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Regular Member

Date Joined Jun 2009
Total Posts : 77
   Posted 6/11/2009 9:21 PM (GMT -6)   
Hello All:
After flirting with active surv. almost 4 yrs after diagnosis in '05 at 41 yrs old psa 3.8 (at the same time combing major hospitals around the country for options besides surgery and multiple follow-up biopsies one of which was in fact negative!) , I finally yielded to robotic surgery 2 weeks ago (psa  6.5 at this point). Catheter is out and going through the various stages of post-catheter issues. Not doing so bad. Doing my Kegels religiously. Erections ? Definitely some troop movements down there after 2 weeks! All incisions dry except the large one where the prostrate was extracted which is about 98% dry. Pathology is all clear. organ confined, no SV invation and LN clear. Very happy given that I waited that long!
Still dealing with some pain in my mid section especially when I sit for a long time. Right now my biggest issue is soreness around the general groin and rectal areas especially after I pass stool (pain in the ass literally!). The stool softners don't work that good for me. I also experience some burning/discomfort when I urinate. are these 2 common? And words of wisdom for me?

DS Can
Regular Member

Date Joined May 2009
Total Posts : 195
   Posted 6/11/2009 9:32 PM (GMT -6)   

Welcome Ike,

I waited until after surgery to join this forum, too.  Sorry you are here, but we're all glad to help.

I had a lot of pain when urinating after the catheter removal.  It lasted for about 4 weeks.  My doc was not concerned. It has cleared up now for a while at 8 weeks post op.  If your pain concerns you be sure to call your doc.  I had the pain in the butt too but I'm not sure if it is the same as yours.  That has mostly cleared up now, too.  Mostly, it is about waiting and getting better a little bit at a time.

Also, if you could post a signature, that would be helpful.  Click on control panel after you log in.






PSA 01/07 was 1.2, PSA 01/08 was 1.9, PSA 01/09 was 2.5.
BIOPSY 02/24/09, adenocarcinoma DX at age 52
 Right:GS 3+3=6, tumor 3/6 cores, 10% involvement,PNI-Yes
 Left: GS 3+3=6, tumor 1/7 cores, <5% involvement,PNI-No
LARP 04/09/09,nerve sparing. Final pathology:
 GS 3+4=7, Margins uninvolved, 2 lymph nodes negative.
Catheter removed on 04/17. First no-pad day was 05/03.
ED treatment is 25 mg Viagra nightly.
First followup PSA results on 05/28/09: <0.1,undetectable!

Veteran Member

Date Joined Feb 2008
Total Posts : 655
   Posted 6/12/2009 7:14 AM (GMT -6)   

Greetings, Ike.  Sorry you have to be here, but welcome to the other side of prostate cancer.  Your symptoms that you are experiencing are fairly normal.  You might ask your doc if there is anything else to take in addition to the stool softener.  I think the burning when urinating is fairly normal as well.  I don't know what your doc has said about taking one of the ED drugs just to get things going, but I would encourage you to take them if that is what he prescribes.  My doc prescribed them for me but I got a fairly firm erection about 2 weeks out - just after the catheter was removed.   I didn't take the meds for about 3 months and should have.  Found that I never got back to pre surgery firmness and size until I took the meds.  Started taking levitra 2 times a week just for routine maintenance and it works.  There is a reason they want you to take the meds.  Some of us guys and I mean me in particular just don't like meds of any kind.  What I have learned is there is nothing to be afraid of - they have them for a reason so take them. 

Glad you are doing so well at this point.  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
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me

Regular Member

Date Joined Mar 2009
Total Posts : 260
   Posted 6/12/2009 7:57 AM (GMT -6)   
Hi Ike,

I experienced the same symptoms as you for about a month after surgery. In addition to the stool softener I found that prunes and prune juice were helpful.

At this point, 6 months after surgery, I have no pain whatsoever and do not need any medication. Still suffering from some incontinence though.

Good luck to you,
Age 69, First ever PSA 7.8 taken June 2008, Biopsy July 2008, 10 of 12 cores positive, Gleason 3+3=6
da Vinci surgery December 10, 2008, catheter removed December 29 2008
St. Lukes Hospital, Bethlehem, Pa.
Dr. Frank Tamarkin

Prostate weight 73.0 grams, Gleason 3+3=6, stage pT3a
Tumor locations: right anterior apex, right posterior apex to mid
left anterior mid to base, left posterior apex to mid
extensive perineural invasion in right anterior apex, right and left posterior apex to mid
seminal vesicles negative

First post PSA < .1 Jan 16 2009
Second post PSA < .1 Apr 17 2009

Regular Member

Date Joined May 2007
Total Posts : 338
   Posted 6/12/2009 8:57 AM (GMT -6)   
Just so you will know, you may pass some blood clots in your urine even weeks after surgery.  It's not something that you will feel.  

Regular Member

Date Joined May 2009
Total Posts : 60
   Posted 6/12/2009 3:20 PM (GMT 0)   
Looks like you made a good choice.  It takes a lot of time and hard work.    Congratulations on your success!
Not to change the subject :)   but I stumbled across this following a link from Uro Today on  changes in attitude towards ED in post RP patients:
I had this early intervention (start ED meds immediately after surgery, VED 3 X weekly) and it was very successful.  It seems like treating the whole patient and not just his prostate is catching on.  My surgeon was very much outcome driven.
There are several related abstracts on "penile rehabilitation" at the link above.  One study showed a significant improvement in erectile function if the recovery efforts started at 1 month rather than waiting until month 6.
Another abstract describes how you can tell if your erectile nerves indeed made it through the surgery.

