Hi all,

My name is Scott Vanderstelt and I live in rural South Carolina. I went to my family doctor right after the first of the year for a routine physical exam. I had no complaints its just that my wife and I have 'arrived' at middle age (48) and decided we needed to get started with routine physicals. Everything was A OK except an elevated PSA, 8.5. My doctor prescribed antibotics for 30 days and retested after 40 days. The result is 7.8. My doctor did not note abnormalities upon the DRE. I have been referred to a specialist and been advised by my GP to be prepared for the recommendation of a biopsy. I am concerned about the prospect of overtreatment and thought that a forum like this would be the best place to go for real world advice. Thank you for your interest in my situation.

Scott

I notice in reading some other posts that there are conditions prior to blood draw for PSA that I was not given ie; no sex, exercise etc. I am on a routine regimine of exercise 5 days a week and I also did not limit sexual contact before either of these blood draws.

Scott,

The best advice I can give you is to read Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, especially the part about selecting an excellent urologist. I have found that this is the best source of information on prostate problems, and it is essential that you select a urologist who has the skill, the experience, and familiarity with recent research on diagnosing and treating prostate problems. If you are concerned about over-treatment, this book will put you on the right path. This book will also help you avoid under-treatment or mis-treatment.

Scott:

Prostate cancer in most cases will have no symptoms, but if it is caught early it's cure rate with any of the treatment modalities is very high.

You could try getting a "free" PSA test - if it comes in lower than 19% a biopsy would be a good idea.

Biopsies are no fun, but not that bad either. With your PSA being elevated even after medication, it might be wise to rule out cancer or catch it before it goes any further.

It is recommended that 72 hr before blood draw you do not have sex, no bike riding or heavy exercise and the DRE should be done AFTER the blood draw.

Good luck to you.

Major

The suggestion of a the "free PSA" test is logical:
With PSA's between 4 and 10, 70% relate to benign causes, the most common one being an enlarged prostate.

The prostate naturally produces PSA, and the larger the gland becomes, the more PSA it produces, so for a PSA number to mean anything, the prostate size needs to be factored in to calculate "PSA density"

The reason that exercise and sexual activity prior to PSA testing might not have been mentioned is that studies have failed to support the theory that this can affect PSA results.

There are a number of recent articles on over treatment which you mentioned:
www.prostate-cancer.org had a recent article on the subject in their Nov 06 newsletter.

Catching the cancer early is the best cure. Like sparky0911 mentions, biopsies aren't fun, but it gives you valuable information. My PSA was 12, I had a normal DRE and no symptoms. I had a biopsy done and it came back cancer positive in 2 of the 10 sites.

After my biopsy and diagnosis, I contacted the Amercian Cancer Society and joined a prostate cancer support group called Man to Man. The group was composed of men like me, who were in the process of deciding what to do and also cancer survivors that have gone through various treatment options already. I found these group meetings to be very educational and helped a great deal in my decision. I know where your at I've been there, I hope this helps some.
Good Luck, slosurfer

Hi Scott,

I would opt for the biopsy, as it is really the only way to be certain that cancer is the problem. In my case, my PSA 13.5 and I had no symptoms whatsoever. I found this out due to a routine physical at age 52.

The biopsy is not fun, but it's not horrible either. The after effects of the biopsy were more of a problem than the actual biopsy. My results showed a good percentage of the left side of my prostate involved, and none of the right side.

Surgery showed that an even larger portion of the left side was involved, as was a portion of the right side. And it was determined after the surgery that mine was a grade more aggressive than the biopsy showed.

Also, when I first had my PSA results, I too asked my doctor about exercise and/or sexual action prior to the blood test, and he said that it has been shown to be inconclusive if that activity raises PSA.

The book, "Dr. Patrick Walsh's Guide to Surviving Prostate Cancer" is indeed a good source as others have said. It tells you from start to finish what you will need to know, and pretty much what to expect.

