Surgery Update

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Regular Member

Date Joined Jan 2009
Total Posts : 40
   Posted 4/12/2009 3:03 PM (GMT -6)   

Hello All

Today I’m 17 days out of rrp surgery, last Thursday I got my final pathology report.  It was Gleason 3+3= 6 pT2B, pNX, pMX.  Nodes were negative, seminal vesicles negative, No extra prostatic extension seen.  If I’m reading the staging right I had a tumor that was more than 50% on the right side with nothing on the left. What’s strange is that my biopsy showed pc on the left side with nothing on the right.  I’ll have to question that at my six week follow up.

Continence:  I’ve only been catheter free for two days but so far progress seems good.  I can get through the night dry.  I get up once to use the facilities then its back to sleep.  My bladder fills when I’m sitting and as long as I use the bathroom as soon as I get up I stay pretty dry.  When I’m more active (walking etc) I seem to drip more.  From what I’ve read all of this seems to be normal.  I’m just hoping to be on the quick side.

ED:  I had nocturnal partial erection while the catheter was still in.  After the cath. came out I think I’m about 75%.  I’ll take that as a good sign.  Orgasms seem less intense, but from what I’ve read they improve over time.  I’m very happy that the ED might not be a long term issue.  I just starting low dose Viagra to ensure the blood keeps flowing…don’t want to take the chance of going backwards.

It’s been quite a stretch since I was dxed back in December…defiantly a stressful time in my life.  Overall I feel good that it’s done, feel good about my decisions.  I’ll get through the various issues most of us deal with and then be happy to move on with life.  I guess the next big moment will be hopefully a zero psa result in another four weeks.  Thanks to all who contribute here…the information and experience shared have really helped me.  Knowledge is power.



Age 44, DX 12/08
Psa 2.6 free 11%
One of twelve cores pos. with 5% pc Gleason 6 3+3
RRP performed for 3/26/09 Dr. Libertino, Lahey Clinic
Post-op Path  3+3=6 pT2B, pNX, pMX

Regular Member

Date Joined Mar 2008
Total Posts : 162
   Posted 4/12/2009 3:23 PM (GMT -6)   
Hi smc64,
Looks like you are on your way to a full recovery. All your numbers looks great. Hope all your post PSA result are undetectable. Good luck.
Occupation: Mechanical Engineer

Biopsy: 3/5/2008; Pre surgery: Gleason 6 (3+3), involving left lobe
t2b. DaVinci Surgery on 4/21/2008 in Austin by Dr Randy Fagin.[/color]

Pathologist report upgraded to a Gleason 7 (3+4); Margins: Clear

First PSA (06/17/08) = <0.04 Undetectable

Second PSA (10/27/08) = < 0.1 Undetectable

Third PSA (02/11/09) = < 0.1 Undetectable

Veteran Member

Date Joined Apr 2008
Total Posts : 1132
   Posted 4/12/2009 3:49 PM (GMT -6)   
Sounds like you are making great progress on all ends. You are very young. I thought I was young being diagnosed at 48. Assume yours was caught with a PSA test?
Age 49
occupation accountant
PSA increased from 2.6 to 3.5 in one year
biopsy march 2008 - cancer present gleason 7
decision - surgery (robotic)
Surgery May 9, 2008 - houston, tx
Pathology report -gleason 8
margins clear
9 month  PSA <.04 (low as the machine will go)
continent at 10 weeks (no pads!)
ED is still an issue

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2460
   Posted 4/12/2009 5:03 PM (GMT -6)   
Hi smc64,
It sounds like you have had a good start on the way back to recovery. Lets hope that by the time you get your 1st PSA you will get a big zero, be dry and fully functional sex life. Good luck.
Age: 67
Retired in 2001 and living in Austin TX.
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 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 2/9/09
Surgeon: Dr. Randy Fagin, Austin TX.
Post op Pathology report:
Prostate weighed 57 grams
size:5.2 x 5.0 x 4.9 cm
Bilateral 10-20% involved
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx
Negative margins
Lymph nodes: not dissected
seminal vesicles clean
1st PSA test 4/7/09 result 0.1

Elite Member

Date Joined Oct 2008
Total Posts : 25382
   Posted 4/12/2009 5:36 PM (GMT -6)   

Sounds like you are doing real good, both on the staying dry and the ED, hope it continues in that positive path for you.
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

Regular Member

Date Joined Aug 2007
Total Posts : 118
   Posted 4/13/2009 11:37 PM (GMT -6)   

This is great news. As you can see from my stats, I had a very similar diagnosis and early recovery. A year and a half out, I still take a bit of Cialis, 5mg every three days, because I am having too much fun. The orgasms will improve with time. Honestly, other than the Cialis, which I probably don't need, the lack of ejaculate and the very tiny port scars, my wife and I wouldn't even know that I had surgery. I think you can look forward to a terrific recovery.


