Six Week Post-Op

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New Member

Date Joined Sep 2008
Total Posts : 7
   Posted 10/8/2008 11:17 PM (GMT -6)   
I had a radical prostatectomy on August 28, 2008.  Today was my six week post-op appointment with my urologist. 
I'm happy to report that I'm feeling much better, overall.  I can finally see beyond today and feel like I can make plans to do things in the future--something I wasn't so sure about a few weeks ago.
The surgical pathology recorded my prostate at 43 grams and showed adenocarcinoma (Gleason score of 6) involving both right and left lobes of the prostate staged as pT2 (more extensive than reported in the original biopsy).  The tumor was within 1 mm of the surgical margins but those margins were negative and no evidence of metastasis was found in any of the lymph nodes, bladder, seminal vesicles or vas deferens.  All of this is, of course, good news.
I'm regaining some bladder control--e.g., I manage to stay dry during the night.  Leaking during the daytime, however, varies depending upon the amount of fluids I drink and the degree of fatigue I experience throughout the day. 
Finding the right size "pads" to cope with the incontinence is a challenge.  Underwear type  (e.g., Depends) are a bit bulky, uncomfortable and unnecessary as leakage isn't usually great enough to warrant wearing them.  These do provide a little more secure protection, though, so I use them when I have to be out. 
Kotex overnight pads work well except that they are too narrow and I've had an accident or two where I leak around the side--not my idea of a good time, especially in public! 
So, I'm wondering--what do some of you use for absorbant pads? 
I also have to report that I have had no erections since surgery.  This is disappointing but not unexpected. My doctor put me on 2.5 mg of daily Cialis and said the objective is to get blood flowing, not necessarily produce erections.  Once we have established good blood flow, we will work on the erections.  He didn't set a time-table on restoration of sexual function and while I don't mean to be impatient I am, understandably, concerned about that.
Have any of you have followed a similar course of action?  If so, how you feel about the outcome?  Has anyone found any "non-medical" treatments that help restore sexual function?  Has anyone tried Horny Goat Weed with any success?  I ask because the doctor told me that a prescription for Cialis, etc., could cost between $50-100 per month, depending upon my insurance coverage. 
Thanks for any suggestions and thoughts.  Best wishes to all of you who are facing these issues, as well.

Steve n Dallas
Veteran Member

Date Joined Mar 2008
Total Posts : 4838
   Posted 10/9/2008 4:38 AM (GMT -6)   
I used the following:
I'm about 16 weeks post surgery and haven't seen anything close to an erection. Doc gives the impression he won't be concerned about this the first 12 Months. <yikes>
Are you using a pump? They're suppost to go hand in hand with Cialis to help kepp the little buddy healthy. I use:
I have the manual model....about $600.00 - my United Healthcare insurance paid 80% The battery version is another 100 bucks.

Age 53   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Gleason - 6
(biopsy done March 4, 2008-> 2 of 12)
06/25/08 - Da Vinci robotic laparoscopy
10/03/08 - 1st Quarter PSA -> less then .01

Surgeon - Keith A. Waguespack, M.D.

Las Colinas and Plano Offices


Regular Member

Date Joined Apr 2008
Total Posts : 270
   Posted 10/9/2008 8:57 AM (GMT -6)   
I am not sure what you are referring to with Depends unless you are looking at the full diaper type. That of course is unnecessary. There are Depends underwear liner pads for men that work great. They come in light, medium, and heavy. I suppose they are comparable to womens kotex, but I have never worn one of those.

At any rate it sounds to me like you are doing well and right where you should be regarding incontenence and ED. The drying up period takes longer for some than others. I am almost 6 months out and am only slightly leaking when something out of the ordinary occurs (coughing, straining, etc.). I wear a light pad just in case. As far as ED you will have to work at it with the items discussed on this forum, but for most of us the process is slow - but there is always hope and from what I have experienced and read gradual progress. From my experience I am thankful for what has happened so far, and would do the same thing again. Some of the consequences of surgery are a little inconvenient, but considering that we have had cancer - they are no big deal. Stay patient and best of luck.