I have written other entries here that discribe my experiences both before and after the surgery. If you have the time, I'd suggest you look them up. While everything went according to plan for the most part, there were some surprises than no one told me about. Maybe my experiences can help you avoid some stressful situations if you opt for surgery.

Good luck, and keep us posted.

Dan

Thank you all for your advice,

I have an appointment in two weeks with the specialist, in the meantime I will get the book several of you have mentioned and do some more research on this site. I remembered that two years ago I purchased a life insurance policy for which the company did a complete workup, I have contacted them and asked for the bloodwork, so this will be a PSA from two years ago maybe it will help the Dr. Thanks again, I will continue to post as my situation progresses.

Scott

Ok I got the Walsh book, you were all right to recommend it.

I am going to have a blood draw on Monday for a free psa so that I have that result when the urologist examines me on the 26th.

After scanning the book I realize that I have had some symptoms now for about one year the two main ones being a sudden extreme urgency to go and then some difficulty in completely emptying and sometimes leakage after thinking I had completely emptied. I also have had some burning sensation just at the point of emptying. None of this occurs everytime and I guess that is why I had dismissed it.

Putting all of this together with the 'normal' DRE by my internal Dr. I am hoping for a diagnosis of BPH, this is also the reason I asked my regular Dr. to order the free psa as I understand that a high percentage of free psa indicates a condition other than cancer.

We own a wholesale greenhouse business and we are just getting into our busy season, the next 4 months are make or break and I do all of the delivery which means I'm driving a truck for 12-15 hours/day 6 days a week stopping once an hour or so and offloading rolling racks of plant material. I can't just hire someone to do it as we deal with exclusively high end independant garden centers and the job is as much a sales function as a delivery function. I am concerned about my ability to do this after a biopsy. I have read no lifting for 5 days, what about sitting for hours, can someone give me some real world experience here?

My thought is if the urologist agrees that the DRE is unremarkable and the free psa is a high percentage I might wait until July for the biopsy? I would appreciate anyones comments on this thought.

Thanks for you interest. Scott

What you are going to find in this whole area of prostate health is that you will always be balancing odds and trying to make the best judgment. There is never an exact answer. It would not seem unreasonable to wait four months for a biopsy. Your doctor may suggest treating the symptoms of BPH first to see what the result is or may decide that another PSA test is in order before going to biopsy. If your earlier tests were in single digits, and the second test lower than the first, you probably have time to wait.

I don't remember difficulty sitting after the biopsy. I pretty much got off the table, drove home to change clothes, and went to work. I have a desk job so I sit a lot. After robotic surgery, for the first month or so, traveling long distances in the car was uncomfortable, but I combated that by sitting on lots of pillows. I don't think this would pose a major problem for you, but waiting probably doesn't hurt either.

Even with a biopsy, you are playing odds that the needle will actually hit the spot of the cancer. I had a dozen samples taken and only one showed any cancer cells, in less than 5% of that one sample. Yet, after surgery I learned that more than 10% of the prostate was cancerous. If it hadn't been for that small part of one sample, I would have never known until later.

Pick a good doctor and ask him what you have asked us. A biopsy is not the end of the world, and neither is prostate cancer for that matter. Nevertheless I hope that you discover that your PSA and other symptoms have another cause. Good luck.

After surgery, your doctor could require several repeat PSA readings before attempting to logically gauge the situation, and what future approach can be considered.

He'll have to consider your full profile, eg:
whether there are three subsequent PSA rises,
PSA doubling time. For example a doubling time of less than 3 months is usually considered more serious.
pathology report, postive margins, gleason score,
residual tissue.

All of this can be discussed, and what timeframes and figures he has in mind.

John

Scott;

At your age, I don't think you will have any problem with getting a biopsy ASAP and not wait until July. Under normal circumstances, having biopsy surgery is minor and should not affect your work for more than a day or two. I do much heavier physical work than you describe and I had no problem getting back to work the next day.

In my opinion, I'd say that your concern should be more about having PSA readings in the 7 to 8 range.

