New C.U.P ( complete urethral preservation ) procedure in prostatectomy to help post surgery incontinence? Any feedback, any one had this ?

Hi Loobjo Thank you for sharing this information as it’s so important  for men and women to being informed of any new treatments available and I’m sure it will make a difference to a lot of men knowing there’s an option like this available. 
I can’t help but be annoyed at the initial position you found yourself in with having active surveillance at a Gleason 7 and I think this is also a good piece of information to share as men need to be aware that there is a risk of escalation with a “4” and monitoring needs to be a strong part of AS at that level.

Hopefully this will all be behind you now and you can move on.
Best wishes for you both and your husband's recovery.

L

Hi Loobjo I was just reading a medical paper on this procedure which is a fascinating read, unfortunately I can’t share it here. It seems that it makes a huge difference to incontinence and recovery by keeping the urethra intact and also there is no loss of length as the section is retained, The question I would be asking your consultant is: “ As this is a relatively new procedure what monitoring will my husband be having from now on. What are your thoughts on the piece of urethra left intact and are there any concerns that there could be a possibility of the urethra having residual micro cells left from the tumour,” Your consultant has previously said that the cancer was faster growing than expected and it had spread throughout the prostate so I think that’s a fair and valid question.  The paper I read was mainly concerned with incontinence and recovery, data on reoccurring was not mentioned. 
I don’t want to be negative about this as it seems a very good procedure and it will make a lot if men’s lives better,  but I would personally like to know after care and what monitoring would be offered as well as its new. 

L 

Absolutely fascinating and amazing isn’t it , I even found pictures of them  doing  it online . I have all those doubts  about it that you mentioned . I’m going to make a list of questions to ask on our next visit to hospital in October. I’m concerned about the urethra that wasn’t cut out as it was sitting in a prostate full of cancer for I don’t know how long . How did they get that bit out without pulling any cancer out . I’m sure it’s all ok but we weren’t even aware of this til a couple of days ago . And yes disgusted we were put on active surveillance now we understand more . I wouldn’t advise surveillance to anyone now . We feel lucky . The consultant changed from out 1st visit initially to 2nd visit which I think was for the better he was more pro active . 

Yes it is fascinating and hopefully recovery will be a lot easier, It‘s playing on my mind though as to why you were never told before surgery what was happening with retaining  the urethra.

Another question I would have is; what data they have on recovery and scaring of the surrounding area of the incision. My husband had RT obliterating the prostate and I’m presuming along the sides of the urethra? And it was made quite clear to him there could be problems later with scaring, tightening up and obstructing the flow and he may need another procedure (turp?) in the future. Hopefully you can get some answers. Of course this all links to ongoing aftercare and clarifying what you can expect next. Will you come back here after your meeting in October and let us know the follow up conversation as it will be most helpful for others. 
Onwards and upwards for you both, and thanks again for sharing such important and interesting information. 

Loobjo,

thanks for the information and good luck going forward.

My surgeon mentioned that many things were being tried and he said that sectioning the prostate to remove it leaving the urethra intact was one of them.

I wonder how they avoid releasing cancer cells during this procedure as the idea of removing the prostate intact along with a length of urethra is specifically to avoid shedding cancer cells? Perhaps diathermy allows them to cut, kill and seal as they go? Lasers would burn too? V interesting approach.

Does CUP automatically mean no nerve sparing is possible as that means complete loss of erectile function? Maybe it doesn't but follow up advice on achieving erections would be useful to for us all to know if you have time.

It would be interesting to know what influenced him choose to undertake this procedure especially if this had not been consented for too. Maybe something he saw during surgery?

Regards

Albert

It was a shock to us when the 6 week post surgery telephone call happened last week and Dr told us . Initially we were just happy that he had done something to prevent incontinence but know thinking lots about all different things , especially like the cancer cells escaping . We imagined they used lasers to burn and seal as they did it , but we are a complete blank other than what I’ve  read online . No nerve sparing  was discussed before surgery as surgeon thought cancer was right to the edge of prostate and he wanted to make sure he got rid of it all which he is hopeful he has as it was right up to the margin of prostate . The  procedure was never mentioned in the meeting we had when he explained the cancer had grown quicker than expected and the prostate was now full of disease.  we had already decided on surgery before we had entered the meeting so we just got on with arranging it  . we are happy no incontinence so just concentrating on recovering but confused as to what was done , why it was done and why weren’t we asked . Husband at moment is just relieved it was caught in time , feels he’s extremely lucky as we were seen and operated on in 4 weeks which we thought was amazing this was NHS in West Midlands I’m sure when it sinks in a bit more he will start questioning it . Definately will be questioned by me at meeting in October . 

Interesting.  Every day’s a school day.   AW

Loobjo,

4 weeks is astonishingly fast!

I was nearer 6 months. I wonder how long the average wait is across the country?

We were very suprised and pleased . Initially told 8-10 weeks on the Friday , had phone call Monday to say 4 weeks time . Very very pleased with everything at urology at New Cross , fantastic place . can’t praise them enough . I was wondering what the average wait time was also ?