No Incontinence, no ED -- Why?

1. Every person is different.
2. Every surgeon is different.
3. Every surgeon has good days and bad days.
4. One little milometer here or there with the scalpel can make a different.
5. The luck of the draw.
6. God.

In general it seems to me, younger guys recover from surgery better than older guys.

My surgeon stuck ice bags in me when he did the surgery. He felt it helped keep the swelling down. I was immediately continent .... had full control when the cath was pulled. Not sure if was the ice.

I had a large Prostate (72 grams). Surgeon said it would be hard to pull the nerves off of a large Prostate. I ended up needing pills or Trimix.

My surgeon did a fellowship on how to use the DaVinci. He was young and had only done 35 Prostate removals. Maybe I got lucky, but I figure maybe youth helps a sugeons hands, and training is a must. I feel some surgeons are huuriedly trained on the DaVinci, and they repeat the same errors on every patient.

I give most of the credit to my surgeon, but the fact that I was in good shape and was walking 3-5 miles a day two days after surgery made a difference too.

Tom

RCS said...
In general it seems to me, younger guys recover from surgery better than older guys.

My surgeon stuck ice bags in me when he did the surgery. He felt it helped keep the swelling down. I was immediately continent .... had full control when the cath was pulled. Not sure if was the ice.

I had a large Prostate (72 grams). Surgeon said it would be hard to pull the nerves off of a large Prostate. I ended up needing pills or Trimix.

My surgeon did a fellowship on how to use the DaVinci. He was young and had only done 35 Prostate removals. Maybe I got lucky, but I figure maybe youth helps a sugeons hands, and training is a must. I feel some surgeons are huuriedly trained on the DaVinci, and they repeat the same errors on every patient.

Re: the large prostate, mine was 107 gms. I was told afterwards that this often was the cause of a prolonged recovery time for incontinence. And I'd say I have had that compared to some anyway. As for the ED, I was told upfront to expect it due to a need to cut wide.

I was fully continent (I do rarely experience a stress incontinence causing a couple of drop leak out) and was experiencing erections post surgery at night while I still had the catheter in. I too have wondered why some men have problems and others don't.

I can tell you my surgeon said if you had urinary or sexual problems before surgery they would be worsen after surgery. And if you are obese, diabetic, have heart or other related problems these can worsen the SE's.

I can tell you I credit my surgeon that was trained at MD Anderson, his skill with the daVinci robot and even though I was 60 years old, I was in very good to excellent shape without any prior health problems.

I did have both nerves spared, but I also had a little positive surgical margin which might come back to haunt me in the future.

Ditto Tiger

There is a level 4+3 and above anything positive is a huge positive. Higher the number no offense but the lower every odd.

But if surgery is a viable endgame v part of solution then agreed surgeon is a massively important decision. Plus hitting them at their best is also another way to up the odds but that part is randomized.

Naturally as a G9 our first concern was the extent of the cancer. But I was lucky in the other departments. One nerve spared and have no problems in that regard and can't complain about incontinence.....only when I exercise sometimes.

Age perhaps, skill of surgeon, the big tip I gave the doctor and staff before I went into surgery, etc....

There are a number of things you can do to improve your odds -- get fit, change your diet, lose weight, choose an appropriate treatment, find an experienced practitioner to perform it, understand the requirements and timeline for recovery and rehabilitation -- but having done those things there are still a number of factors which can be neither foreseen nor controlled. These emerging factors are most usefully thought of as "luck" and they can weigh quite heavily in the outcome. The best you can do is to do your homework, make the best choice you can, and pull the lever. You will know the odds on the machine but there is no guarantee where the cylinders will land when they stop spinning.

When it's all done, if you are one of the fortunate majority who come out OK, don't forget to thank your lucky rabbit's foot. There are a lot of limp and leaky guys who did exactly what you did to prepare for treatment.

And if you are one of the not-so-lucky guys, don't beat yourself up. Lots of guys who chose the same treatment as you did came out fine. You were unlucky. Feel free to curse your luck and whine endlessly here on the forum. That's what I do. But don't forget that while you can't go back you can usually go forward. With pills and pumps, slings and implants, injections and artificial sphincters there will be something to get almost everybody back in the game.

Several surgeries by my surgeon the day I had mine - 2 had perfect recoveries. Mine ended with ED (still have it) and incontinence (still have it).

We have no clue why I, as a younger guy in reasonable health, did much worse than the other two (much older and bad general condition).

I'll say luck of the draw.

It has been said countless times on this forum to do one's best and select the physician who has not only done a lot of surgeries but who also has a great track record.

I am one of the fortunate ones as I do not have any leakage or ED issues.

1. Prayer
2. Great physician
3. Being in good shape prior to surgery
4. Understanding wife who initiated ED therapy and has been a rock of support.

What are the statistics? How many of us have side effects versus almost immediate return to full function? Wouldn't it be great to have those stats by surgeon or by degree of fitness, etc?

I'm 3 weeks after surgery and so far 1 for 2. The incontinence is slowly getting better but I am nowhere near controlling it when I stand up. On the flip side the erections are full. They started 3 days after catheter was removed and had 3 out of 5 days before adding 5mg Cialis. They are now daily. I need to get out and start walking more to see if that will strengthen the pelvic muscles. I can't tell you why the erections came back immediately if it was the doctor technique, luck, or predisposition combined with nerve sparing.