2 Weeks Since Surgery

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masterguns
New Member


Date Joined Nov 2008
Total Posts : 16
   Posted 11/26/2008 8:37 AM (GMT -7)   

Hello all.  It was two weeks yesterday that I had a robotic RP and it has been 1 week since my catheter was removed. I was expecting to be much better that I am but due to a lot of pain, I am not.  I just talked with my surgeon's nurse and she said the healing process can take much longer.  I have a lot of pain that seems to be in my bladder area and radiating down through my penis.  The pain I just described is there no matter what I do, what position I am in, and tylenol doesn't help at all.  I also have pain from time to time located just behind my scrotum that seems to be initiated by Kegel exercise.

For anyone here that has gone through a RP, I would just like to know from anyone, how long did the healing process take in your specific case? Is all this normal?  I am no where near being continent and I can only have faith that continence will return with time.  Having said that, I am not too worried (yet) about continence, I am just concerned with the pain described above.

Any advise or thoughts would be highly appreciated.

Thanks

 


Sephie
Veteran Member


Date Joined Jun 2008
Total Posts : 1804
   Posted 11/26/2008 8:57 AM (GMT -7)   
Hello MasterGuns...my husband had a robot-assisted prostatectomy in March of this year. He was petrified of the pain afterwards and even the OR nurse told him he'd feel pain from the CO2 pumped into his abdomen during surgery. A self-administered morphine line was put in but my husband never needed it (it was removed the next morning). I must say that he had no pain at all from the surgery ... the catheter was a different story though and he absolutely hated the darn thing. Once the catheter came out (9 days after surgery), he was fine.

The pain in your bladder area might just be bladder spasms which are not uncommon after this type of operation. Your bladder and urethra were stretched to close up the space where the prostate used to be so there's alot of bruising inside. Our urologist gave us a prescription to help with bladder spasms should my husband have them.

As far as continence goes, 2 weeks post op is still very early in the healing process. My husband still leaks and struggles with bladder control every day after 8 months. While there has been improvement, it's been a slow process. He saw the urologist/surgeon last Friday for his 3 month follow up and the doctor said that everything my husband is experiencing is "normal" and that it will get better. The urologist did tell my husband that there's differences of opinion as to whether kegel exercises help the healing process ... he did say they definitely do not hurt the process.

Good luck in your recuperation, and please be patient with yourself and your body.

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25354
   Posted 11/26/2008 10:32 AM (GMT -7)   

Masterguns,

I feel for you brother, this Friday it will 2 weeks from my open RP.  I am still in a lot of pain, but I have been on Loratab 10 mg every 4 hours, today I dropped for first time to 5 mg, and then at the 2 hour mark, I take 2 regular advils.  Your dr. doesn't have you on any real pain med at this point?  The bladder spasms can really hurt, had them for a while, but not so bad at this point.  Pain is a very subjective matter, everyone has different threshold of pain, dont be afraid to make your pain known to your doctor.  There is no reason to suffer needlessly in this day and age.  Fighting pain, will slow down your healing process, any nurse will tell you that.

I hope you feel better soon, each day gets a little better for me, though I still have to have my cath. in for another 20 days (ouch), I hate that nasty little external bladder bag. lol.

David in SC


Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
 
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal High Grade PIN noted
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Nerve bundles not able to be spared, awaiting pathology report, Cath scheduled to be removed on 12-15-2008,


masterguns
New Member


Date Joined Nov 2008
Total Posts : 16
   Posted 11/26/2008 1:23 PM (GMT -7)   
To "David in SC",
 
I am very new to this forum and still trying to figure out how things work.  So, if I am posting this reply in the wrong way, oh well.
 
Considering that robotic surgery is now considered the preferred method of a RP, why did you have open surgery?  Just curious.  The doctor told me that I would be up and around within a few weeks but since it has now been 15 days since my surgery (robotic) I do not believe I will be as active in another week as I was before the surgery. 
 
He did prescribe Hydrocordone but so far I haven't taken it because it has an adverse effect on my digestive tract.  I took that stuff after my TURP this past May and learned the hard way.  I really think that what I am experiencing is bladder spasms so I am about to start a round with Detrol LA and hope it helps.
 
Anyway, thanks for the come back and I hope you are feeling better real quick.
 