I'm 58 and my PSA reading went from 2.6 to 3.8 in about 18 months and my final PSA prior to surgery was 4.3 only one month later.

Although within a reasonable range for my age, they were concerned about how fast it had elevated.

Your readings are high to begin with when you consider your age.

If I were you, I'd move as quickly as you can to get the biopsy results so if any further treatment is indicated, you'll be ready to schedule it for the summer. Not to mention that you'll have peace of mind about your direction once the biopsy results are in.

Best wishes...

Just one more thought...

I don't know whether it's been mentioned but you may want to consider getting more than one opinion about your situation. Most uro's are ready and willing to suggest a 2nd opinion as confirmation.

Thanks Tony,

I'm seeing the urologist on Monday the 26th and will have a fresh psa/free psa and lots of questions. My internist is a good doctor and a personal friend who is not going to let me do anything stupid. I'll post as soon as I have the Drs recommendation. Scott

OK, new info and not good. Got the results of free psa today, total 7.7 %free 4.5. I guess I won't be asking for an extension on the biopsy the Dr. is most likely to demand. If I understand the numbers right, although it is not in stone this makes me way over 50% chance of PC at my age of 48. I'll post again after the appointment on Monday 03/26. Scott

and Tony I'll definately be asking about a confirming opinion. Thanks.

Hang in there buddy...

Your are in my thoughts and prayers!

Ok, saw the urologist,

He is a nice enough, confidence inspiring man, if it does come to surgery I will do more checking. He looked at all the paperwork, asked questions about symptoms and did the DRE. Where my Dr. detected no inflamation on the DRE the urologist did. He thinks it is more likely a benign inflamation rather than cancer but is insisting on a biopsy which we have scheduled for 3 weeks from today. Thanks for the input and advice, I am hopeful of a minor inconvienience followed by an uneventful recovery. Best to everyone here. Scott

Sounds like a plan that you can "live" with (excuse the pun)!

You are a busy guy running your own business but I must say that, in my opinion, you are very wise to get that biopsy out of the way ASAP.

Very wise!

Hello,

My father in law has been very sick w/ a UTI that has been festering for 2+ months and he never told anyone. He is 53. Well his PSA numbers came back at 25. He see the urologist next week. With such a high number, is it more than likely Prostate Cancer?

Dear umaangel00;

A high PSA reading like 25 is reason to become concerned but this reading does not, by itself, indicate prostate cancer. There are many things that can raise the PSA level. A high PSA reading is a very good reason to see a urologist. Most likely the urologist will suggest having a biopsy of the prostate gland taken to confirm anything. Hope this helps.

yes that did help. My father in law is normally a very healthy man. We don't know what went wrong!

I would not consider the issue of over or under treatment without first determining whether you have cancer. In my case, my PSA was marginally high (4.1), and my doctor was not concerned. I asked for a follow-up because of the velocity and the urologist biopsied, finding a few "suspicious" cells and scheduling a second biopsy in six months. Prior to the second one, my PSA dropped to 3.7 with a Free PSA of 35%, both indicators of a positive nature that was not borne out by the biopsy. Surgery scheduled April 13 with da Vinci and friends.
If you have cancer, you have options for treatment. A PSA of 8.5 is not to be trifled with, though certainly not a certain indicator of cancer. Look up the Partin tables if you want some probabilities.

Well w/ my father in law it's not cancer. Due to his raging UTI that has been festering for 2+ months it caused his PSA levels to skyrocket!

I haven't posted for couple of months, there is now new information to post.

