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    Old 05-21-2010, 07:40 PM   #1
    jic
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    Change of life

    It all started back in December 2010 when my Family physician took a routine blood sample to check cholesterol levels and added an additional test (PSA) because I am 57. It was the first time my PSA's were ever checked, on a return visit he advised me that the PSA came back at 5.2 indicating that I could have a serious problem (CANCER) with my prostate, and recommended I find a local Urologist to discuss this high PSA number or travel an hour or so away to a teaching Hospital that had a state of art Urology center. I love driving so it was a no brainier, before making the appointment, my Doctor ordered another test to confirm the results, this time it came in at 4.8, he said it was to high to be ignored so after much procrastination I made an appointment. On my first examination I had a DRE, the Doctor reported the size of the Prostate was smooth, and normal except, hard on one side he recommended I have a biopsy. Again I procrastinated but finally had the 12 point biopsy and when I received the results, it changed my life.

    The results are as follows: 3+4=7 left apex, Adenocarcinoma in 1 of 2 cores, involving 5% of needle core tissue and measuring o.65mm in length.

    3+4=7 Left base, Adenocarcinoma in 1 of 2 cores, involving 5% of needle core tissue, and measuring 1.4mm in length.

    Gleason Pattern: Primary (Predominant) Pattern: Grade 3
    Secondary (Worst Remaining) Patter en: Grade 4
    Total Gleason score: 7

    Up until two weeks ago, I would have had no idea what someone was talking about if they referred to any of the above information. However after spending countless hours of reading other accounts in this forum, I have bought books, studied the anatomy of the Prostate and recently interviewed with a Radiation Oncologist to help me make a decision as to which course I should take to treat my Prostate Cancer.

    To be honest, I think, the more I learn the further away the answer seems to be, mean while I'll keep studying and taking advise from anybody that can give me some incite on how to come up with a decision that can and will effect the rest of my life.

    JAYK
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    Old 05-22-2010, 06:49 AM   #2
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    Re: Change of life

    Just keep doing what you are doing. Read everything you can. This will help you make an informed decision. Then don't look back. I did this seven years ago. I am still very happy with my decision. It was right for me. I had Brachytherapy. It may or may not be right for you.

     
    Old 05-22-2010, 09:02 PM   #3
    jic
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    Re: Change of life

    White Lighting

    Thank you for the advice, I've already made up my mind, I guess I'm just searching for someone to tell me it's the right decision. After hearing the pros and cons of Radiation treatment from a the Radiation Oncologist, it confirmed my already preconceived idea that it could work for me but I don't think I would ever feel it was the right decision.

    From the moment I was diagnosed with Prostate Cancer, there's only one thing I've have wanted and that is to remove it, and thats not even my worse fear, it's life there after.

    Will I be one of the ones that fall into the low percentage group and loose all bodily functions?

    Do I prepare for the worst and hope for the best, how do you prepare your state of mind not knowing the outcome?

    I will soon have an appointment with the Surgeon, from what I learned so far he is well experienced in robotic radical prostatectomy and will be using the most up to date machine in a teaching Hospital. Are there any other bases I need to cover?

    JAYK
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    Old 05-23-2010, 06:17 AM   #4
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    Re: Change of life

    I was that way also. .... till my doc (surgeon) told me he thought that I should talk to a Radiation Oncologist. Made the appointment and after three hours of talking with him just knew that Brachytherapy and his care and treatment plan was right for me. I had done more homework before the appointment and had questions that he answered. I was comfortable with the decision, had the blessing of the trusted surgeon and it just made sense.

     
    Old 05-23-2010, 04:50 PM   #5
    IADT3since2000
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    Re: Change of life

    Hi JAYK,

    I would like to join White Lightning in welcoming you to the board! Yes, all of us would rather not have a reason to have joined, but we are a good group.

    I'll add some thoughts in green to your post #3 in the thread, building on White Lightning's helpful comments.


    Quote:
    Originally Posted by jkillesr View Post
    White Lighting

    Thank you for the advice, I've already made up my mind, I guess I'm just searching for someone to tell me it's the right decision.

    I generally try to stand back a bit when I read a comment like yours, but in this case I think you need to kick the tires hard again and give that motor another look before you fully commit to surgery. Okay, this is prostate cancer and not buying a used car, but some of the principles are similar regarding risk taking. By the way, I too selected surgery and called Johns Hopkins to set up an appointment for my challenging case. They rejected me, but my initial feeling of dismay and rejection turned in time into gratitude. It's so important to match the therapy to your circumstances, as well as your preferences. Surgery may still turn out to be the option you like best, but there are some more key bases to touch.

