Removing nerve bundles on one side

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/6/2009 6:29 PM (GMT -6)   
My robotic surgery is scheduled for Monday and my surgeon told me that he will not spare the bundles on the left side because of my high Gleason score and the fact that the cancer was found to be on the left side. Did anyone with a similar situation ever overcome ED? Your response is appreciated.
Age: 67
5ft 10 inches 182 lbs
Married. 4 children; 11 grand children
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/6/2009 6:51 PM (GMT -6)   
Good luck on your Monday surgery, try to enjoy this weekend. We look forward to hearing back from you on the other side. We are here for you brother.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Bob D
Regular Member


Date Joined Mar 2008
Total Posts : 199
   Posted 2/6/2009 8:10 PM (GMT -6)   
We all are wishing you well.
I had open RPP 11 months ago. Erections are back.
Both nerve bundles were spared but I have heard from
others that had one side saved and regained their erections.
The real problem is if neither nerve bundles are saved. In that case
natural erections are very unlikely.
 
    1. Age 59, psa 4.7 in Jan. 08. Biopsy: one positive sample out of 13. 1% of one sample cancer. Prostate removed on 3/5/08. Open Surgery. Northeast Georgia Medical Center, Gainesville Ga. Nerves spared. Cath out 12 days later. Continence good. No pads needed since 6/10/08. First PSA: Less than 0.1 on 6/17/08. First erection five days post op and have been improving well since then. Full erection now possible (less than four months post op) with the assistance of Cialis.  Post Op Biopsy : No malignant cells in lymph node. Gleason 3=4=7. Tumor on both lobes. Urethral margins/apex free of neoplasia. Right and left seminal vesicles free of neoplasia. No invasion of prostatic capsule of the resection margins are noted by the tumor. Tumor occupies 10 to15% of the prostate gland. Path staging T2c, NO, MX- Group staging II.  Focal areas of perineural invasion by tumor are noted. 80% natural erections and full erections with 10mg Cialis. 9/22/08-Took 10mg Cialis on Monday night, had very usable full hard erection at night, the next morning, and the following Thursday morning, 60 hours after original dose !! Orgasm quality Excellent.!!!!! I am pleased with the progress so far. Married to same wonderful woman for 39 years. She is still beautiful and sexy as ever. A great help in my recovery !!:


carver
Regular Member


Date Joined Jan 2009
Total Posts : 27
   Posted 2/6/2009 8:40 PM (GMT -6)   
One nerve bundled spared in 1995. Partial erection. Never regained full erection sufficient for penetration. Edex (alprostadil for injection) has worked its miracle for me/us for the last decade. Perfect erection for 45 minutes! (Oral meds did not work for me.) The injections restored the JOY of sex to our marriage! Don't despair! Best wishes for a return to normal erections after a sucessful operation. Al

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/6/2009 8:46 PM (GMT -6)   
Thank you Carver, your story has given me hope. Of course, right now the most important thing for me is having a successful surgery with no EPE. and good PSA thereafter.
Age: 67
5ft 10 inches 182 lbs
Married. 4 children; 11 grand children
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


Kark60
Regular Member


Date Joined Jun 2008
Total Posts : 91
   Posted 2/6/2009 9:03 PM (GMT -6)   
I had the left nerve bundle removed and the right bundle spared. My understanding is having one bundle spared simply REDUCES the odds of achieving an erection and could make the healing process longer, but does not ELIMINATE this ability!! I now am able to achieve a usable erection with Viagra and a vacuum pump. However, I've been showing improvement over the past couple months getting "natural" erections. Nothing "natural" usable yet, but I can tell it is changing and getting better.

The key is to be patient. My doc said it could take up to 18 months, I'm currently just over 8 months post-surgery. Also, you need to consistently work on "rehabilitation" including stimulation, taking oral meds, and using the pump. You don't want to atrophy and need to keep the blood flowing down there to aid in healing. Of course, wait until your doc gives you the "go ahead" post-surgery before messing with any of this.