Best Regards,
DIAGNOSIS:
 
PROSTATE (ROBOTIC ASSISTED LAPAROSCOPIC PROSTATECTOMY):
 
ADENOCARCINOMA (CONVENTIONAL, NOT OTHERWISE SPECIFIED)
 
 TOTAL GLEASON SCORE: 7
 PRIMARY PATTERN:   GRADE 3
 SECONDARY PATTERN: GRADE 4
 
 TUMOR LOCATION:  RIGHT AND LEFT SIDES ("LOBES")
 
 TUMOR EXTENT:
 CONFINED TO PROSTATE:  BILATERAL INVOLVEMENT OF PROSTATE - pT2c
 
  REGIONAL LYMPH NODE STATUS:  CANNOT BE ASSESSED - pNX
 
  SURGICAL RESECTION MARGIN STATUS:
        MARGINS UNINVOLVED BY INVASIVE CARCINOMA, THE TUMOR IS <1.0 MM.TO RIGHT
        ANTERIOR LATERAL MARGIN.
 
  EXTRAPROSTATIC EXTENSION:  ABSENT
 
  SEMINAL VESICLE INVASION:  ABSENT
 
  DISTANT METASTASIS:  CANNOT BE ASSESSED - pMX
 
  PERINEURAL INVASION: NOT IDENTIFIED
 
  HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN):  NOT IDENTIFIED
 
  PROPORTION (PERCENT) OF PROSTATIC TISSUE INVOLVED BY TUMOR: APPROXIMATELY 8%
 
  ADDITIONAL PATHOLOGIC FINDINGS:
       -NON-NEOPLASTIC PROSTATE WITH GLANDULAR AND STROMAL HYPERPLASIA.
       -CALCIFIC ATHEROSCLEROSIS


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25354
   Posted 11/26/2008 1:39 PM (GMT -7)   
Two reasons, first, there is only one hospital and one surgeon certified to do the robotic rp op in the whole state of sc, and the one surgeon has very little hands on time doing the op. Second, based on ultrasounds, bonescans, other tests, my dr/surgeon predicted complications due to a very deep pelvic bed, and in the end, he was right. He said had it been done robotic, he would have had to aborted the operation and re-done it via open. It was a non nerve sparing in the end, so I have a lot more to worry about then some short term pain. I hope you feel better soon, I think they often over rate the quality after surgery a bit more with the robotic surgeries. I hope you improve quickly. Ive got a ways to go, but I knew this going into this whole PC thing.

David in SC
Age 56, 56 at DX
 
PSA 2007 5.8
PSA 7-2008 12.3
PSA 9-2008 14.9
 
Biopsy 9-2008 Positive
7 of 7 cores positive, ranging from 40 - 90%
2 tumours noted, Gleason 4+3 and 3+4
Periunual Invasion noted
Additonal High Grade PIN noted
 
Open RP surgery completed on Friday, November 14, 2008 at
St. Francis Hospital, Greenville, SC, Dr. Ronald Smith - Surgeon,
Nerve bundles not able to be spared, awaiting pathology report, Cath scheduled to be removed on 12-15-2008,


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 11/26/2008 2:05 PM (GMT -7)   
Hi

I was also prescribed the Hydrocordone but was able to stop using it after a week. Also had the open RP as the daVinci was not an option. The cancer was real fast acting and my PSA went from 4 to 10 in one year. My Gleason scores were 8 & 9, with the left side totally cancerous. I was able to have the nerves spared on the right side. PSA has been zero since the surgery which was May 21.

But I was totally free of the pads at 8 weeks. I have a "leak" every once and awhile but usually when I'm working hard outside.

Lungman
Regular Member


Date Joined Jan 2008
Total Posts : 276
   Posted 11/26/2008 3:19 PM (GMT -7)   
Hello Masterguns and Welcome, even though the robotic surgery left you with minimal outside damage, the internal trauma is the same as an open procedure. You were placed head down for the procedure, for an extended time. This often results in some back pain along with all of the cutting and re-atttachment that went on in the lower pelvic cavity, which will also cause pain and discomfort. It was about 4 weeks or so before my pain, esp in the rectal area, began to be unnoticeable. Walk all you can, this seemed to help with the stiffness in my lower back. I was continent just after the cath removal, but still have problems with ED, some are the opposite, some have no problems. Just one thing we can all count on is that we all recover differently, just hang in there, the worst is over, just take your time and get better.
Randy
46 you when diagnosed, now 48
Pre-Op PSA 9.9
1 of 12 cores positive, Gleason 3+3
DaVinci on 9/5/2007
Post-Op Gleason 3+6, Negative Nodes and Margins
Less than 1% of prostate involved with CA
3 Month PSA 0.01, 6 Month PSA 0.01, 9 Month PSA 0.01
One Year PSA 0.01
Incontinence resolved 9/15/2007, one day after cath removal
ED showing significant improvement.
Occasional Success with Oral Meds
Success with BiMix