Update on erectile dysfunction in prostate cancer patients.

<!--AuthorList-->Kendirci M, Bejma J, Hellstrom WJ.

Department of Urology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey.

PURPOSE OF REVIEW: Evolution in the management of prostate cancer includes increased attention being paid to patient quality of life after treatment, specifically with issues related to sexual function. Erectile dysfunction is one of the major concerns of patients undergoing treatment for prostate cancer. There are several recognized factors that determine the postoperative incidence of erectile difficulties, including patient age, degree of cavernosal nerve sparing during surgery, cancer stage, and associated vascular comorbidities. Early initiation of rehabilitation protocols after radical prostatectomy has been advocated to promote the speed and degree of recovery of erectile function. The aim of this communication is to review recent initiatives in erectile dysfunction restoration after prostate cancer therapy. RECENT FINDINGS: In recognition of the neurogenic basis of erectile dysfunction after radical prostatectomy, new strategies have been devised to initiate the rehabilitation process. Type 5 phosphodiesterase inhibitors, vacuum erection devices, and intracavernosal and intraurethral application of vasoactive agents have all been reported in a positive light in recent studies. Developments in cavernous nerve graft interposition procedures, perioperative neuroprotection measures, and postoperative neurotrophic treatments aim to preserve prostate cancer patients' qualities of life. SUMMARY: Data generated from a number of clinical investigations document that pharmacologic rehabilitation programs provide a higher rate of recovery of erectile function following radical prostatectomy. Both intracavernosal and intraurethral applications of vasoactive agents and vacuum devices can speed the recovery period for return of erectile function. Various neuroprotective and neurotrophic approaches are thought to provide integral roles for the maintenance of sexual function in men undergoing prostate cancer therapy.

Regular Member

Date Joined Jun 2009
Total Posts : 77
   Posted 6/12/2009 11:02 AM (GMT -6)   
Thanks so much guys! This is very helpful information indeed. It's good to know that some of the discomfort is pretty normal. Regarding ED, I was given a prescription for Viagra 100 mg " begin erectile dysfunction therapy, if needed, two months after the catheter is removed" (extract from my discharge instructions) - if needed? I am sure that's highly rethorical question:).

Soon after catheter removal 10 days from surgery, I started to have about 50% erections (without medication) and it's happening and improving consistently (although only one bundle was completely saved) which does 2 things - gives me hope and reveals rather pleasanty that length and size wasn't compromised!
I will make sure to take my viagra as instructed. I am happy that everyone is doing well with ED. Great source of inspiration.

I will append a signature soon. Thanks to all again!

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4126
   Posted 6/12/2009 8:09 PM (GMT -6)   
ike-d: You are one lucky man. Sounds like you will make a speady recovery congrats.
Jeff T Age 57
9/08 PSA 5.4, referred to Urologist
9/08 Biopsy: GS 3/4=7
10/08 Nerve sparing open RRP- Path Report: GS 3+3=7 Stg. pT2c, margins clear
3 mts: PSA .05 undetectable
 ED- 5 mg Cialis daily, pump daily,

Regular Member

Date Joined Jun 2009
Total Posts : 77
   Posted 6/13/2009 10:11 AM (GMT -6)   
Thanks Jeff. I am one lucky and blessed SOB! My worry now is the urinary stuff. I am fine while lying down but do not get the urge to go otherwise and the urine just flows out. Is this common initially? Can you walk me through the various stages or how you got yours back? I am trying ti stay positive but I had hope to see a glimmer (too ambitious?) of light after 2 weeks...Thanks

Regular Member

Date Joined May 2007
Total Posts : 338
   Posted 6/13/2009 10:46 PM (GMT -6)   
The day that I had the cath removed I thought that I was fine and was just wearing my normal underwear.  I stopped by my office for about 15 minutes before going home.  A few minutes after getting home I was standing in the kitchen when it let go with no warning at all.  I was lucky that it didn't happen in my office.

Regular Member

Date Joined Jun 2009
Total Posts : 292
   Posted 6/15/2009 2:37 PM (GMT -6)   
I found that I had no problems as long as I was still so night time and sitting on the couch was easy.
However, once I was up and moving around all bets were off. I noticed it particularly on the walks my wife and I would take around the neighborhood. I began to think my legs acted like bilge pumps keeping my bilge empty and the pad moist. That lasted for about 2 weeks. Eventually, I determined a pad wasn't necessary but the risk of a bit of a squirt when I laughed unexpectedly, or moved in such a way to put pressure on my bladder was more than I wanted to take in public. I wore two pairs of underwear for a week or so to soak up those minor surprises that could embarrass me if they got to the outside world. I used that extra layer to ward off humiliation until last week. I do know I went from "will this never end" to "oh boy, things are dry" in just a couple or three days. The transition was quick. Getting to the transition point was what took time.
Diagnosed at 54
PSA 8.7
Biopsy 1/7/09
4 of 6 cores positive, one at 90%
Gleason 3+4=7
Neg bone scan 1/15/09
One shot Lupron Depot 1/27/09
Tax Season
RP 4/29/09
Neg lymph nodes, postive seminal vesicle, 1 positive margin
Gleason 3+4=7 with tertiary 5
Catheter out at 2 weeks no nighttime incontinence
Pad free week 5
PSA 6/6/09 <0.1

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