, “penis shrinkage” was on my list of questions for the surgeon. I believe he said it can happen, but it’s usually not noticeable.
Posted 5/29/2012 3:02 PM (GMT 0)
Urinary leakage during sex only has happened once but that was enough.
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