Greetings, Cas1955. First, let me welcome you to this group. Although all of us would prefer to be somewhere else, you are among friends who will always shoot straight with you. As is evident, we don't all agree on what to do or what is best but that is ok - you need to know what all the options are. Also, keep in mind that while we have informed opinions based on very personal experiences, we are not medical professionals (at least most of us aren't). So for what it's worth, here are my 2 cents.
I was very close to your age (I had been 55 for about 2 months). I also had a fairly low PSA at 3.2. My urologist told me I had plenty of time to make a decision and in fact whatever I chose I couldn't do anything for at least 6 weeks after the biopsy because of the healing needed after the biopsy. While I haven't heard of an infection, I could definitely see how someone could get one from the biopsy. I can't remember for sure, but I think my doc may have given me an antibiotic before the procedure as a preventive measure.
While you have time and may be able to do what is called "watchful waiting" that is something that you will have to decide. For me, I couldn't stand the thought of having cancer in my body and not doing anything about it. I realize some guys can do that, but I couldn't. It doesn't happen to everybody, but in my case, after my surgery the pathology was upgraded to a more agressive 4 + 3 rather than the 3 + 3 that was indicated from the biopsy. I was glad that I had made the decision to have the surgery and get it out of there.
As to open or robotic, I agree with those who have said go with the doctor you have confidence in and what his specialty is. In my case, my urologist referred me to a surgeon who did open surgeries. I established a rapport with him and came to have great confidence in him. He told me that he thought robotic was the wave of the future and there was a lot of good things happening on that front, but that he wasn't there yet. He is in his late 40s and said that he anticipated in the future he would be doing mainly robotic surgeries, but for him, just not yet. I appreciated his openness and honesty. He indicated that he liked to get in to the surgery and be able to feel around and look around. In fact during my surgery he marked a spot, did the prostatectomy, went back to the spot and took it out and sent it to the lab. It turned out to be benign, but I was glad he had an opportunity to look around.
I also appreciated about him the fact that he told me right up front that he monitored his patients for ED and incontinence. He told me to expect issues for 2 years. As it turned out, I haven't had a lot of issues with either. I have been continent right from the start after catheter removal. I use the ADC version of cialis and levitra but don't have real issues with ED.
My urologist - not my surgeon - was the one who recommended surgery for me. He said at my age I was better off getting rid of the cancer and surgery was the best way to insure you get rid of it. There are other effective treatments as you will hear about here, but at my age he recommended I have surgery and get rid of it. I then went to a surgeon and learned more about the surgery.
My surgeon calls me his star patient because I have done better than most of his other patients and he attributes most of my good progress to the fact that I am relatively young. I am convinced that for me, I made the right choice. One other factor that I considered as I made my decision for surgery was the fact that you can have surgery and then follow-up radiation if needed but it doesn't work the other way. You can't have radiation and then take out the prostate (some have tried but there are some pretty horrible stories about the results). I just wanted to take the route that gave me the most long-term options.
Sorry you have to be here but trust you will find help here. I appreciate all my brothers - and sisters - on this board even if we don't always agree. Please keep us posted on how things are going. David
Diagnosed Dec 2007 during annual routine physical at age 55
PSA doubled from previous year from 1.5 to 3.2
12 biopsies - 2 pos; 2 marginal
Gleason 3+3; upgraded to 4+3 post surgery
RRP 4 Feb 08; both nerves spared
Good pathology - no margins - all encapsulated
Catheter out Feb 13 - pad free Feb 16
PSA every 90 days - ZERO's everytime!
Great wife and family who take very good care of me