Age:45 (44 when diagnosed)
Father diagnosed and cured at age 52.
08/21/07: Diagnosed with T1c cancer
1 of 12 biopsy cores positive; 10% tissue
Gleason score: 3+3=6
PSA level prior to biopsy: 4.3 (velocity < 0.4ng/ml)
10/19/07: da Vinci prostatectomy by Dr. Vipul Patel
              Difficult surgery due to prostate inflammation.
              Both nerve bundles spared.
              Spongy erections began within 24hrs of surgery!
10/24/07: Catheter out; down to 1 Serenity pad/day next day.
              Final pathology: neg margins, no capsular penetration,
              Gleason 3+3=6, 5% tumor involvement, multi-focal.
11/04/07  First usable erection with Cialis
11/22/07  Thanksgiving - Bye-bye, pads
01/17/08  First post-surgery PSA result: < 0.008 ng/ml
03/17/08  Erection quality mostly back to pre-surgery levels with Cialis;
              have not tried without meds yet.
04/23/08  Second post-surgery PSA result: < 0.008 ng/ml
07/30/08  Third PSA: 0.01 ng/ml
11/04/08  One year PSA: 0.01
              Still taking 10mg Cialis every other day - enjoying the results
              too much to stop yet.
02/07/09  Taking 5mg Cialis every other day - having too much fun to try
              to stop for now.
03/23/09  PSA: 0.02

Bob D
Regular Member

Date Joined Mar 2008
Total Posts : 199
   Posted 4/14/2009 1:11 AM (GMT -6)   
It all sounds good so far. Lets hope for zeros on the future PSAs.
The nocturnal erections sound good. I got my first one 5 days post op.
Did it hurt when you got your erection with the catheter in? Mine hurt a lot,
but it was worth it. Now one year post op I am in the zero club, continent and
can fully "get it up" anytime without meds. You have a lot to look forward to.
Congrats !!!! tongue
    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 !!: 3/12/09: Full natural erections with penetration. 10mg Cialis makes them easier to maintain but I have had several med free full erections lately, Yipieeee !!!!!!!  3/24/09: One year PSA <0.1.  3/28 & 3/29: had sex with full naturals with no meds. Erections are gained and maintained with very little manipulation. Getting more like pre op every day.

Regular Member

Date Joined Jan 2009
Total Posts : 40
   Posted 4/14/2009 12:46 PM (GMT -6)   
Bob D

The erections with the cath in were not exactly pleasant, but certainly a welcome sight. Last night with 25mg of viagra I was at 100%...I don't think I needed it either.

Congrats on your progress!!

Age 44, DX 12/08
Psa 2.6 free 11%
One of twelve cores pos. with 5% pc Gleason 6 3+3
RRP performed for 3/26/09 Dr. Libertino, Lahey Clinic
Post-op Path  3+3=6 pT2B, pNX, pMX

Regular Member

Date Joined Jan 2009
Total Posts : 40
   Posted 4/14/2009 12:48 PM (GMT -6)   
Thanks to all for the well wishes!!
Age 44, DX 12/08
Psa 2.6 free 11%
One of twelve cores pos. with 5% pc Gleason 6 3+3
RRP performed for 3/26/09 Dr. Libertino, Lahey Clinic
Post-op Path  3+3=6 pT2B, pNX, pMX

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 4/15/2009 10:52 AM (GMT -6)   
Congrats on your "normal" recovery path. Looks as if things are progressing properly.
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

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 4/16/2009 6:16 AM (GMT -6)   
Great progress. Congratulations! And keep up the good news. David
Age 55
Diagnosed Dec 2007 during annual routine physical
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 positive with 2 marginal
Gleason 3 + 3 = 6
RRP 4 Feb 08
Both nerves spared
Good pathology - no margins - all encapsulated - Gleason 4 + 3 = 7
Catheter out Feb 13 - wore pad for couple of days - pad free Feb 16
Great wife and family who take very good care of me

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