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 11/26/2008 6:57 PM (GMT -7)   
Hello, Materguns. I'm curious as to how many sugeries your Dr. has done and does he, or she(to be politically correct) have a record of post-op patients symptoms and treatments. This was very important to me as I am having DaVinci in the near future. If you feel it is necessary, or if it gets to that point, I wouldn't hesitate to seek another doctor's advice. Hope all gets better. Happy Thanksgiving.
Bob
 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci scheduled for Jan. 2009


masterguns
New Member


Date Joined Nov 2008
Total Posts : 16
   Posted 11/26/2008 7:42 PM (GMT -7)   
ralph alfalfa said...
Hello, Materguns. I'm curious as to how many sugeries your Dr. has done and does he, or she(to be politically correct) have a record of post-op patients symptoms and treatments. This was very important to me as I am having DaVinci in the near future. If you feel it is necessary, or if it gets to that point, I wouldn't hesitate to seek another doctor's advice. Hope all gets better. Happy Thanksgiving.
Bob

Good hearing from you Bob.  To answer your questions, 1) my doctor had performed 297 previous DaVinci surgeries and well over 600 open surgeries.   He is the Chief Professor Urologist at Southwestern Medical Center here in Dallas, Texas. He is top notch and I feel I was truly lucky to have him as my surgeon.  2) Yes, he presented me with all his post-op results and they are outstanding.  and 3) He was my fourth opinion.  and 4) Now that my prostate is under some pathologist's microscope, what would be the purpose of another doctors advice.
 
I was diagnosed with prostate cancer as a result of a TURP (trans-urethal resection of the prostate) done in May 08.  If it hadn't been for the TURP, I probably wouldn't had been diagnosed with the PC for many years.  The highest my PSA ever went was 1.1 and that was due to accute chronic prostatitis.  I had suffered with that since my early teenage years.  I am now 59.  Once I can fully recover from this operation, I am confident I will be cancer free. I suppose that should be all of our No 1 concern. 
 
But, I am only 2 weeks out from the DaVinci operation, and I guess I will be experiencing pain for a while longer.  I am sure the pain will gradually go away but it is the continence thing I am concerned with mostly.  I guess I am just one of the unfortunate ones that is not continent immediately after catheter removal.  I hope to see improvement soon.  From what I understand, continence returns in stages; first dry at night, then dry early in the day and gradually longer.  As the day progresses, and as your muscles fatigue, incontinence issues may arise.  Some men, or rather most men from what I understand, have some sort of incontinence issues for months/years (stress incontinence most likely).  Whether they admit that or not, I read is in fact the case.  I believe that very soon I will be able to achieve an erection as simply doing my Kegel exercises now cause a low grade erection.  I haven't been able to read anything about that but it has got to be a good sign.
 
Well Bob, good luck to you and stay in contact.
 
Best Regards,
 
 
 
 
AGE: 59 DIAGNOSES: 5/27/08
PSA ONE WEEK PRIOR TO DAVINCI ROBOTIC: .84
ROBOTIC ASSISTED LAPAROSCOPIC PROSTATECTOMY):11/11/08 
TOTAL GLEASON SCORE: 7
PRIMARY PATTERN:   GRADE 3
SECONDARY PATTERN: GRADE 4
CONFINED TO PROSTATE:  BILATERAL INVOLVEMENT OF PROSTATE - pT2c
REGIONAL LYMPH NODE STATUS:  CANNOT BE ASSESSED - pNX
MARGINS UNINVOLVED BY INVASIVE CARCINOMA, THE TUMOR IS <1.0 MM.TO RIGHT
ANTERIOR LATERAL MARGIN.
EXTRAPROSTATIC EXTENSION:  ABSENT
SEMINAL VESICLE INVASION:  ABSENT
DISTANT METASTASIS:  CANNOT BE ASSESSED - pMX
PERINEURAL INVASION: NOT IDENTIFIED
HIGH-GRADE PROSTATIC INTRAEPITHELIAL NEOPLASIA (PIN):  NOT IDENTIFIED
PROPORTION (PERCENT) OF PROSTATIC TISSUE INVOLVED BY TUMOR: APPROXIMATELY 8%
ADDITIONAL PATHOLOGIC FINDINGS:
-NON-NEOPLASTIC PROSTATE WITH GLANDULAR AND STROMAL HYPERPLASIA.
-CALCIFIC ATHEROSCLEROSIS


