Why is incontinence so different among us?

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Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2458
   Posted 9/19/2009 7:51 AM (GMT -6)   
Recently we had a survey about ED. I think we should have another one about incontinence. From reading various posts, it seems that some are continent almost immediately yet others suffer for a long time. I'm curious to know why. It doesn't seem to be related to age or surgery type. Could it be the the physical condition of the patient prior to surgery? The skill of the surgeon? The amount of nerves damaged during the surgery? The size of the prostate prior to surgery? What else?
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
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 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Cajun Jeff
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Date Joined Mar 2009
Total Posts : 4106
   Posted 9/19/2009 8:00 AM (GMT -6)   
My guess Ed is yes to all the above. I think the skill of the Dr has a lot to do with both conditions. You could think of the Dr as a machanic.

Jeff T
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
 10th month  PSA <0.01
ED- 5 mg Cialis daily, pump daily, going to try MUSE next


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/19/2009 8:19 AM (GMT -6)   
EdC, I think its all of the above you mentioned, plus other factors that we aren't even considering. If a poll were to be done accurately, you would have to have some good pre-surgery base questions, i.e. Did you have any non-PCa prostate probems before your PCa dx?
Were you getting up at night to urinate? Were you straining or retaining urine in any way pre-surgery? Did you have prostate infections prior to surgery? Etc, etc.

From a purely surgical point of view, there would be lots of things I have read about that could cause the variances that you mention. And you are right, there are men among us who are dry as soon as their catheter is removed, others in a few days, myself - let's call it a month at the most (and most of the time it was in my head), others for 6 months to a year, and others way beyond that.

Some men faithfully do their kegals even pre-surgery, and around the clock post surgery, and with some it helps, and others it doesnt. My own uro/surgeon feels they are a waste of time generally, and that if you do them too much post surgery, you actual make things worse by tiring out the bladder control muscles by not allowing them to heal. Once again, we would find a thousands variations and exceptions.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


Ed C. (Old67)
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Date Joined Jan 2009
Total Posts : 2458
   Posted 9/19/2009 9:56 AM (GMT -6)   
Thanks David. I think you right on all accounts. What I'm trying to find out is whether an aggressive surgeon may do too much damage to the muscles that control urination or whether all these other issues are the cause. I consider myself reasonable fit, I exercise or play golf almost daily and yet it took me almost 5 months to become 99% continent, yet I have a friend who is out of shape, overweight who was 100% continent after 2 months. By the way, we both had the same Uro.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
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 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/19/2009 10:04 AM (GMT -6)   
EdC

I too, was not in great physical shape pre-surgery, somewhat overweight (not obese), and suffered from years of Chronic Fatigue. Pre-surgery, could hold my bladder all day if needed, never ever got up at night to pee, never had an UTI in my life, and my prostate was not enlarged pre-surgery. Perhaps some of those factors helped me post-surgery, or just the luck of the draw. I did kegals post surgery for at the most, 10 minutes total, and decided on my own that it wasn't for me.

With both of my post surgery corrective surgeries/procedures to clear those annoying sticture/blockages, I was fully continent again within 24 hours of having the catheter pulled.

In my odd case, I often wonder if the magic card for me is the fact that I was on catheters for so long, which gave my parts up there a much longer chance to heal without strain, unlike the way it is for most men, who have surgery and their one and only catheter is pulled lets say 7 to 14 days out from surgery, when everything is still so swollen and sore up there. My own uro/surgeon does not discount that possibility. I wonder too if it explains me having no ED problems from the get-go, again because of all the extra healing time.

Might just be guessing, but interesting to think about.

David in a very rainy soggy South Carolina, boo
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 9/19/2009 10:24 AM (GMT -6)   
I was 99% dry in about a week and I am still 99% dry I only have a small dribble at night when I am at home I am to lazy to worry about a small leak I have not done any Kegals one thing my doctor said about continence was that is is all about the way the urethra is reattached to the bladder and he said that he had a 95% continence record and of the other 5% only half were totally incontinent
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
 First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms
Gleason upgraded to 3+3 Tumour not closeto prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
 


Worried Guy
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Date Joined Jul 2009
Total Posts : 3732
   Posted 9/19/2009 10:42 AM (GMT -6)   
Colin, Is it any wonder why you're a "marked man" if you ever come to my town? Watch your back, buddy. You lucky, lucky b*stard. (And you know why I repeated the "lucky")

Ed, I was curious about this subject too, and found a few standardized incontinence surveys. Another factor that needs to be considered is the PCa state at the time of surgery. What was PSA? What is the pathology report. T1 T2 T3? Gleason.
Someone who has a a very mild case should be rated differently from someone who has a more aggressive form.
I can look up those surveys if someone is interested.