    After hearing the pros and cons of Radiation treatment from a the Radiation Oncologist, it confirmed my already preconceived idea that it could work for me but I don't think I would ever feel it was the right decision.

    From the moment I was diagnosed with Prostate Cancer, there's only one thing I've have wanted and that is to remove it, and thats not even my worse fear, it's life there after.

    There are a couple of facts I thought you might want to know, but I'd like you to know first I've wrestled a bit whether to tell you; I don't want to discourage you, and belief and confidence do play a role in success, I think. I've decided to pass this on because the second part of your sentence shows there's actually something you want more than to "remove it," and removing it may compromise "life there after." Okay, stop reading here if you wish, but here are the facts. I'll follow the discouraging facts with some very welcome information that cushions the impact.

    In studies done on good, low-risk surgery candidates (probably Gleason 6s, PSAs <10, stage 1 and 2a), substantial percentages already had prostate PSA cells, thought to indicate prostate cancer, in their circulating blood and bones! In one study of patients with clinically localized prostate cancer just prior to planned surgery, 57% - more than half - had PSA in bones when one side of the body was checked, and 74% - virtually three quarters - had PC cells already in the bones if both sides of the body were checked! (Source: Melchior, 1997, Journal of Clinical Cancer Research, p. 7 of 8; you can check the abstract at www.pubmed.gov, a site we can use on this board because it is Government sponsored, and there is a link to a free copy.) Therefore, while researchers aren't sure that all PSA in bones is due to cancer, they are leaning strongly that way; it's more likely than not that you already have some PC cells in your bones! Moreover, this study and others have found a lower but substantial percentage of patients had circulating tumor cells in the peripheral blood (meaning not just in the prostate but rather circulating throughout the body) of low-risk prostate cancer patients.

    So where's the good news? Here it is: despite these facts, the proportion of patients with prostate cancer who have recurrences is "by far" below the proportion who have PSA in their bones! As the authors put it, "We speculate that dissemination of prostate cells to the bone marrow in patients with prostate cancer occurs frequently, but that in most cases, especially with curable tumors, the cells do not survive...." There is still uncertainty as I understand it, but the question appears to hinge on whether the cancer is "curable."

    PARTIN TABLES

    Okay, now lets look at the odds that your cancer is still within the range of surgery (basically not extending beyond the capsule or seminal vessicles). You probably know about the Partin Tables, but I'm not getting a sense that you have taken the odds into your calculation. Am I wrong? My copy of the Primer has the Partin Tables as of 2001. I think there has been an update, but the new figures are likely very close to the 2001 figures. Let's look at figures for a case like yours: a PSA in the 4.1 to 6 ng/ml range, T2a (could be T2b or T3 based on what you have posted, do you know?), and a Gleason of 3+4=7. The table says there is a 46% chance that the prostatec capsule has been penetrated (but small chances of seminal vesicle or lymph node mets). But if the stage is notched up to T2b, the chance of penetration increases to 51%, slightly better than a coin flip. If the capsule is penetrated, then surgery is not going to get it all!

    However, brachytherapy is able to deliver a powerful dose to the prostate itself and can also, in the hands of talented doctors, give a strong dose to the key millimeters just beyond the prostate. That's critical, because, for prostate cancer caught early, it's extremely likely that cancer that has spread beyond the capsule is still within those crucial few millimeters that can be adequately dosed by seeds placed around the capsule.

    You may want to do some additional staging to gauge what you are up against. The Gleason scoring should be done by a pathologist with special experience and skill in prostate cancer, not just by a general pathologist, because quite often general pathologists somewhat underestimate (and sometimes overestimate) the grades of the disease. it's common to get a second and expert pathology opinion. (On the other hand, your biopsy report provided the kind of detail that is needed; your pathologist may have been an expert, but check whether he's a generalist (doing children, adults, men, women, dogs, cats, you get the idea .)

    You may want to get a repeat PSA, to help gauge the PSA velocity, a very useful piece of information, and along with it a PAP test (prostatic acid phosphatase), which is quite useful in predicting metastases and the success of both surgery and radiation. (The Primer gives some of the key data about that.)