Keep in mind the top priority should be to get rid of the cancer, followed by regaining continence, and then conquering ED. As someone once said on this forum, "I would rather be a living steer than a dying bull" (or something like that!!).

Best of luck and get well soon!!
Husband and father of two (current ages 5 and 7).
Age when diagnosed: 47 (currently 48)
Biopsy showed cancer only on left side.
Pre-surgery PSA: 13.7
Pre-surgery Gleason: 4+3=7
Pre-surgery Staging: T2
CT Scan, Bone Scan, PET Scan: Clear
Robotic Surgery on May 28, 2008, at Barnes Hospital in St. Louis.
Right nerve bundle spared; left bundle removed.
Catheter for 8 days with infrequent "stress" leaking. Pad-free after five weeks.
Continuing ED: attempted Viagra, Levitra, and Cialis with no response. However, had SUCCESS in October 2008 using MUSE.
POST-SURGERY PATH REPORT:
Bad news-
Gleason: 4+3=7
Involved 10% of prostate; all quadrants involved
Extraprostatic extension at left base and apex
Extensive perineurual invasion present.
Non-neoplastic prostate shows PIN, high grade, diffuse.
T3a
However, good news-
Bladder neck, lymphvasular space, seminal vesicles, 17 examined lymph nodes, and all margins are FREE of tumor.
Four-week post-surgical PSA = 0.1
Seven-week post-surgical PSA = .01
October 2008 PSA = 0.0
January 2009 PSA = 0.0
Next PSA scheduled for April 2009.


kw
Veteran Member


Date Joined Nov 2006
Total Posts : 883
   Posted 2/6/2009 10:21 PM (GMT -6)   

    Hey Old67,  I was a bit younger (43) at surgery than you but I also lost my left side bundle.  I'm two years out and things are pretty good.  I have some natural erections but most are with the use of Viagra.  I hope things work out for you.

    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.  Working Great, only light drips and dribbles.
    Jan, 31st, 2009 - PSA ????? Will post when I get the results!  


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/6/2009 10:47 PM (GMT -6)   
Thanks KW. I hope the same.
Age: 67
5ft 10 inches 182 lbs
Married. 4 children; 11 grand children
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


apacker1950
Regular Member


Date Joined Nov 2008
Total Posts : 122
   Posted 2/6/2009 11:58 PM (GMT -6)   
old 67,  I had nerve sparing open RP in Nov. 05 but never regained natural erections.  I use trimix injections with very good results.  Best of luck to you.  Allan

Dx PCa age 54. Jly 05- PSA 8.1 Sept 05- PSA 10.7
Sept 05- Biopsy  9 of 12 cancerous, Gleason 3+3=6, T2
Bone scan and cat scan showed hot spot on hip bone.
Oct 05- bone biopsy, ouch.  benign , no cancer in bones.
Nov 05- PSA 15.4 Nov 18, 05- Nerve sparing open RP at Huntsman Cancer Center, by Dr. Robert Stevenson. 100% continence at 3 months. ED- Tried the big 3 pills with no results. Feb 06-Started VED, worked, but painful with constriction rings. May 06 started Trimix injections.
ED appears to be perminant but doing great with Trimix.


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 2/7/2009 12:15 AM (GMT -6)   
Old67,
Dr. Fagin did my surgery May 19th last year - I am 8 + months out from it. Neither of my nerve bundles were spared. My diagnosis was severe enough that he was concerned to be sure there were no positive margins. This is the number 1 goal. He called it "cutting a wider path" but also said it is never all or nothing. He further treated me beyond the surgery with the drugs (Viagra etc.) as anyone with the hope of recovery.

I am using Cialis and Trimix with some success. Even better, I have recently had some activity (although not sufficient yet) down south with just the Cialis - this means to me that even without total nerve sparing I may someday recover to pre-surgery form. The bottom line for me is that I would do the same thing all over again. I have great confidence in Dr. Fagin and believe if you are going the surgery route you are in the best of hands.