I had the biopsy two weeks ago, and saw the Dr. for a followup today. One of eight samples had a minor percentage of cancer. I am fortunate in catching it so early. I was assigned a gleason's of 6. I am now going to consult again with my family Dr. and will see the urologist again in two weeks. We are scheduling a bone scan and CT. The urologist advised me to take my time and consider my options carefully, I have already done so, I just was not prepared for the diagnosis of cancer, (who is). As I am only 49 radiation is not an option due to the increased risk of incontinence/ED after surgery which could very likely be necessary sometime in the future. I am leaning toward the robotic procedure and have been advised by the urologist that given my present condition and drugs which he can administer to further slow the progression of the cancer we can wait up to a year. This is good as it gives me time to plan so that our business is not adversely affected during my recovery. I'll be back here reading and posting a lot. Thanks for the interest you folks have shown in my situation, wish me luck, I wish the best for you all. Scott

I am scheduled for the DaVinci procedure on July 30. I will be number 8 in this hospital and with this doctor who is being proctored by Dr. Scott Burgess from Tulane. I have been through various stages of stress, etc... and am finally getting used to the idea, (like I really have a choice). I think I have a good doctor and I'm getting the latest procedure, I'll let everyone know how things progress. Best wishes to you all. Scott

Are you saying this will be the 8th robotic surgery by your surgeon?

I am scheduled for the DaVinci procedure on July 30. I will be number 8 in this hospital and with this doctor who is being proctored by Dr. Scott Burgess from Tulane. I have been through various stages of stress, etc... and am finally getting used to the idea, (like I really have a choice). I think I have a good doctor and I'm getting the latest procedure, I'll let everyone know how things progress. Best wishes to you all. Scott


you DO have a choice (as to which surgeon you use); granted its the latest 'procedure'.

Not to rain on your parade but if you're only the 8th patient to have robotic surgery w/this doc I'd seriously think again. There is a learning curve with any procedure and 8 doesn't sound like a lot. Granted somebody has to be the first ones but you don't have to be one of them, especially with yours being caught so early. My surgeon had over 500 robotic procedures behind him. I'm not putting down your doc at all, it's just that it's your body/life in his hands, I'd want the most experienced I could find. Hope it all works out, take care & God Bless.

I completely agree with the above post. Granted the robotic prostatectomy is the "latest procedure." However, newer isn't necessarily always better in medicine. In inexperienced hands robotic prostatectomy can actually have more complications and worse outcomes than the old fashioned open radical prostatectomy performed by an experienced surgeon. You have early disease and plenty of time to consider your options. Good luck.

Thanks for the posts concerning the upcomming surgery; My rational is that this is a skilled surgeon establishing a new procedure in a booming market. He is being proctored by a Dr. who has performed hundreds of these procedures and who will be right there in the operating theater. My Dr. has offered to send me to Duke where they have performed over 1000 Davinci procedures but I feel comfortable with this guy and he and the hospital system have as much on the line as I do. I meet with the Dr. again on 09,July this time with my wife and we will be peppering him with questions. So for now I am scheduled but can reconsider at any time. Thanks again for the comments, I'll let you know about the next consult. Scott

PS the comment about choice was concerning the need for surgery,not that this is the only surgeon!

Hello all,

My wife and I met yesterday with the surgeon who is going to cure my prostate cancer. He is Dr. O'Kelly in Florence, SC and the surgery is scheduled for Monday, July 30. He is proctored by Dr. Scott Burgess, and interestingly enough his brother is also a urolorgist in SC who practices from the same hospital. His brother is older, and better looking, (just ask Dr. O'Kelly). I know I number of you have advised caution concerning the low number of procedures, but I have decided to proceed based on my comfort with Dr. O'Kelly as an individual along with the endorsment of my interinst (who is a personal friend), and other factors. I will be treated with the 'Da Vinci' procedure and am hoping for a complete cure and minimal side effects. I'll let you know how it all transpires. Best to you all. Scott

Hello gpgscott ;

Just a short note to encourage you in your upcoming procedure. For all of the reasons you list, your comfort level with your urologist is paramount. I had da Vinci surgery. I don't share much in the way of my experiences and opinions anymore so I'll spare you the details of my journey except to say, I am very contented with my outcome. I had no surprises whatsoever. I'm so happy that I did not find this forum until "after" my surgery. Had I found it "before" my decision about which treatment to choose, I would have been very confused by all of the conflicting advice that is posted. It seems that you may have had a taste of that yourself and came away a bit confused. This forum should never take the place of the advice of the professionals that are treating you.