    Will I be one of the ones that fall into the low percentage group and loose all bodily functions?

    Do you have urinary trouble now? If so, that's a consideration against radiation, but that consideration is just one, with others, including cancer control and cure, being primary.

    By the way, a single course of triple hormonal blockade for thirteen months with mild drug maintenance has had stunning success, with recovery from side effects within a few months and long-term cancer control, but it is quite unconventional. (Longer term intermittent triple blockade has been the only therapy I've used.) I can provide leads and more information if you wish.


    Do I prepare for the worst and hope for the best, how do you prepare your state of mind not knowing the outcome?

    I will soon have an appointment with the Surgeon, from what I learned so far he is well experienced in robotic radical prostatectomy and will be using the most up to date machine in a teaching Hospital. Are there any other bases I need to cover?

    There's a good, but far from certain, chance that he could cure you, in your particular case circumstances, with minimal side effects.

    You could go an extra mile and get an endo-rectal MRI with spectroscopy from a center of excellence like UCSF or Memorial Sloan Kettering. You could get a color Doppler ultrasound biopsy to determine blood vessel support of the tumor (vascularity), size, location, etc. You could go to Belgium to get a Combidex scan to determine spread to any lymph nodes throughout the body.


    JAYK
    Good luck to you, and take care,

    Jim

    Last edited by IADT3since2000; 05-23-2010 at 07:50 PM. Reason: Changed "prostate cancer cells" to "prostate PSA cells", etc., about 10:44 PM. Corrected Melchoir to Melchior. Blood %.

     
    Old 05-25-2010, 01:52 PM   #6
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    Re: Change of life

    I would add one more important consideration to Jim's very comprehensive and detailed reply. If it turns out you are a good candidate for curative surgery, i.e. fully organ confined as ascertained by endo-rectile MRI, color doppler or whatever is the latest most reliable means then your risk of those life changing side effects can best be minimized by the skills, experience and technique of the surgeon. What I'm saying is that the surgical technique, open prostatectomy, laporoscopic or robotic are trumped by the skill and experience of the surgeon you select. A world class surgeon such as Walsh, or Scardino who have performed thousands of prostaectomieswill have better and more reliable outcomes with the older open surgery than a less skilled and experienced surgeon who specializes in the robotic. Also you should be aware that some of the most reknowned and experienced robotic
    surgeons have reverted to the slightly older laporoscopic procedure because they've concluded that patients experience fewer side effects when the surgeon actually uses his own hands for this intricatee surgery rather than the extended arms of the robot from across the room.
    Hope this doesn't overwhelm you but I thought you should have access to these facts if you end up choosing the surgical option.
    Best of Luck with whatever your course. We've all been through the agonizing process of discovery, research and decision making you're going through now and it isn't easy. I only wish I had access to the knowledge and support available from these boards when I went through it 10 years ago, but fortunately I muddled through by having consultations with 4 of the top surgeons in the top centers of excellance for prostate cancer at the time: Columbia Presbyterian, Sloan Kettering,, Johns Hopkins,and Cedars-Sinai. I then went with my gut as to which surgeon would do the best for me. The surgeons don't appreciate surgeon shopping but it works for me. !0 years later I'm fine and have no regrets about my decision.
    Bob

    Last edited by shs50; 05-25-2010 at 01:57 PM.

     
    Old 05-31-2010, 04:32 PM   #7
    jic
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    Re: Change of life

    Hello Jim

    I agree, we are a good group and I would like to say, that I'm glad to be a part of it! Did I just say that, well you know what I mean. Thank you for taking the time out to give me support!

    In the beginning everything seamed to be overwhelming, I was lost but now thanks to everyone on this site, I can see the light at the end of the tunnel. I've come to realize how fortunate I am, I read about others and their condition, it makes what I'm going through, not seem so helpless. I've received good direction and as you say, I'm going back and give them tires a good kick.

    I have to say, the part that you wrestled with a bit to tell me, I had often thought about. After all I think blood has to travel through the prostate to nourish the cells, so what's stopping the cancer cells from floating away. It makes since that this cells would be detectable all though the body. I understand your point, and figure I'll cross that bridge if or when I come to it.

    I like the part at the end (the good news) the part where the cells to not survive, I would like to think maybe I could have a say about that, changing my diet, daily exercise and supplements, to minimize the areas in the body that cancer cells might thrive.