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 <.01 10/30/2008


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/7/2009 9:05 AM (GMT -6)   
RB,
Your story is encouraging. In my discussions with Dr. Fagin I made it clear to him that getting rid of all the cancer is priority number one. The ED is secondary. I certainly would love to find that my cancer is encapsulated in the prostate with negative margins. I started my liquid diet today and the countdown has started.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


RBinCountry
Regular Member


Date Joined Apr 2008
Total Posts : 270
   Posted 2/7/2009 11:58 AM (GMT -6)   
You will find the hospital there very professional, and I think you will be amazed at how quickly and relatively easy your stay. I personally had minimal pain, was up that night walking around, and although they did have me on drugs so that I was sleepy my considerable family almost had a party in the room that night.

If you read that book they give out and that is on the website you will know everything you should do - they really have the routine down. If you have any questions let me know. I remember well the path you are taking with the liguid etc.. All of it will pass quickly. I wish you well!

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 <.01 10/30/2008


kcragman
Regular Member


Date Joined May 2008
Total Posts : 240
   Posted 2/8/2009 8:09 AM (GMT -6)   
Good luck, Old67!!!

As has been mentioned multiple times on this board - remember stool softeners when you get home, ask your doctor about bladder spasms, take a big soft pillow to sit on for the ride home, and be sure to laugh at yourself every once in awhile - especially in the early days.

I'm sure you'll do well.

Heal on!
kcragman
Age: 53; 52 at DX
March 2006: PSA 2.5
Dec 2007: PSA taken for insurance application. I did not see the results until late
              Jan '08 - after I was rejected. Their lab said PSA 4.5.
Feb 2008: PSA 3.7.
March 2008: Biopsy. Gleason 7 (4+3) 12 cores taken. 5 on the left side were
              cancerous and the 6th was suspect.  
May 5, 2008: Da Vinci robotic laparoscopy at GW Hospital, Washington DC.

Post op: Gleason 9 (4+5). 15% of prostate involved. Stage: pT3a. Negative margins. Lymph node and nerve samples taken, and appeared to be cancer free.

July 2008: PSA at 7 weeks was undetectable.
August 2008: PSA at 14 weeks (3 months) was undetectable.
Nov 2008: PSA at 6 months was undetectable.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/8/2009 8:23 AM (GMT -6)   
Good point, Kcragman, be sure to ask your dr about ditropan for the spasms. Cheap drug, works great, if you need it, you will be thankful to have it, if not, cost about 8$ tops at Walmart as a generic
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Ralph Alfalfa
Regular Member


Date Joined Nov 2008
Total Posts : 469
   Posted 2/8/2009 11:20 AM (GMT -6)   

Dear Old,

Liquid diet ...Yuch.  I'm 3 weeks post-op tomorrow and if I never have broth or jello again, that's O.K. with me.  I had partial nerve sparing on the left side and the doc said he took a little wider margin than he thought he would have to.Right side was spared.  9 days post I had a 60% erection with no ED drugs taken.  Will see my doc on Thursday to discuss ED rehab along with drugs and pump.  Take it one day at a time and walk a lot while in the hospital as it does help with getting things on the road back to a bit  like normal.

\Bob


 AGE:57
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 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. 19, 2009.Dr. Scott Montgomery, KC Urology,
Shawnee Mission Med. Center. Kansas


hb2006
Regular Member


Date Joined Nov 2008
Total Posts : 299
   Posted 2/8/2009 12:37 PM (GMT -6)   

Hi old67

My gleason scores were just like yours, a 8 and 9. I had the open surgery on May 21, 2008. Was dry at exactly 8 weeks. Had the right side nerves spared. The oral meds weren't working so the doctor switched me to Caverject and Edex injections. Both of which worked extremely well, 4 hour erections but with the alprostadil pain. Now I'm on the lowest dose of Trimix which also works very well.

In the last month, I switched to Levitra which has also started working. I also obtained it from AllDayChemist and found that their pills worked better than ones here in the states.

