I had the great fortune of having a wife who is an OR nurse. She would often discuss in generalities the differences in skill levels that she and the other nurses noticed in the surgeons they assisted. Names were not named, but it became clear to me that surgeons are NOT created equal. And, it's not just skill and talent. Attitude plays a big role too. The worst surgeons are usually the arogant and rude ones. The assisting nurse is at ground zero and she is very sensitive to what is going on during the procedure.
I have a brother-in-law doctor (Neurologist but works ER) and two nurse sisters who left the profession. Their advice boiled down to "Get lots of second opinions" Neither was close enough to my home to recommend a specific surgeon.
When I realized that my first urologist was not putting my best interests first (to describe the situation politely), she (wife) started asking for references. Her primary care physician was the source for my eventual choice. He was described as "poor bedside manner, but crackerjack surgeon" A doctor talking to her nurse patient can be more honest, knowing her confidence will be honored.
I liked his committment to his ED recovery program (ED meds started immediately after surgery, use of the VED starting at 3 weeks). I was already taking 25mg Viagra daily for my BPH. We were pretty sure that both my nerve bundles could be spared based on my pre-treatment numbers, but he said the nerves would be bruised, and the increased blood flow from the Cialis or Viagra plus the VED would accelerate their recovery. He preferred Cialis, but I had a lot of off-shore Viagra in stock that I had been using for my BPH. Erectile function was very important to me. My wife is 10 years younger than I am.
I liked his unabashed enthusiasm for the Da Vinci robot. I'm an IT guy, and I KNOW that new is USUALLY better (except for Microsoft's operating systems). People won't spend the money for new equipment unless there is an advantage to be realized. I know how robots have revolutionized manufacturing processes, increasing both speed and precision.
He talked about the importance of bladder neck re-attachment before I had ever heard the term. He used a different word for it. During our consultation he didn't once say "The most important thing is, we get the cancer out" That IS important, but it's really a given. The rest is equally important.
I agree with Godfather that just doing a huge number of surgeries should not be the only qualifier. This is a long and tedious surgery if it's done right. There is no way to rush the most important aspects. Someone is cutting corners, and those corners are probably your nerve bundles and bladder neck.
I like Godfather's choice of the surgeon who kept and shared his stats. This speaks to pride and motivation. Wanting to do the best job possible. Trying to improve.
I also agree that many recommend their choice of surgeon, even though their outcomes don't speak that highly of the choice they made. There is a natural desire to trust our physicians. The price for this trust is often very high.
Diagnosed June 2008 at 63, PSA 6.5 Gleason 6, On-going BPH w/ high PSA for five years, free PSA number drove the biopsy
Robotic RP 11/2008 DR Todd Waldmann, at St Alphonsus, Boise No pain, some (well, really LOTS of) anxiety. I was up and walking almost immediately after the surgery. Wore some paths in the carpeted corridors outside the rooms. What else is there to do? "Walk and pass gas and you get to go home" I didn't need pain meds after discharge. Abdomen was a little tender, but that was all.
Prostate at pathology more involved than at biopsy, but still Gleason 6. Clear margins, no extension, no other involvement, prostate size 89 grams "We got it all"
Catheter pulled 7 days later, completely dry the following day. "No lift, no sex for six weeks" reduced to 3 weeks. Some erectile function at 3 weeks, sufficient for penetration, but . .. Got worse for a while, then started getting better. Two months' testosterone replacement (5mg Androderm patch daily -had to fight for it, urologists don't like testosterone on principle) for two months starting Jan2009 coupled with two week vacation in Arizona seemed to ice the cake. Wife didn't have to go to work every day
Erectile function improves steadily, but I still do not have the pre-op erection quality and drop-dead dependability at 6 months. Continue to take daily Cialis or Viagra. Viagra works best but makes my nose stuffy. Continue to use the VED 3 x weekly. I really feel that I'm doing my part --but my penis is slacking.
The only visible evidence of the procedure is a 2" vertical scar where the camera went in and the prostate came out, the other incisions have vanished.