Hi Mike , i agree with most posts here , it is crucial for a long life after PCA and succesful surgery to chose the right Surgen , seems like yours is a bit limited ...heer is part of an article of Dr Walsh of John Hopkins lettrs that relate to early diagnosis :
"Dr. Stamey infers that nerve-sparing was responsible for the positive surgical margins. That conclusion is not correct. Dr. Epstein, in another publication, analyzed the influence of nerve-sparing on the presence of positive margins in this series of patients. He found that 24 (4.7%) of the patients potentially had positive margins caused by attempts to preserve the neurovascular bundle. "Of these 24 patients 4 had progressive disease after radical prostatectomy. Three of these patients have manifested elevated PSA levels as their only evidence of progression and 1 has a proven local recurrence. These 4 patients represent 0.8% of the total population who underwent radical prostatectomy. The 20 patients without evidence of disease have follow-ups ranging from 3 to 8 years with a mean and median of 5.5 years".
Thus, I am very careful when and where I spare nerves and for this reason nerve sparing rarely interferes with excellent cancer control. Conversely, most patients with positive surgical margins have extensive cancers which cannot be cured with surgery. Fortunately, with the development of PSA for the early diagnosis of prostate cancer, more patients are being detected at an earlier curable stage. In my last 200 consecutive patients, the frequency of positive surgical margins was 12%, similar to the 18% reported by Dr. Stamey in his most recent series. Thus, I believe that Dr. Stamey's comparison was unfair because he compares patients operated on a decade ago when tumors were more advanced than they are today.
if you want to read the full article it in posted on thier site in this link
April 2007 PSA 8.4 for last 6 months biopsy shows PC 3+3=6
June 13 2007 Nerve Sparing
open RP / Dr. Christopher Johnson at St. Francis Hospital NY.
4 days later home for Fathers Day, and Catheter.
Removal of catheter 10 days later , incontinence not an issue, no pads used from the get go.
1 month PSA next to not detected
ED is a longer battle:
1 month out start using occasionally Cialis and 50MG Viagra to promote blood flow with no response. 3 months and 6 months PSA not detected
ED 6 months mark starting with VED therapy and being more aggressive with meds , in addition taking Folgard supplement daily.
April 2008 : 10 month out and start seeing some serious improvements with ED while using Meds and VED , can achieve erections, Mid nights erections almost on a regular basis , and uncontrolled 90 % erections spontaneously.
UPDATE 1 YAER FOLLOW UP
ED: With Viagra Usable erection for intercourse , AND AT 80% without any medications !!
Fully continent since removal of catheter.
PSA one year : 0.0 as of 6/13/ 2008 BIG Wooohoooooooooo!!!!
UPDATE AS OF Dec 2008 (18 months out)
PSA still Undetectble!!!!
No continance issues!!!!
ED Mostly getting better with oral meds and the right woman = good sex
80% without any help and 95% with oral Meds ... 100% with VED
hope to keep progressing and by 24 months get back to 100% potency WooooHoo!!!