 


Age 60
PSA 2007 4.1
PSA 2008 10.0
Diagnosed April 2008
Biopsy: 6 of 12 cores positive
Gleason 4 + 5 = 9
CT and Bone Scan negative
Open surgery at Shawnee Mission Medical Center May 21, 2008
Right side nerves spared
Radical prostatectomy and lymph node dissection
Cather removed on June 3rd, totally dry on July 9th
pT2c
lymph nodes negative
PSA Sept 28, 2008 0.00
PSA Jan 22, 2009 0.00


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/8/2009 12:47 PM (GMT -6)   
Thank you all for your encouragement and support. I've been on a clear liquid diet for one a half day and won't be eating any solid food for another day or more. I'm getting ready for the first step of a long journey. Your input and advice has been a source of strength. I'm ready to face this monster head on with God's help, my family's support and all of you on this forum. I'll report back as soon as I get back from the hospital. Again, many thanks to all of you.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


sandstorm
Regular Member


Date Joined Dec 2008
Total Posts : 194
   Posted 2/8/2009 3:23 PM (GMT -6)   
old67,

29 days post-op here. Both nerve bundles were spared, but sorry to say no erections yet just some lengthening at night while asleep. I discover this if I get up to urinate during the night. Keeping the fingers crossed.

Hey, good luck to you tomorrow. Will be thinking about you and looking forward to a report when you feel up to it.
Age at DX 57
5-18-07 PSA 7.7
5-06-08 PSA 4.6  8% free psa, but stable
10-23-08 PSA 5.65 4% free psa
11-04-08 biopsy
11-11-08 2 of 12 cores positive
Gleason 3+3  6  stage t1c / post-op 3+4  7  stage t2c
CT and Bone scan negative
Da Vinci RRP 01-09-09
Catheter removed 1-15-09
Pathology Report says it's gone!
First Post-op PSA due 2-17-09


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/8/2009 8:00 PM (GMT -6)   
Sandstorm,
Thank you for your prayers. I'm actually anxious to get this over with. Waiting is the hardest thing.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 2/8/2009 8:20 PM (GMT -6)   
old67,
My very best to you, brother, on your op tommorow. As you go for that, we will be waiting for you on the other side. My your surgeon have exceptional skill. By the time you get back, I will have the results of my first post surgery psa, so I hope to have good news to give you.

At this point, my only advice, is to trust.

David in SC
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3
3rd Biopsy 9/8 Positive 7 of 7 cores pos, 40-90%, Gleason 7
Open RP surgery 11/14/8, Non-nerve sparing, 4 days hospital, staples out 11/24/8, 5th cath out on 1/19/9
Post-surgery Pathlogy Report:Gleason 3+4=7, pT2c, 42 grm, tumor 20%, Contained in capsular, clear margins, clear lymph nodes 
First PSA Post Surgery   2/9/9
 
 


Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2460
   Posted 2/8/2009 9:53 PM (GMT -6)   
Thanks David. I hope your results are exactly what you wish them to be. I'll be watching the site for the posting of your results.
Age: 67
5ft 10 inches 182 lbs
Retired in 2001 and living in Austin TX.
Dx 12/30/08
Scheduled for Robotic surgery on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
12 sections tested 2 with cancer
Left Medial Apex 4.0 mm. Gleason score 9 (4+5)
Left Lateral Apex. 2.0 mm Gleason score 8 (4+4)
Negative CT scan and bone scan done on 1/16
PSA 3.5

New Topic Post Reply Printable Version
Forum Information
Currently it is Tuesday, September 18, 2018 1:07 PM (GMT -6)
There are a total of 3,004,330 posts in 329,135 threads.
View Active Threads


Who's Online
This forum has 161737 registered members. Please welcome our newest member, adartist12.
214 Guest(s), 12 Registered Member(s) are currently online.  Details
Tim G, Mind body spirit, For My Hunny, Rikky1, 3timechamp, Admin, getting by, Q22, InTheShop, mareish, RunJerRun, straydog