Post Edited (Worried Guy) : 9/19/2009 11:21:00 AM (GMT-6)


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 9/19/2009 10:50 AM (GMT -6)   
Jeff I will not concider myself as lucky until I hopefully get a PSA reading of zero on the 6th November
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
 First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms
Gleason upgraded to 3+3 Tumour not closeto prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
 


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/19/2009 2:50 PM (GMT -6)   
Colin,

You quite correct, that first zero will be a big plus in your favor, and a string of them will give you confidence you may the beast under control.

David in SC
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


Worried Guy
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Date Joined Jul 2009
Total Posts : 3732
   Posted 9/19/2009 3:28 PM (GMT -6)   
Just for the record, my 6 week PSA matched my s*xual activity. ---- Zero. zero 5.

Piano
Veteran Member


Date Joined Apr 2008
Total Posts : 847
   Posted 9/19/2009 5:21 PM (GMT -6)   
Think of the analogy of the foot on a hose-pipe. Whether you can shut off the flow depends (pun intended!) on a few factors:
* The water pressure
* How broad the foot
* How much force you can apply
* How flexible the hose-pipe

I expect all those factors apply to our internal plumbing too -- after surgery we are using a different sphincter to hold back the flow, so if it is out of shape, it will take some training to improve. And if you happen to have a narrow "foot", no amount of training will improve that.

The nerves that control erection are separate from those that control the sphincter. I was non-nerve-spared, Gleason 8, T2, but fully continent from the outset.

So I think the major factor is the shape of our internal plumbing, but I will concede that damage to the sphincter control nerves, if it happens, would also be a factor. If it does happen, do the doctors ever tell us?
Pre-op:
Age 63 at diagnosis, now 64.
No symptoms; PSA 5.7; Gleason 4+5=9; cancer in 4 of 12 cores.
Operation:
Non-nerve sparing RRP on 7 March 2008.
Two nights in hospital; catheter out after 7 days.
Post-op:
Continent; no pads needed from the get-go.
Pathology showed organ confined and negative margins. Gleason downgraded to 4+4=8.
PSAs:
6-week : <0.05
7-month: <0.05
13-month: 0.07 (start of a trend?)
ED:
After a learning curve, Bimix injections (0.2ml) are working well. VED also works but we find it inferior to Bimix.
14 months: Occasional nocturnal erections.


TheoTeacher
Regular Member


Date Joined Jul 2009
Total Posts : 47
   Posted 9/19/2009 6:18 PM (GMT -6)   
I can't remember where I read it, but it seems that the degree of incontinence is a result of surgery; the amount of "extra" tissues removed and the spot on the urethra where it is cut and reattached to the bladder.  No two men are the same, no two surgeons are the same and no two surgeries are the same (even with the same doc.)  This surgery is not an exact science.  Data seems to suggest that 30 - 50 kegels daily 60 days prior to surgery and 90 days post surgery assists the process, but not significantly.  As I remember the article, the end result % was close with and without kegel, only the time it takes to get there was different.  Kegels seem to assist the process.  Yet, as others have said, too many kegels tires out the muscles you're trying to build up.
 
As for me, I have good days ang great days in the world of bladder control!  A great day is 3 pads in 24 hours; a good day is 5 or 6.  But it is getting better each week.  A little wettness sure beats a prostate full on cancer!
Dad dx at 72 with Pca; RP at 73; Died 11/08 at 88 from Pca met.
3 Uncles have had Pca; 2 deceased from Pca met.
Me: Age 51: Joyfully Married; father of 7!
Routine Physical 11/07 PSA 1.73 DRE normal
Routine Physical 1/09 PSA 2.77 DRE abnormal.
1st Urologist visit 2/09 DRE normal, small - PSA 6.3!
Biopsy 3/17- St. Patty's Day! 3 of 12 cores positive with 5-8% Pca
3+3 Gleason; Visit Johns Hopkins 3/26/09 and decide for surgery.
Lapro RP 6/29/09; discharged 6/30/09
Cath out 7/9/09 Gleason unchanged 3+3;
"Larger amount of cancer" than expected.
Organ confined Pca, positive margin as "artifact" of surgery.
All other tissues clear.
7 wk psa 8/20/09 - 0.05

"We walk by faith, not by sight."


