Does the size of the prostate effect incontinance?

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Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2455
   Posted 3/15/2009 4:02 PM (GMT -7)   
I have a friend whose prostate was extremely large (8 times normal size) who has been incontinent for 10 months even with Kegel exercises prior and post op. My question: is there any correlation between the size prostate and the length of recovery from incontinance?
Age: 67
Retired in 2001 and living in Austin TX.
PSA 3.5 free PSA 11%
Dx 12/30/08
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed on Feb 9th
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
10-20% involved
Bilateral
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean


lifeguyd
Veteran Member


Date Joined Jul 2006
Total Posts : 664
   Posted 3/15/2009 4:28 PM (GMT -7)   

 

http://cat.inist.fr/?aModele=afficheN&cpsidt=15071831


PSA up to 4.7 July 2006 , nodule noted during DRE
Biopsy 10/16/06 ,stageT2A
Aggressive Gleason 4+4=8  right side
DaVinci Surgery  January 2007
Post op confirms gleason 4+4=8
No extension or invasion identified
Few continence problems
PSA 90 day (-.01)  , (6 month -.01) , (9 month +.02) , (1 year +.02) ( 18 months +.02) (two years+.03)
One side nerve spared
success but some plaque with bimix 
born in 1941


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 3/15/2009 5:01 PM (GMT -7)   
I can only offer my experience. I had a 110gm (20 to 25gms. normal) prostate removed and was continent very quickly, within a week actually.....8 times normal would be 160 gms or so, a new record in bragging rights here.

turn
Again, it is really variable for each man and his particular set of circumstances with surgeons skill, his anatomy, rate of recovery and healing and so many more variables.... turn

I found this part of the cite from lifeguyd interesting- concerning the reoccurance rate of PCA for men with greater than 75gm size. A little comfort for me...

Potency and continence rates were similar between the groups. CONCLUSIONS Prostate size at RRP does not affect the risk of impotence or incontinence afterward. A prostate of >75 g is associated with a lower likelihood of PSA-relapse, potentially as a result of lead-time bias. While an enlarged prostate may contraindicate other potentially curative cancer treatments, the outcomes of RRP appear to be unaffected.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Post Edited (James C.) : 3/15/2009 6:06:18 PM (GMT-6)


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25353
   Posted 3/15/2009 5:16 PM (GMT -7)   
Not that I ever heard of, but an interesting question
Age 56, 56 at DX, PSA 7/7 5.8, 7/8 12.3,9/8 14.5
3rd Biopsy Sept 08: Positive 7 of 7 cores, 40-90%, Gleason 7, 4+3
Open RP surgery 11/14/8, Right nerves spared, 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 .05, 6 month on 5/9
 
 


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 3/15/2009 6:55 PM (GMT -7)   
Like James C I also had a 110-er. At 5+ weeks post-surgery is still dripping away (but only 1 pad a day if not a lot of exertions going on). Cannot say if it is getting any better just yet.

Good question and thanks Life for that link -- also interesting.
Age 58, 192lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
open RP surgery 02/03/9, Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Post-surgery Pathlogy Report - All margins clear - No Invasive spread - no change in Gleason score.
Cath out on 2/18/9, passed a STONE within hours. To be analyzed by doc.
Using pump (encore) daily since catheter out -- Viagra and Levitra samples now and then (no effect).
03/06/09 Started Levitra 20mg rehabbing.

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