Best wishes,
Able

Thanks Able,

I have not been around much we have been traveling to family events, a 50th wedding anniversary for my folks, my dads 75th birthday, a nephews wedding and my wife ran in the Peachtree 10k on July 4th. We are now at home and getting ready for the procedure. I feel ok about it, I wish it was not me but it is and the good thing is that this is a curable disease. I appreciate anyone who takes time to post and will consider all opinions but the final desision for everyone is a personal matter which in my case I base on reseach, logic, and instinct. Thanks again for your kind words, I'll post again after the procedure. Scott

Thanks Able,

I have not been around much we have been traveling to family events, a 50th wedding anniversary for my folks, my dads 75th birthday, a nephews wedding and my wife ran in the Peachtree 10k on July 4th. We are now at home and getting ready for the procedure. I feel ok about it, I wish it was not me but it is and the good thing is that this is a curable disease. I appreciate anyone who takes time to post and will consider all opinions but the final desision for everyone is a personal matter which in my case I base on reseach, logic, and instinct. Thanks again for your kind words, I'll post again after the procedure. Scott

Wow Scott, we are living parallel lives I think.

We just celebrate my parents 50th - and I had the huge party for them, my dad's 75th birthday, my husband's 50th birthday and lots of graduation parties. My husband's surgery is this Monday. I am really struggling with this final week. Hard staying happy, positive, etc. Just so strange to think how much our life may be changing. I'm hoping all goes well, we have an outstanding surgeon, tops in the country from the Cleveland Clinic. He's a great guy and we couldn't feel more comfortable with someone. Still, at our age, facing this, is the scariest thing we've had to deal with in our immediate household. I've had the hardest time communicating my feelings to others - people our age don't understand this I think - and have isolated myself a lot. I try not to, but its been tough.

I'll keep you posted. Best wishes to you and your family.

Debbie

Debbie,

I just wanted to tell you to keep your chin up and focus on one event at a time. This makes it a little easier to get through the whole process. Both my wife and took this approach and it worked pretty well.

I thought that the recovery process would take longer than it has. Two weeks post surgery and I feel as well as I did before. I know that I am still healing and am not able to get back to the tennis court or the golf course, but the energy level is there and the desire to get on with my life is there as well.

Surround yourself with friends and family. All those positive ***** really help.

Good luck on Monday.

Mark

Hi to Debbie and Mark,

Thanks for the post to you both. Yes Debbie it does sound like we are on the same path family and otherwise, your husband is one week ahead of me and trust me I am just as anxious as you. I understand that the CC is one of the best so you are no doubt in good hands. Just try to relax and go with it, thats what I keep telling myself. Please post as soon as he is out of surgery and let us know whats going on.

Hey Mark,

Real happy for you that you are recovering so rapidly, I hope it goes the same for Debbie's hubby and me as well. I believe a large part of it is mental, it sounds like you do too. Thanks for the encouragement. Scott

Hey Scott,

Thanks for the kind words. Just stay positive throughout the entire process and take each segment as it comes.

Pre-op I focused on kegels and losing some weight.
Op Day. I was amazed at the great care I got from beginning to end.
Post-op Discharge from the hospital and living a week with the catheter..
Post-op Catheter removal and pathology report.
Post-op Dealing with the incontinence. I figure it is a small price to pay for good health although it is bothersome at times. I have only been catheter free for 10 days so I am not expecting much at this point.
I am able to get through the night without any leakage, but mornings are interesting as I make the mad dash to the bathroom.. My wife and I now laugh about jumping out of bed in the morning. Keep your sense of humor, it helps.;) ;)

Regards,

Mark

Debbie,

I just wanted to tell you to keep your chin up and focus on one event at a time. This makes it a little easier to get through the whole process. Both my wife and took this approach and it worked pretty well.