    They said my cancer is localized in the Prostate, I think more in teams that that's where the cancer has caused damage, for whatever reasons. They say it is curable, we'll see! I will definitely take your advise and get a second opinion before committing to the surgery. My appointment to see the Surgeon is scheduled tentatively July 5. Is it alright to mention the Surgeon's name and Hospital on this site? How do I do an objective search of his record before the interview?

    You mentioned the "Partin Tables" and NO you are not wrong, I have not taken the odds into my calculation, it's the first time I've heard of this. I plan on asking the Hospital to send me a complete report on any findings, are they obligated to give them to me, for analysis by another Pathologist or do I have to go somewhere else and get another DRI and biopsy done? I plan on going to my Family Doctor to get additional PSA test.So far they have given me whatever I have asked for, however I simply did not know what to ask for (example am I a T2a,T2b or T3). Can my Family Doctor do a PSP test?

    I have some Urinary trouble now, its kind of strange, some times the stream is very strong and other times very weak and either way happens when I go a lot of go a little. Some days the urge to to go is not demanding 2 or 3 times and other days I go ten times. The Radiation Oncologist did not seam to think it was a problem. Another strange occurrence is I leak seminal fluid sometimes when I have a heavy bowl movement, again everyone says its strange but don't seam to be concerned about it, I do plan on mentioning this to the Surgeon in case my rectum is exceptionally close to the Prostate, (my own guess).

    I'm still reading, however I must admit some days I just have to go without thinking, reading, or talking about my Prostate Cancer, it gives my mind a break, and then like a race horse, I'm chomping at the bit.

    JAYK
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    Old 05-31-2010, 05:18 PM   #8
    jic
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    Re: Change of life

    Hello Bob

    Thanks for sharing this information, it will be a new quest for me to dig into, now that I know what I have is not the end of the world. I still have much research to do, to gather all the information that will provide me with the decision of which treatment plan I will pursue.

    The four Centers and Surgeons you mentioned that were the top at the time, are they still the top. What do you look for when picking a Center or a Surgeon? The Surgeon I will be interviewing with in July does about 400 Da Vinci Prostatectomies a year, I'm not sure for how many years he been doing them, but I plan on finding out.

    It's encouraging to hear you had this done 10 years ago, and everything is fine! I have four more years to retirement and I always hoped for at least 10 years of healthy retirement, we'll see!

    JAYK
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    Old 08-18-2010, 02:36 PM   #9
    jic
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    Re: Change of life

    Hello guys,

    Well as it turned out I was a T1c, and based on the partin tables it helped me make my decision to have a prostatectomy. I had my surgery on Aug.11 and my Surgeon said the reconstruction went very good, and he was optimistic of the results we could expect of the biopsies taken around the surrounding tissue during surgery. I should receive the results when I go back to have the staples removed and the catater taken out.

    I have started a blog leading up to the surgery, and will continue to post daily during my recovery, after all I have nothing else to do for awhile, and hopefully it could help someone else to get some insight into what to expect. I have posted my blog under Prostate Cancer and seen there was an option to post the blog to this string, would that be a good idea?

    Thanks JKAY
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    Old 08-18-2010, 05:03 PM   #10
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    Re: Change of life

    Hi Jayk,

    I am in a similar situation you are in. My first ever PSA was 5.87. I had two biopsies. First biopsy 12 cores-negative, second biopsy 2 from 26 cores- positive. My Gleason Score is also 7 (3+4). Clinical staging T1c.

    My medical oncologist sent me to a see a radiation oncologist tomorrow. He also has scheduled me to see another urologist next week. This urologist is supposedly the top man in town, (although my own urologist has done over 500 cases of robotic radical prostatectomy). Last night I talked to my friend who is his patient. After one and a half year post surgery, my friend still suffers both impotence and incontinence. He emphasized that it is not erectile dysfunction, it is impotence.

    I have watched video of radical prostatectomy and I wonder how the urologist could avoid or spare all the nerves surrounding the prostate gland, seminal vesicles and bladder.

     
    Old 08-18-2010, 09:11 PM   #11
    jic
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    Re: Change of life

    Hello Netirati,

    I will enter my responses in green to make it a little easier to flow.
    Quote:
    Originally Posted by Netirati View Post
    Hi Jayk,

    I am in a similar situation you are in. My first ever PSA was 5.87. I had two biopsies. First biopsy 12 cores-negative, second biopsy 2 from 26 cores- positive. My Gleason Score is also 7 (3+4). Clinical staging T1c.