Age 61
Original data - pre-operation
PSA: 5.1
T1C clinical diagnosis, Needle biopsy - 10 cores, Gleason 7 = 3+4 in 1 core (40%), 7 cores Gleason 6 = 3+3 ranging from 5% to 12%
All scans negative
Lupron administered 4/9/2008 for 4 months (with idea I would undergo external beam radiation followed by seed implants - then I changed my mind).
Robotic DiVinci surgery - Dr. Fagin (Austin) May 19th
Post operative - pathology
pT2c NX MX
Gleason 3+4
Margins - negative
Extraprostatic extension - negative
seminal vesicle invasion - uninvolved
1st Post PSA <.04

Veteran Member

Date Joined Apr 2006
Total Posts : 1732
   Posted 10/9/2008 9:27 AM (GMT -6)   
Glad you're on the mend. Sounds all good so far!
Horny Goat Weed does have some similar action to a PDE5. In fact, it is currently gaining attention of the pharm groups. It was only a matter of time before they got the hint. Research is underway.
I'd sure like to see someone give it a try for a while. If you do, please let us know. The biggest issue is finding a quality brand. So many of the brands of herbs and naturalpaths are of such low quality. Nature's Way or PURE may have it. I've used those brands for may remedies and like them.
Good luck and stay well,

Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 10/9/2008 12:33 PM (GMT -6)   
Hello Codger.
I use the Depends "Guards" pads for men and after having also tried some of the generic no-brand pads from Walgreens and CVS pharmacies I went back to Depends "Guards" because the fit seems better.  I haven't found any heavy duty pads though, just the regular ones.  I'm one-month post-op.  I have used the Depends briefs on several occassions, particularly at night after my catheter was removed, and they worked well; I use them with a pad inserted for added protection.  I've had some annoying chafing of my inner thighs when the pads/briefs rub against the skin and I've started wearing an ace bandage at the point on the thigh where the abrasions are occurring.  I saw my Urologist earlier in the week and he told me I should start seeing an improvement in the incontenence after 3 months - in the 3 month to 6 month time period (following surgery).
about the Cialis:  My Urologist has me on Cialis 3 times weekly, together with MUSE.  It's soon after surgery for me and I don't expect an erection at this point.  8 of the Cialis tables (per month) are covered by my Blue Cross/Blue Shield, the remainder aren't - and my cost, after co-pay and full-pay will be about $150 per month.  The MUSE is covered but my co-payment is about $50 per month.  So, this will cost me about $200 per month for everything.
I've been fatigued lately, something I'm not accustomed to, and the Urologist suspects my Iron count is low - so he's having me take an Iron supplement daily.  Also, he didn't think I was getting sufficient protein in my diet and asked me to take a protein booster each day; I've selected one of the protein mixes (powders) at GNC.  I had my baseline PSA test and one of the nurses telephoned yesterday and left a message saying the result was "0.0", but I'll call back to find out what the number behind the ".0" is so that I can track it in the future.

Age:  59 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (19 days post-op)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)


Post Edited (Mavica) : 10/9/2008 11:43:21 AM (GMT-6)

Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 10/9/2008 3:05 PM (GMT -6)   
My sentiments are the same as all, I wish you the best during this healing process. Stay close. We'll be here to cheer you on.

Age 46 (44 when Dx)
Pre-op PSA was 19.8
Surgery on Feb 16, 2007 @ The City of Hope
Post-Op Pathology: Gleason 4+3=7, positive margins, Extra Prostatic Extension (EPE)
Bilateral seminal vesicle invasion (SVI); Stage pT3b, N0, Mx
HT began in May, '07 with Lupron and Casodex 50mg (2 Year ADT)
IMRT radiation for 38 Treatments ending August 3, '07
Current PSA (September 17 '08): <0.1 ~ Undetectable!
You can visit my Journey at:

Veteran Member

Date Joined Feb 2008
Total Posts : 1858
   Posted 10/9/2008 6:34 PM (GMT -6)   
I also wish you well during the healing process. A pad I found particularly good in the earlier days was the Tena brand triangular pad. It has good absorbency, is not too bulky and the shape is ideal in avoiding accidents out the side.
1/05 PSA----2.9 3/06-----3.2 3/07-------4.1 5/07------3.9 All negative DREs
Aged 59 when diagnosed
Biopsy 6/07
4 of 10 cores positive for Adenocarcinoma-------bummer!
Core 1 <5%, core 2----50%, core 3----60%, core 4----50%
Biopsy Pathologist's comment:
Gleason 4+3=7 (80% grade 4) Stage T2c
Neither extracapsular nor perineural invasion is identified
CT scan and Bone scan show no evidence of metastases
Da Vinci RP Aug 10th 2007
Post-op pathology:
Positive for perineural invasion and 1 small focal extension
Negative at surgical margins, negative node and negative vesicle involvement
Some 4+4=8 identified ........upgraded to Gleason 8
PSA Oct 07 <0.1 undetectable
PSA Jan 08 <0.1 undetectable
PSA April 08 <0.001 undetectable (disregarded due to lab "misreporting")
PSA August 08 <0.001 undetectable (disregarded due to lab "misreporting")
Post-op pathology rechecked by new lab:
Gleason downgraded to 4+3=7
Focal extension comprised of grade 3 cells
PSA September 08 <0.01 (new lab)

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