I thought that the recovery process would take longer than it has. Two weeks post surgery and I feel as well as I did before. I know that I am still healing and am not able to get back to the tennis court or the golf course, but the energy level is there and the desire to get on with my life is there as well.

Surround yourself with friends and family. All those positive ***** really help.

Good luck on Monday.

Mark

Thank you so much Mark!!!

I'm trying. Tonight is so rough. I've been so crabby today from all the anxiety. Just awful. Can't sleep either. I do have some anti-anxiety meds to try. Taking that now. I'll keep you posted!

Glad to hear things are going so well! best wishes!!!

Hi to Debbie and Mark,

Thanks for the post to you both. Yes Debbie it does sound like we are on the same path family and otherwise, your husband is one week ahead of me and trust me I am just as anxious as you. I understand that the CC is one of the best so you are no doubt in good hands. Just try to relax and go with it, thats what I keep telling myself. Please post as soon as he is out of surgery and let us know whats going on.

Hey Mark,

Real happy for you that you are recovering so rapidly, I hope it goes the same for Debbie's hubby and me as well. I believe a large part of it is mental, it sounds like you do too. Thanks for the encouragement. Scott

Thanks Scott!

I'm trying. The day before... just awful. I'm so crabby :( Not at all what I expected. I'm sure its just how nervous I am.

Have to be at the hospital at 8:30 am. I hope all goes well! So scared. Keep us in your thoughts

Debbie

Hi Debbie,

I have been thinking about you both all day, it is now 3:00pm so he should be settled into his room resting, I hope it all went well. I am looking forward to your post. Scott

Hi Debbie,

I have been thinking about you both all day, it is now 3:00pm so he should be settled into his room resting, I hope it all went well. I am looking forward to your post. Scott

Hi Scott,

I posted under Cancer Dilemma.

Surgery was long. Rough. Please read my posts there.

Good luck to you! I'll keep you posted. I didn't get home until 9pm

Debbie

Hello to everyone from the post op world.

Thank God it is behind me, it went OK, in at 6:30 on Monday morning prep this and that into surgery at about 8:00 and in recovery by 2:30. Monday afternoon was ok, still in a daze from the general and of course a dry raspy throat. The night shift let the pain meds slip and I didn't get any sleep until after 1:00am. The doctor had originally planned to send me home Tuesday afternoon but I just hurt too much, lots of gas and cramping. I ate something real on Tuesday evening broiled fish, brocolli, and carrots which improved my outlook on life a lot and they did a better job of staging the pain meds. I slept most of the night from about 9:00pm to 3:00am. At four a nurse helped me to the toilet, the first time standing was kind of rough, dizzy and lightheaded and the gas moving in my bowel was very painful for about 3 minutes and then all of a sudden releif and it has been better by the hour since. I came home at 2:00 this afternoon and promptly fell asleep for about 3 hours. The report is that the surgery was normal with bilateral nerve sparing. I see my doctor next Thursday for removal of the foley. So far so good, I was bummed out last night when I still felt so crummy but I really feel good right now. Scott

Hello to everyone from the post op world.

Thank God it is behind me, it went OK, in at 6:30 on Monday morning prep this and that into surgery at about 8:00 and in recovery by 2:30. Monday afternoon was ok, still in a daze from the general and of course a dry raspy throat. The night shift let the pain meds slip and I didn't get any sleep until after 1:00am. The doctor had originally planned to send me home Tuesday afternoon but I just hurt too much, lots of gas and cramping. I ate something real on Tuesday evening broiled fish, brocolli, and carrots which improved my outlook on life a lot and they did a better job of staging the pain meds. I slept most of the night from about 9:00pm to 3:00am. At four a nurse helped me to the toilet, the first time standing was kind of rough, dizzy and lightheaded and the gas moving in my bowel was very painful for about 3 minutes and then all of a sudden releif and it has been better by the hour since. I came home at 2:00 this afternoon and promptly fell asleep for about 3 hours. The report is that the surgery was normal with bilateral nerve sparing. I see my doctor next Thursday for removal of the foley. So far so good, I was bummed out last night when I still felt so crummy but I really feel good right now. Scott

Congrats!!!!! Welcome home!

glad to hear that you're doing fine. isn't it amazing how much better you feel with each passing day. for me, the big three issues were: fatigue, fatigue, and fatigue. my first few days of walks were little more than shuffles across the room. :-) that catheter is worse in concept than it is in realization. and you can count the hours until it is removed. i know i did.

again, glad to hear your on the mend. keep posting.

