I am 57 years old and in good health and physical shape. I do not smoke, drink moderately and exercise often. I do not take any medication.
I had my first PSA test at age 46 with a result of 1.3. From age 51 to 56 it ranged between 1.8 and 2.65. In January '09 it elevated to 3.6. In June '09 it went to 3.9 so it was time for a biopsy.
My urologist at the Michigan Institute of Urology performed the needle biopsy. This procedure was less painful than a toothache. He numbed the prostate with a shot of Lidocaine and then took 12 samples, all in less than 10 minutes. The pathology report showed cancer in 3 of 12 core samples, all in the right side of the prostate. My Gleason scores were 6 (3+3), 7 (4+3) and 6 (3+3). The clinical staging was T1c.
My urologist explained all my options and advised that I take some time to research which type of treatment I would like to have. He also sent me to a Radiologist for a consultation.
After doing much research on-line, consulting with my wife and speaking with two other PC survivors I decide to have the "little Devil" removed once and forever. I opted for the Da Vinci robotic surgery. My urologist had performed about 200 of the robotic surgeries so I decided to get a second opinion at the Vattikuti Institute of Urology at Henry Ford Hospital, Detroit, Michigan. A friend had the operation at Vattikuti 3 years ago with great success. He returned to normal continence in four months and erectile function after one year.
I met with Dr. Mani Menon and his staff for the consultation. My wife and I were very pleased with the staff, the facility and their expertise. Dr. Menon is the most experienced surgeon in the world in Da Vinci robotic surgery. He and the Henry Ford Vattikuti Urology Institute, pioneered the robotic prostatectomy in the US. He has done over 2,500 surgeries since then.
My surgery was on November 10th. I arrived at the hospital at 5:30am for my 7:30 surgery. Pre-operative prep ok. After meeting with the surgeon and anaesthesiologist I was given some Happy-juice and wheeled into the operating room. The last thing I remember is seeing what appeared to be a 62" TV monitor near the robotic equipment. I was told later that the surgeons use it to enlarge the view of the prostate tenfold for easier viewing during surgery.
I awoke in recovery at 10:30 and was in my room by noon for a light lunch of chicken broth, jello and juice. My wife arrive and gave me the good news. Dr. Menon told her that the surgery went very well. He was able to spare all of the small nerves using the "Veil of Aphrodite" procedure and also removed the Lymph nodes without complications.
I was outfitted with the "onQ" pain medication pump and a supra-pubic catheter. The pump administers precise amount of pain medication for five days. I have been pain free other than some tenderness around the stomach area.. The catheter is great since it does not go into the penis but rather comes out of the bladder just below the navel with no pain or irritation. I was out of bed at 5:00pm for a few laps around the nurses station. This is to remove the gas build-up of the anaesthesia. I drank lots of water so that my urine could flow freely. I had a good night of sleep.
My wife and I and four other patients went to the post-operative care class to learn about things like changing your bag, dressings, showering, etc. I was discharged at 2:30pm. I have been home for 2 days. I feel great physically and mentally. I still have to take it easy for the next 6 weeks.
I return to the hospital next Tuesday for catheter removal and results of the pathology diagnosis. UPDATES to follow.
Later: I was at home for 4 days with no major problems or much pain thanks to the OnQ pump. On day 5 I began to cycle my bladder to urinate through my penis and then through the catheter. This is to be done for two days prior to catheter removal to allow the doctors to see the volume of urine flow which is to be measured in a large beaker. This is accomplished by turning off a catheter drain-tube valve until your bladder is full or you get the urge to go. At this time you urinate through your penis until it stops, then open the valve and let the residual urine drain out for 5 minutes. At this point the valve is shut and you cycle again as often as the day allows. Each of the samples are measured and logged for a record. Sounds simple and it is. However, bladder spasms could occur during this time. Guess what? I had a very excruciating one after the 5th cycle on DAY 1, enough to bring me to a sitting then lying position for several minutes until it cleared. I stopped cycling for the day as instructed. Day 6 was good for 2 cycles then I spasmed again but not as badly. I called the nurse and was told not to cycle any longer.