    It sounds like you have been doing your homework, and "Yes" we do have some similarities, there is so much to take into consideration, besides the clinical data, we should consider age, health, attitude, support, and the fact that each and every one of us are built differently. However the clinical data is a powerful tool that if used to it's fullest can help us in making in informed decision in choosing a treatment plan.If you haven't already I would strongly suggest reading the book (A Primer On Prostate Cancer, The Empowered Patient's Guide) by Strum and Pogliano, you can find in on-line.

    My medical oncologist sent me to a see a radiation oncologist tomorrow. He also has scheduled me to see another urologist next week. This urologist is supposedly the top man in town, (although my own urologist has done over 500 cases of robotic radical prostatectomy). Last night I talked to my friend who is his patient. After one and a half year post surgery, my friend still suffers both impotence and incontinence. He emphasized that it is not erectile dysfunction, it is impotence.

    Even though I did a lot of reading, (another book that is available, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer, second edition) and thought I new all I needed to know about radiation treatment it wasn't until I had my appointment with the Radiation Oncologist, that I found out how much I didn't know, she really helped me and my wife to understand both the positive and negative outcomes of this treatment. In my case both the Radiation Oncologist and Surgeon felt strongly that either treatment option would work for me. Any treatment option has the risk of collateral damage. I would have never based my decision on the outcome of one individual, I did the homework and then made a personnel choice.

    I have watched video of radical prostatectomy and I wonder how the urologist could avoid or spare all the nerves surrounding the prostate gland, seminal vesicles and bladder.
    I have a deep respect for you, there is no way I would have wanted to watch the real deal before going into it. The animated version was enough for me to get an idea, then I talked to one of the Interns that sat in on my surgery explain a lot to me, it sounded really cool. I know this might sound really crazy but I think as a whole it was pretty awesome. Have you read my blog, it goes into detail the whole experience I will posting my progress as things unfold? My main concern now is the outcome of the biopsies that were taken during the surgery.

    I wish you the best
    JKay
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    Old 08-19-2010, 04:33 AM   #12
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    Re: Change of life

    Quote:
    Originally Posted by Netirati View Post
    Hi Jayk,

    I am in a similar situation you are in. My first ever PSA was 5.87. I had two biopsies. First biopsy 12 cores-negative, second biopsy 2 from 26 cores- positive. My Gleason Score is also 7 (3+4). Clinical staging T1c.

    My medical oncologist sent me to a see a radiation oncologist tomorrow. He also has scheduled me to see another urologist next week. This urologist is supposedly the top man in town, (although my own urologist has done over 500 cases of robotic radical prostatectomy). Last night I talked to my friend who is his patient. After one and a half year post surgery, my friend still suffers both impotence and incontinence. He emphasized that it is not erectile dysfunction, it is impotence.

    I have watched video of radical prostatectomy and I wonder how the urologist could avoid or spare all the nerves surrounding the prostate gland, seminal vesicles and bladder.
    Hi Netirati,

    Adding a few words to Jayk advice, (it may help who reads this) I would like to inform about the experience from two of my friends cases that, as me, chosen surgery. They were in similar situation as yours. Their PSA pre-OP was 2.8 and 6.1 and were Gs6 and GS7, both T1c. One of them (PSA 6.1) choose RP with the nerve spare technique. He is just conducting a normal life with no ED problem. His PSA has been 0.06 level now 9 years The other friend and I went through RP without nerve spare so that we have ED. My second friend (PSA=2.8) is ok with very low PSA of 0.03, now six years.
    My case, PSA=24.2 pre-OP (now 0.79), I had little chances for a successful (free of cancer) result in choosing surgery, probably radiotherapy would have been better, but after ten years surviving the cancer I can say I am doing just fine, no disturbing side effects, no symptoms and still active in lovely nights. I wrote about my experience in one thread down here.
    (Could you please give the address of Jayk’s blog)

    Wishing you the best
    Baptista

     
    Old 08-19-2010, 06:48 AM   #13
    jic
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    Re: Change of life

    Hello Baptista,

    Please find below the address to my blog!