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 11/26/2008 7:53 PM (GMT -7)   
Hey Master, Sorry to welcome you to the club. Lungman is right. Eventhough they lable Robotic as "less invasive" you still had major surgery that involves alot of work inside. Take your time and let your body heal. I can take months to get over all the pains of the surgery. I wish you well on your recovery. Feel free to holler at us anytime you want.
KW
    43 at Dx and Surgery (RRP)
    PSA 5.7, Biopsy 3 of 12 positive (up to 75%) all on left side of prostate, Gleason 7
    RRP on Oct. 17, 2006 - Nerves on right side saved. All Lab's clear. 
    Cathiter in for 28 days due to complications in healing. Removed Nov. 9, 2006
    First Post op PSA on Dec. 11, 2006  Undetectable 0.00.
    ED workable and usable with Viagra.
    Feb. 20th, 2007 - Feb. 4th, 2008  Cystoscope, Two Collagen injections,Second Opinion Consultation for Incontinance at OU Medical Center, Bio-Feedback training, Chiropractic, Accupuncture  to try to resolve ongoing incontinance (4-6 pads a day)  All PSA's 0.00.
    Feb. 22nd, 2008 - Surgery to install the AMS AdVance Male Sling.
    March 27th, 2008 - Sling not working, Little or no improvement.
    April 18, 2008 - Collagen injection.  Back to using 4-6 full pads a day within a week.
    May 14, 2008 - Another collagen injection to try to Band-Aid the leaking for our June cruise.  Will start making conusultation appiontments for AUS after we return.
    July 14th, 2008 - AUS consultation with Dr. Morey at UT Southwestern (Dallas).
    July 30, PSA 0.00.
    Aug. 22nd, 2008 - AUS Surgery by Dr. Morey
    Oct. 6th, 2008 - AUS Activation by Dr. Morey
     


anglophile
Regular Member


Date Joined Apr 2008
Total Posts : 82
   Posted 11/26/2008 8:35 PM (GMT -7)   
Welcome, Master.

I don't remember being in such pain as you describe, more like great discomfort. A few days before the two week mark, I got my cather out and was celebrating.

Those first few weeks are the hardest but I'm here to tell you that we all got through them. I'm a little over 7 months out from robotic surgery and this is my first week without pads! So there is light at the end of the tunnel.

Hang in there.
Age 59 - diagnosed in Jan. 08 after biopsy
da Vinci Robotic Prostatectomy 4/11/08 - both nerves spared
Catheter removed 4/25/08
Prostate Pathology:
Gleason Grade 6 (3+3)
5 wks post-op Continence: 1 pad night, 2 during day
7 wks post-op Continence: 2 pads every 24 hours
First post-op PSA at 7 wks: >0.1
14 wks post-op Continence: 1 pad days, no pad nights
Post-Op PSA at 5 months: >0.1
First pad-free day/night at 7 months!


apacker1950
Regular Member


Date Joined Nov 2008
Total Posts : 122
   Posted 11/28/2008 12:07 PM (GMT -7)   
Masterguns, I got my cathater out at 10 days. No control for about a week and then gradually got better over the next 2 months. about 3 months out I was fully continent but even now 3 years later I have to be careful about heavy lifting and twisting or I have a little leakage. As far as the pain goes I think everyones body heals differently so it's hard to compare pain, plus we all have a different threshold for pain. If it gets too bad go see your Dr.. Best of luck to you.

RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 11/28/2008 1:07 PM (GMT -7)   
Masterguns,
I had very little pain after surgery, and by the time the catheter was removed almost none. I was generally sore down south, and my personals blue for a while. We are all different however, and I suspect your pain may be related to the TURP you previously endured.

As far as continence - again we are all different. I have read some on here that were dry immediately. I am more than 6 months and still experiencing some minimal incontinence. I wear 1 pad a day because there is usually some leakage sometime during the day and damp underwear is not acceptable. However, don't let that discourage. First of all I have gotten use to wearing the backup pad, and secondly I fully expect to be completely dry - the point is there is always hope. Things will get better from where you are now! I wish you the best.
RB
Age 61 (now 62)
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
2nd Post PSA <.1 10/30/2008
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