On Day 7 we returned to HFH for catheter removal. I received a cystogram X-ray to see if my bladder was injured or not healing well. The x-ray was normal but the nurse thought it would be wise to leave the catheter in for 3 more days in order to rest it since I was returning to HFH for class.
On Day 11 the catheter was removed without any discomfort. The Penile Rehab class was very informative about what to expect in the next year with incontinence, perineal discomfort, mood changes and erectile dysfunction. A daily regimen of rehab using several products is a must for successful recovery. These aids include Viagra/Cialis/Levitra, vacuum penile erection pump, penile injections and/or MUSE. I chose the pump, Viagra and injection as my aids. Before leaving I received my first injection. It was painless since the needle is almost microscopic. The nurse showed us how to administer it. I then waited about 30 minutes until I had to urinate. Once that was successful I was allowed to leave. On the way out we stopped at the medical supply office and received our erection pump.
My regimen is for a daily small dose of Viagra, penile shots 3 times per week, erection pump use daily and 60 Kegels per day. I'm going to make a chart to keep all this straight, hopefully including my penis.
More to come.
I got great news on December 21st. My first PSA test after surgery was 0.0 non-detectable. Now that's a nice Christmas present.
It's been 6 weeks since my surgery and things are going very well. I am no longer wearing a pad having lost the dribble after one week at home. I continue to do the Kegel exercises twice a day.
I take a low dose Cialis daily and have opted to the shots for penile rehab 2-3 times per week. I tried the MUSE one time but had a bad experience with it. I started using the penile pump after four weeks of surgery and have noticed an increase in length during the past 2 weeks. I started the shots with 10 units and increased by 5 units each time. I have had an orgasm each time I used the shot. It feels the same as always except there is no fluid ejaculating. No mess, I guess.
Stay tuned for more good updates.
I had my 2nd PSA test on March 14, 2010 and got great results once again, <0.1 undetectable.
I have been using the VED pump & 1/4 tab of Viagra daily. I use 30 units of Tri-Mix twice a week with pretty good results. Intercourse is not a problem with this combination. I have noticed that I can obtain a semi-hard erection with good stimulation without the Tri-mix. Orgasms are fine.
I am pretty much continent with the occasional stress-leakage.
I appears that my rehab is on the right track.
My third PSA test was on June 22, 2010 and came back as <.01.
I have no Incontinence whatsoever.
I still use 1/4 tab of Viagra daily as well as the VED pump. I'm starting to get some see some life in the old Penis but not to the point where he can perform without some external assistance. The bi-mix shots (I had mistakenly said TRI-MIX) are helping at 30 units per dose.
Today is my one year anniversary from my RALP surgery.
I thankfully say that I am still cancer free with four PSA readings of <.01 during the past year. I am fully continent. My erectile function is about 75% and I continue using 1/4 tab of Viagra as maintenance. I hope the other 25% will return in year 2.
Sorry for not doing a 2 year update, so here goes.
I had 4 PSA blood test during year 2 with results of 0 ng/ml, or undetectable. I continue to not have any Incontinence issues except small amounts of urine leakage when having penile stimulation after drinking fluids close to the time of sex.
The ED issue is not what I had hoped for after 2 years. I have no problem becoming aroused to a 7-8 out of a 10 scale, with 10 being as hard as before surgery. After intercourse begins I soon lose my erection to where it's like putting a wet noodle in a key hole. I have no problem ejaculating dry with manual stimulation. In order to complete intercourse I have to use 25-30 units of bi-mix. I continue to use 1/4 tab of Viagra at nighttime and the VED pump occasionally during daytime. I personally feel that one must be both mentally and physically into making this work. A wandering mind will deflate you in a heartbeat.
My goal for year 3 is to concentrate more on the mental aspect of making love and to forget all the other stuff. I just need to concentrate on making love and nothing else.
Still cancer free after 3 1/2 years. No incontinence. ED back to about 80 percent of normal.
Life is good....
Approaching 5 years of NO CANCER in November. I feel great. No incontinence whatsoever. My erections aren't as hard as before and don't last as long but my wife and I make each other happy anyhow. Orgasms are same as ever...
Nothing has changed since my last report. I'm coming up on my 6year anniversary for being cancer free. I'm glad to report that my yearly PSA is still "0" (undetectable).
Glad to say that nothing has changed since my last update.
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