Post surgery expectations

Hello TheeAndrew 

Welcome to the group although I am so sorry to find you here. 

I still own 95% of my Prostate so I can't help you on the surgery questions - I know we have plenty of Community members who will be along who have "been there - done that" with answers for you.

I am curious that's all 

TheeAndrew said:

Probably gonna opt for Prostatectomy. I

Have you met with the oncology team and considered other options such as Brachytherapy or HT/RT? - If you want a balanced opinion about these a bit more information would help - PSA's Gleason Score and TNM staging.

Feel free to ask anything - nothing is too trivial.

Best wishes - Brian.

Options provided in my health trust are surgery or 20 treatment Radiography 

PSA 10.8

PIRADS 4

Gleason 3+4

I did raise Brackytherapy with oncology but wasn’t an advised treatment. 

Hello TheeAndrew 

Wow -my thoughts, and these are only my personal thoughts.

* I would be asking why Brachytherapy wasn't on offer.

* For someone with a "strong sex drive" - surgery is a "major operation" and the chances of losing the ability to have a natural erection with surgery are about 40% (link below).

NICE Prostate Cancer - Diagnosis and Management

* Radiotherapy is "done and dusted in 20 fractions"

If I was given the options with your situation I would be asking the surgeon about the chances of retaining a natural erection and I would be having a word with oncology and discussing Radiotherapy and the need to retain a natural erection.

The facts in the Nice documentation are compelling in your case.

Best wishes - Brian.

If sex drive is important and obviously to many it is then probably avoid surgery cos of potential issues.

Radiotherapy is easy, I had it in 2017 and more or less back to normal.

Best wishes 

Steve 

Hi,

I am 10 weeks post op. Not exactly your age bracket, but a young feeling 60.

Since the op I have not lost any of my drive as such. Still super attracted to my missus and no drop in desire, but spontaneous erections are not a thing.

The surgeon managed to spare nerves on one side, but I still only have a small physical reaction (imagine pouring some water into a long balloon from a jug). It is encouraging, but not there yet. Not giving up though as it’s only been 10 weeks. However, ED clinic for testing vacuum devices etc. planned for next week has been very annoyingly postponed two months!! 

The nerves in the penis themselves are still very much alive, so feeling and arousal etc., etc. is still very much present and enjoyable, just not accompanied by the accustomed erection and all that goes with that…

Hopefully things will continue to improved step by step and if the hospital gets its act together and I get my ED appointment, things should progress in leaps and bounds.

Surgery is therefore something to be VERY carefully contemplated. Nerve sparing does help, but it is uncertain. It is difficult to be in the situation where things aren’t working as they used to and occasionally it does weigh heavily on your mind as the future is unknown. I am taking each twitch and feeling as positive and being optimistic though.

It is definitely a decision to be made as a couple as it does affect how you are together. We talked it through in detail up front and agreed we would work through it together. It’s not easy, but we are both looking on the bright side as much as we can.

Wishing you the best with whatever decision you make!!

And on the wee front. Whatever your planned treatment, start pelvic floor exercises now and do them frequently. I did and am now on day 8 being completely pad free only 9 weeks after catheter removal! 

Cracking, honest post Fzh2p0 

I had a TURP operation and used the "Squeezy App" for my pelvic floor exercises.

Link here - Squeezy App.

best wishes - Brian.

So useful. Thank you

Hi, I have a strong sex drive, and opted for Brachtherapy, see my bio. I am now almost fully back to normal… I would like to know your consultants view..  I accept I am quite a bit older, so maybe that’s why they think surgery is the answer, however, there does seem to be a lot more risk…. 

They don’t do it in my hospital trust it seems. I may go back to my private healthcare, which I haven’t used to date, and ask for a second opinion re Bracky