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This member is a YANA Mentor This is his Country or State Flag

Geoffrey Cotterman and Barb live in New York, USA. He was 56 when he was diagnosed in June, 2009. His initial PSA was 23.20 ng/ml, his Gleason Score was 6, and he was staged T1c. His choice of treatment was Surgery (Robotic Laparoscopic Prostatectomy). Here is his story.

I was a healthy married 56 year old, physically fit with a BMI (Body Mass Index) of 21. In April 2009, my company changed life insurance providers and required us to get a full physical, including a PSA. My own physician does not believe in routine screening until age 55 so this was my first PSA. The result came back 17.5 and I was rejected for life insurance until I spoke with my physician. He put me on a course of antibiotics to rule out prostatitis and ordered another PSA after the two week course. Result was 22.5 "Oh my!"

I spent a couple of weeks learning everything I could and set up an appointment with a Urologist followed by a biopsy on June 10, 2009. The results came back 7 cores out of 12 positive up to 70% involvement. PSA 23.2. Bone scan and C/T scans were negative.

More internet searching convinced me that Robotic Radical Prostatectomy was the way to go since I am otherwise healthy, not over weight, will cover quickly and the cancer was obviously growing quickly.

I had RP by Da Vinci on July 14, 2009 at the University of Rochester Medical Center. My final Pathology was pT3aN0MX. The right nerve was partially spared, left nerve removed. My catheter was removed on July 24, 2009 and I received the full pathology report from my Uro:

Gleason 3+4=7 Tumor size: 2.4 x 1.8 cm location: both lobes and apex.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13,
Extraprostatic extension present;
Perineural invasion: present, extensive Prostate mass 55 grams.

During the next 3 months incontinence improved from 7 pads per day to 3 pads per day and seems to be holding at this level.

My Three month PSA was 0.04.

I have total ED and use a pump about once per week. 20 mg of Cialis. 100 mg of Viagra only gives me blue vision and a stuffy nose.

When you have but one prostate to give for your country there is no way to call a do-over. I cannot second guess my decision. If I have to spend the rest of my life without a natural erection and wearing pads, so be it. I am alive.

UPDATED

July 2010

I am at one year. I am incontinent and leak about 140 ml per day.

I have ED and must resort to Trimix since pump and pills do not work. Other that those two "inconveniences" I feel fine. Maybe I will be one of the lucky ones who recover both functions by the two year mark.

My PSA is still low so life is good.

UPDATED

December 2011

Unfortunately, my incontinence and ED did not improve from June 2010. I found the incontinence so distasteful and embarrassing I avoided sex, and my ED recovery suffered. By November 2010 I decided it was time to do something about it. I had an AdVance sling installed in Jan 2011 (18 months) and followed all the light activity rules for the requisite 6 weeks. I am continent now and only wear half a light pad per day for confidence and to catch a drip or two.

My life is back on track except for the ED. My Trimix dose was increased to such a large value I graduated to a double strength mix. Results are still unsatisfactory and I am considering an implant. I met with the ED specialist in October and discussed the merits and demerits of the AMD device. I will wait a little longer before doing anything about it.

At 2.5 years, my PSA is still < 0.01, my underwear is dry, and I feel fine. Life is good!

UPDATED

July 2012

It has been 3 years since my daVinci surgery and 18 months since I had an AMS AdVance incontinence sling installed.

My PSA is <0.02 . I feel great and am just as strong as I was before. The big issue for me is ED. I have not had luck with pills, pump, nor Trimix, and just received a 5ml bottle of Quadmix. If that does not work an implant might be in my future.

Overall, I consider myself a lucky guy.

UPDATED

May 2013

I am almost 4 years post prostate surgery and 2 years post sling surgery for incontinence. PSA is still <0.02. For the first year and a half the sling worked perfectly. Now I'm beginning to notice some dribble. I need to wear a small pad for confidence. With both nerves gone ED is still an issue but I've adjusted to the new norm. My wife does not miss it. I will admit that makes me a little sad. We both are fit and healthy otherwise.

UPDATED

April 2014

My PSA remains at <0.02 as I approach the 5 year mark. I am at a healthy weight and feel great. The side effects of surgery still bother me but I can live with them. Sling surgery (AdVance) fixed my incontinence but I still dribble a little if I have a full bladder.

ED is my biggest problem. I have a nice, healthy T-level around 500 and have the desire but no ability to follow through. I've tried pills, pump, and injections. unfortunately they have all proven to be useless. Apparently, I am, and after 4 years, always will be, a leaker. That one aspect of my life saddens me.

I occasionally have dreams where I have an erection and am having wonderful sex. They seem so real but when I reach down and check I am always disappointed. A few times I've found myself crying. I wonder if I'd be happier if my T levels were low and I did not have the desire.

I tell myself this is not important and I am a lucky guy, but I'd be lying if I said I did not miss it.

UPDATED

May 2015

I just had my 6 year post surgery exam. My PSA was <0.02. Great! I still have ED that cannot be corrected with pills, VED, or injections, due to venous leakage and removal of both nerve bundles. If I were single or had a spouse that considered sex important I would have a pump installed.

UPDATED

June 2016

It has been almost 7 years since my surgery. My PSA remains <0.02 so I consider myself one of the fortunate ones - even with total ED and incontinence "temporarily" corrected by an AdVance sling in Jan 2011.

When I had the sling installed I was told to expect it to work about 5 to 10 years. Well, here I am at 5 1/2 years and I am starting to leak again. Right on schedule. That makes me sad. When my bladder is at about 250 ml, about 3 1/2 to 4 hours, I begin to leak. If I do nothing at 5 hours I will have wet pants. Darn it!

I can have a sling installed again and will consider that, but I am also considering an implant for my ED. I figure if I am going to be laid up I might as well have both done at the same time. My concern at this point is my spouse has gotten used to and is quite happy with the status quo. If I get the implant and then have no place to use it I might be tempted to do something stupid.

I recognize that I am fortunate. However, my Testosterone levels, in the 450-500 range, constantly remind me of all I have lost. I'd be lying if I said I didn't miss it every day.

Geoffrey's e-mail address is: altenergyeng@gmail.com


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