Tamu Update

Happy New Year to All!!!

I addition to being the start of a New Year this is also the two month anniversary of my da Vinci and I thought it appropriate that I add to this thread on where I stand today with my recovery.  As already noted my post op path report was very good and I consider myself cured of the monster.  I will concentrate on the other two milestones in the recovery process.

Incontinence - Going back to the first week after the removal of the catheter I was disappointed that I was not one of the lucky ones that are either dry when the catheter is removed or within a few days.  I was gushing a good bit that first week and was wearing the male undergards type of pads.  After about 5 days the gushing stopped.  I went to the poise type of pad.  I was going through about 4 or 5 pads a day and still leaking a little at night.  about the 4th week after surgery I became dry at night and down to two pads a day.  about three weeks ago I was down to one pad a day and primarily having stress incontinence.  Today, I am almost totally dry.  I can walk a couple of miles without any leakage.  Most sneezes I can catch and prevent leakage.  I can lift things and not leak unless I am lifting from a squat.  My urologist told me before the surgery that on average his patients achieve continence in the first 2 to 3 months after surgery.  Looks like I am going to fall into that average.  The one thing that I did have after surgery which I have not heard discussed before on this forum is the loss of the signal from my bladder telling me that I need to urinate.  I basically have been going on a time basis.  I discussed this with my urologist and he said that it was common and that it would come back.  That was two weeks ago and guess what.  In the last week I have started to have that old feeling coming back.  I can go now 3 to 4 hours without having to urinate and no leakage.  For those coming up on surgery or considering it be sure to query yuor urologist on his complication rates for incontinence.  My surgeon's was 90% fully continent at the 8th month after surgery, another 8% with just stress incontinence at that point and 2% with severe incontinence that would require intervention.

Impotence - This is the area that hits the self esteem the hardest.  There are a very, very few men that come out of prostate surgery and regain erections right away.  There are one or two on this forum but by far the majority will be impotent immediately following surgery and for some time thereafter.  In my case as previously reported I began a penile rehabilitation program using Viagra and the three week mark after surgery.  This is a program that my urologist has been using for almost a year.  That program included on using 25 mgs of Viagra for six days without any sexual stimulation and then 100 mgs on the 7th day and attempt sexual stimulation.  I was really getting excited as that 7th day approached and I had high expectations or should I say rising expectations.  What a let down when nothing happened.  Thanks to Swimom I got straightened out about that and now realize that the Viagra is primarily for therapeutic purposes.  My urologist told me at my six week appoinment that only about 30% of his patients achieve an erection with the Viagra with the first 100 mgs usage point.  He did not tell me this before and I would have been better prepared if he had.  After 2 or 3 weeks of the penile rehab I was frustrated.  My wife and I had set up a once a week pattern for having sex and although that literally did not take place we were having fun and enjoying each other.  At the six week appointment this was the primarily topic.  My urologist felt that with my motivation that penile injections would be the best intervention but since my insurance would pay for a vacuum device that I should try that first.  I ordered a Vacurect and it arrived a couple of days before Christmas.  That following week I had intercourse for the first time in almost two months and while it was good the quality was not anywhere near what it was before surgery.  I have used the pump as suggested everyday for rehab purposes and it has increased my relaxed length and under the vacuum my erected length has also increased.  There is some discomfort with it and I am not satisfied with the quality.  I plan to give it another week and most likley I will be moving on to the injections.  I have researched the injections and as with everything else with PC there are large variations in experiences.  Of course, the biggest issue is giving yourself an injection in your penis but I am confident that I can do that.  The other issue reported is pain/discomfort due to a large and long lasting erection.  It seems to me that if you get the dosage right then that should not be a problem.

Sexual Response - One of the mysteries of prostate surgery is what will change in your sexual response or orgasm.  You know upfront that you will have a dry ejaculation.  You are told that you will have an orgasm but with what you have been used to for upteen years it does not make sense that you can have an orgasm without ejaculation.  Well, I can tell you that is one area that for me has been a pleasant experience.  My orgasms have been just as intense if not more so then they were.  At this point I still ejaculate some urine but that is getting less and less as my incontinence has improved.  My libido took a nose dive after that first failure to get an erection with the Viagra but it is coming back.  I think one thing that has help a lot is the once a week commitment that my wife and I have made to spend quality time being sexual. 

Well, that is about it.  My 2006 was not a very good year except for the birth of my first grandchild.  I am looking forward to 2007.  It has been said by several men that have had prostate cancer that now they look at life completely differently.  I can attest to that and 2007 will be my first year of that new life.

Bless you all that have provided me with the support and comfort over the pass few months and for those that are lurking and wondering may this account provide some help to you in your journey.

Tamu

Diagnosed at age 56 in June '06; PSA that raised suspicions was 4.4 after being 2.9 the year before; Beginning Stage T1c, 4 of 12 samples positive; on one side only; worst of the lot was Gleason 4+3=7, daVinci in August '06, postop path was negative margins, nodes, and vesicles, but was on both sides (T2c); postop worst Gleason was still 4+3=7; at two and one half months postop, PSA was <0.008.