It's Friday morning the 3rd, and my second night at home. I am not yet in my own bed due to the foley. I have two very spoiled cats who own every new thing that comes into the house, I can control them during the day with a squirt bottle but at night the only solution is for me to go the the guest room and shut myself in for the night. I'm dealing with things just fine even made dinner last night just moving very deliberately. The doctor prescribed up to 1 percocet every 6 hours and I have been taking them at more like 10 hour periods. My sugical wounds have stopped ozzing so no more dressings. Feeling better all the time. Scott

Good Morning from one week post op DaVinci.

Better, better, better, is the only way to describe what is going on. Most of the deep pain in my gut is just a memory, I stopped the pain pills yesterday and was down to two a day. I got on my eliptical yesterday and did 5 minutes at 2 mph, enough to get my hr up to about 116 for a few minutes, it felt good, I did the same this morning. There has been no blood in urine for about 4 days now and I am not having trouble with bm. The cursed Foley comes out on Thursday and I can't wait. Wifey might even let me go somewhere by myself today. Now I am just hoping for a normal recovery of urinary function. I am taking it one step at a time but I have to say that it seems to be going very well. Scott

Sounds like you are doing great!!!. I am a couple of weeks ahead of you ...Surgery on the 3rd of July. By the end of the first week of catheter removal, I felt almost as good as before the surgery. By the end of the second week, I felt as good as pre surgery. You will improve greatly everyday.

My continence has been very slow I think....Right out of the box, I had no problems at night or sitting in one spot. Other than that, I feel like a water faucet with a busted washer.

I am able to get to the bathroom with a minimum of dripping during the day and actually in the early AM made it and could hold it before letting loose.

It varies from day to day.

I go for my follow up PSA today and we optimistic about the outcome. I will also meet with a Physician Assistant and I guess we will discuss the course of action for the next few weeks.

Hopefully your path will be similar to mine and we can look at this at some time as a bump in the road.

All the best.

Maury

Best to you as well Maury. Scott

OK, it is now 10 days post op DaVinci, and today I get to loose the extra plumbing and the neat SS piercings in my belly. I have been back to driving the car now since Monday and yesterday we went to pick up our delivery truck which was being serviced while I was being serviced, My wife wanted to drive the big truck but I insisted and it was fine even the rough ride did not give me any discomfort. I'll let you know about the dryness issue. Scott

Good morning,

First morning post foley and everything is going well. I wore a pair of adult diapers to the Dr.s office, there was a small amount of fluid upon the withdrawal of the foley, the actual removal wasn't near as painful as I was expecting, more just an unusual, uncomfortable feeling rather than pain. I stayed dry all night. I got up three times to urinate and all three there where a few bloody drops between the bed and the toilet but no wholesale loss, in fact it took about 5 seconds standing over the bowl to relax enough to begin a stream. Urination burns slightly mostly right at the end. After showering I put on another pair of the diapers and am noticing little bits of leakage with certain movements but again no wholesale flood. The labs on the gland are unconlusive, it is characterized by the path people as "an extremely difficult and unusual case due to marked atrophy of prostatic glands and stroma", it was referred to Dr. Epstein of Johns Hopkins who says "a grade cannot be assigned due to poor cellular preservation consistent with antolysis. The carcinoma extends to resection margins in an area where it is difficult to asses extraprostatic extension versus capsular incision." My Dr. is not particularly concerned as the positive margin is in the left base which is according to the local pathologist "a very unusual place for a positive surgical margin, and this would be a most unusual location for extraprostatic extension. So it seems while I do not have 'clean' margins all around that this one area is little cause for concern and we will know more upon the results of a PSA in one month. All in all I am very satisfied, my Dr. told me to expect erections before the next office visit in one month and that if I did not have satisfactory erections by then we would begin with an ED med. Thats my tale this morning, I hope everyone out there is recovering, preparing, and just living their lives as best they can. Thanks, Scott

Hi Scott,

'Glad to hear you're doing so well.