    Quote:
    Originally Posted by Baptista View Post
    Hi Netirati,

    Adding a few words to Jayk advice, (it may help who reads this) I would like to inform about the experience from two of my friends cases that, as me, chosen surgery. They were in similar situation as yours. Their PSA pre-OP was 2.8 and 6.1 and were Gs6 and GS7, both T1c. One of them (PSA 6.1) choose RP with the nerve spare technique. He is just conducting a normal life with no ED problem. His PSA has been 0.06 level now 9 years The other friend and I went through RP without nerve spare so that we have ED. My second friend (PSA=2.8) is ok with very low PSA of 0.03, now six years.
    My case, PSA=24.2 pre-OP (now 0.79), I had little chances for a successful (free of cancer) result in choosing surgery, probably radiotherapy would have been better, but after ten years surviving the cancer I can say I am doing just fine, no disturbing side effects, no symptoms and still active in lovely nights. I wrote about my experience in one thread down here.
    (Could you please give the address of Jayk’s blog)

    Wishing you the best
    Baptista
    To get to Jayk's blog, click on the tab at the top of HealthBoards home page entitled (USER BLOGS) then type in the search browser Prostate Cancer, the blog is called "D DAY". I will simply add comments to update my daily progress.

    JAYK
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    Old 09-04-2010, 03:01 PM   #14
    jic
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    Re: Change of life

    It's been almost a month since I've had my prostatectomy, and have posted most of my recovery on my blog, however I will be seeing my Surgeon in two weeks and have a couple of questions or should I say concerns I would like to know about NOW.

    So these questions are for those of you that have had this procedure, and might be able to give me some insight; if you experienced the same sensations that I have.

    1. Most of the time it still feels like I have a catheter in me, even though it was taken out two weeks ago. When I have to urinate the feeling comes more from the urethra (the part of it that is in my penis) rather than pressure in the bladder. I can't say these sensations are painful but they are a little uncomfortable, sometimes it seems as these sensations are improving and other times unchanged. As far as being incontinent, it's not a problem at all, I used depends for two days after the catheter was removed, but other than that I've only had 5 or 6 very little leaks in the last two weeks. Are the sensations normal?

    2. I must say BM's are still challenging, although everything is working, I still feel tender inside, and I am not confident in pushing and even passing gas, I guess this will get better with time?

    Any feedback from somebody that has been where I am right now would be greatly appreciated. JKAY
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    Old 09-05-2010, 06:46 AM   #15
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    Re: Change of life

    Quote:
    Originally Posted by jkillesr View Post
    It's been almost a month since I've had my prostatectomy, and have posted most of my recovery on my blog, however I will be seeing my Surgeon in two weeks and have a couple of questions or should I say concerns I would like to know about NOW.

    So these questions are for those of you that have had this procedure, and might be able to give me some insight; if you experienced the same sensations that I have.

    1. Most of the time it still feels like I have a catheter in me, even though it was taken out two weeks ago. When I have to urinate the feeling comes more from the urethra (the part of it that is in my penis) rather than pressure in the bladder. I can't say these sensations are painful but they are a little uncomfortable, sometimes it seems as these sensations are improving and other times unchanged. As far as being incontinent, it's not a problem at all, I used depends for two days after the catheter was removed, but other than that I've only had 5 or 6 very little leaks in the last two weeks. Are the sensations normal?

    2. I must say BM's are still challenging, although everything is working, I still feel tender inside, and I am not confident in pushing and even passing gas, I guess this will get better with time?

    Any feedback from somebody that has been where I am right now would be greatly appreciated. JKAY
    Hi JAYK

    I also had similar experiences when urinating on the first 2/3 days (not one month) after RP, however, my 15 days post surgery were spent in the hospital on a daily monitoring. As far as I read, the sensations could be a cause from an infection at the sphincter. After removing the prostate, the portion of the urethra inside it, it is also cut off (our penis become shorter). The urethra tip is so attached to the bladder neck (tiny muscles nerves) making a short of a “V-neck” shape (detrusor/trigonal musculature), where the control of continence is done. Urine passing these areas will cause in some cases infection, which inflammation could cause inefficient bladder neck opening or restrict urines normal flow. Light cases can be treated with anti-inflammatory pills, but in extreme cases it requires transurethral surgery (through the urethra) for bladder neck incision, which is highly effective to unblock the "pipe", and easy to cure.
    Your doctor will want to know about that the soonest.

    Wishing you the best
    Baptista

     
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