Update on radical prostatectomy done on 3/4/2015 at John Hopkins

For the most part, I am doing well. My stamina seems fine and I haven't experienced any pain since about a week after surgery. My surgery went as planned with nerve sparing on both sides and all negative margins. I was upgraded to Gleason 7 after surgery and my pre op biosphy was Gleason 6. June 2014 PSA was 5.1 and December 2014 it was 3.1. My catheter was removed on 3/14/2015 and surgery was 3/4/2015. My only issue seems to be low to heavy leakage. I keep experimenting with different activities and fluid consumption. I have eliminated both caffeine and alcohol. Yesterday I drank 10 oz of decaf and 10 oz of caffeinated in the am and 8oz of decaf and 8 oz of caffeinated in the early pm( I know I broke my rule yesterday on no caffeine) I had to change depends twice during the night. I also walked about 4.5 miles yesterday at about 4 miles an hour. This is a slow pace for me since I am accompanied to running about 30 miles a week at around 5.5 mile per hour. I am doing regular Kegals and will sometimes feel muscle soreness. This past Saturday I made my first long
road trip since surgery and was in the car about 10 hours. Each time we stopped my pad was soaked. When I do go to the bathroom my stream is strong and I can stop and go fairly easy. I spoke with my surgeons nurse last Thursday and she felt my progress was fine. Some of the things I wonder about: 1) have I got the wrong fluid balance and is that a factor 2) At least 5 days a week I walk 3-5 miles at a moderate pace usually in two intervals. Is that helping or slowing progress? 3) how is improvement measured, gradual, suddenly quick, 4) when doing kegals how hard should I contract, 5) at four weeks since removal of catheter, should I increase the amount of kegals? 6) even though it's early, I worry about the possibility of permanent incontinence. Am I just an excessive worrier? I am very healthy with no other medical issues. I would appreciate any recommendations or thoughts on my post.

at this point you need three things: Moderate walk, kegals and time.

I know it feels like slow progress, but you're doing fine.
Just give it a bit more time.

Andrew

Thanks very much for the advice. I agree that I'm probably over doing the walking and have started to slow it down today. Again thanks.

Hi John -- post op pathology report sounds good -- organ confined disease, I think you said negative margins, lymph nodes negative for cancer. Great choice to have it done at Johns Hopkins -- they are great at nerve-sparring procedure. JH has a BIG prostate surgery practice -- the wing I was on, I think every room (30 rooms, maybe more) had a guy in it who was there to have his prostate out. Men come from all over America and around the world to see the prostate docs at Johns Hopkins. Lots of experience by the surgeon doing the procedure is one of the keys -- or probably THE key, to get the likely best outcome. You done good!!

Ditto what others have said about take it easy. Ease off on all that walking a bit, slow it down.

My surgery procedure (open RRP) was done at Hopkins mid-January 2015. I leaked profusely afterwards for two months, then out of the blue the tap just seemed to suddenly almost completely close, then maybe another 2-3 weeks of one pad a day, and the last 2 weeks I'm about 99 percent dry. The first 3-4 weeks I was a fire hose, going through 8-12 pads a day. It was just impossible. But at 8 weeks I was down to 4-6 pads/day, which I was ecstatic over -- a fifty percent reduction, I was celebrating. Be patient. Sorry you had to find this place, but happy you did too. Much experience and wisdom and support exists here. Welcome! Remember, no question is too trivial or too obvious (in your view) or too embarrassing, to ask. In general this crowd is un-embarrassable (new word, that one, I made it up). And it fits!

Bill Positive

John, I'm on your same path, and am pad-free at night for the last few nights, and I wear a thin pad during the day. I'm actually thinking about going pad-free this weekend at home, just to see what happens. Sometimes I wonder if the pad 'tickles' the tip of my penis and stimulates a drip.