I had the DaVinci procedure as well and 10 days out of surgery I am gradually gaining daytime continence and am satisfied with the overall results.

On your positive margins topic... I think you are right not to be too distressed about the pathology report at the moment.

An article contains this quote:
"It is important to note that most patients with positive margins are cured."

Cheers!

Jim

Thanks for the note Jim,

Apparently I am very fortunate to be as continent as I am, I switched from pants to a liner today which is much more comfortable, I am retaining urine in my bladder and feel urgency when I need to go, I do have this bit of bloody dribble, a few drops at a time and that is what I am catching with the pants/now liner. I do notice that I have a need to empty my bladder frequently, but like you I am overall pleased at this point. Best wishes to you for conintued improvment. Scott

Scott,

I just posted a reply on the incontinence issue on another thread. It might be of interest. You will improve but it will seem like forever--even if it is only a few weeks.

Jim

Good morning,

It is two weeks post op DaVinci and four nights post foley. I am doing very well. I have been using one pad per day, the main problem is a bit of bloody dribble, just a few drops at a time which I notice this morning is all but non existant. I have been getting up twice at night to empty my bladder, I still notice the need to go with a small amout of fluid. My penis is beginning to relax and is not nearly as sensitive, since the surgery it has been drawn up and very firm to the touch, its feeling much more normal now. I hope everyone else is also continuing to have proper recoveries. Scott

Scott

It is amazing how different everyone reacts to this surgery. I am 5 weeks postop and 4 weeks post catheter.

I am dribbling constantly when I stand up. If I sit still or lay down. I have no problems. I never feel the urge to go, but I don't need to get up at all at night. I do have to make a mad dash to the toilet when I do arise. It is somewhat frustrating, but I am just thankful that the cancer is gone, the PSA number is 0 and I still have a life.

I also had some bloody drops once in a while as well and I was told not to worry about it.

Maury

I am 6 months post op, and I still have to rush when the urge comes. As you said when i am lying down or sitting down the urge is not so much. The moment I stand up i need to go and empty. I am getting more time in between now. Earlier I have to go every hour, but now i get upto 2 or 3 hours. The amount of fluid is 200+ml now. If lying down the amount comes up to 300ml. It seems improving, but at night i have to get up around 2 pm or I leak.

Hi Scott,

I am 13 days post-op and using 2-3 pads per day.

I have no problems at night, except having to get up once or twice to go.

I still have some leakage in the act of standing up or sitting down and laughing doesn't help things!

I wish you the best on your progress!

Jim

It's hard to believe that three weeks ago right now I was undergoing the procedure. The time has passed quickly. I am still using one pad a day, I have a small amount of dribbling first thing in the morning and intermittantly throughout the day usually associated with sneezing, coughing. The bleeding quit two days ago and the burning at the end of urination is almost gone. I have been having some short sharp pains in my penis and some cramping deep in my gut neither of which last to the extent I take any pain meds. My penis is feeling more normal and I am having some expansion and elongation sometimes to the point of being turgid, but nothing that would qualify as an erection yet. I'm feeling just fine about the way things are progressing but am anxious to see a more serious erection response. Hope everything is good for you others out there. Scott

Some pretty significant improvement on day 22 post op. I can sit now in almost any position without discomfort and urination is much easier, a better stream, less spray and fewer dribbles at the end. Scott

Oh and Jim, I hear you on the laughing but I'm not giving it up and I bet you are not either. Scott

Hi Scott,

'So glad to hear your doing better! And, no, I'm not giving up either :-)

Jim