Jstars
Regular Member


Date Joined Oct 2005
Total Posts : 489
   Posted 9/19/2009 9:36 PM (GMT -6)   
I think Colin and Piano have it right. The surgeon's technique has to be the main factor.

Also, have you ever seen the suturing technique that is used to re-attach the urethra to the bladder neck??

It is amazingly complicated where the suture thread is loosely looped many times from one side to the other side all the while the two ends are only loosely in contact with each other. When all the loops are done the thread is then slowly pulled taking up all the slack and the two ends are draw together.

I would think then the surgeon has to guess about how tightly to snug it all down (around the catheter tubing etc).

There has got to be a lot of variation in that. I think also the surgeon has to balance between making the seal tight, but not so tight that later on the scar tissue contracts too much causing too much constriction later on.

Finally, I would say that having a short period of a few months of incontinence and still be able to gush like a firehose rather than dribble is worth the extra wait (if it were the case that quick IC end means a really snugged down sphincter to start with).

That might be a survey question to ask in relation to how well you can void urine after continence is reached : gusher, normal or dribble -- to see if it has any correlation with the quickness that continence is reached.
Age 58, 195lbs, 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 size 140+ cc (110 grams post op).
02/03/09 open RRP surgery , Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Pathology Report: All margins clear - No Invasive spread - no change in Gleason score.
02/18/09 Cath out, passed a 1cm oblong STONE within hours.
03/06/09 Started Levitra@20mg / Viagra@100mg / (04/01) Cialis@20mg -- no real effect (thru 09/2009).
04/01/09, 07/07/09 PSA <0.1 - Stone Was Oxalate stone -- X-ray no stones.
08/07/2009 - MUSE@1000mcg@Uro Office -- worked OK -- AlProstadil ache not bad.


MrGimpy
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Date Joined Jul 2009
Total Posts : 504
   Posted 9/20/2009 6:16 AM (GMT -6)   
Every person is different, healing and regaining lost function is no different

Environment, nutrition, genetics, mental outlook, etc, there are so many different contributors to this equation that is impossible to determine why some people heal faster than others

Even the illness itself, how many cancer cells did one person have and what how much of an impact to ones nerveous, skelatel, muscular, etc system varies vastly from one person to another
Stats:
Age: 52
PSA (2008)=1.9
Biopsy on Jan 09, 2009
One (1) out of twelve (12) cores was positive, plus external nodule found
Gleason Score = 3+3
Surgery (Da Vinci, robotic prostatectomy): 4/7/09
Removed Catheter: 04/19/09
100% bladder control - Pad free 7/09
PSA 7/09 undetectable, under .0


CPA
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Date Joined Feb 2008
Total Posts : 655
   Posted 9/20/2009 1:02 PM (GMT -6)   

Greetings, everyone. Good discussion - I tend to come down with several others that it is the skill of the surgeon and his experience.  My surgeon had a great reputation (still does) as it relates to both incontinence and ED.  One thing he told me when we met together for the first time on January 2.  He said don't worry about doing a certain amoung of kegels - I just want you to stop your flow of urine a minimum of 5 times every time you urinate between now and your surgery (which was Feb 4).  I know that is a subtle difference but for me it worked.  I was basically dry the day after catheter was removed. 

I am also not in great physical condition - I'm overweight and always have been.  I do walk and even used to jog but still was overweight.  I don't eat healthy - I can go weeks with no sweets but I do love fried foods and salty type snacks like chips and dips and pizza and stuff like that.  I have gotten better the last couple of years, but still not nearly where I should be.

So, I come back to skill of the surgeon - I'm grateful mine did such a good job.  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


wd40
Regular Member


Date Joined Jan 2008
Total Posts : 218
   Posted 9/20/2009 1:17 PM (GMT -6)   
I have wondered if a big factor could be where you stopped-started peeing. That is if you used the valve in your prostate as the main shutoff then when its gone you have to retrain yourself.
12/06/07 DaVinci and open prostate surgery after difficulties in breathing stopped the davinci.


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 9/20/2009 2:03 PM (GMT -6)   
David/CPA - I tend to agree, I think precise surgical skill in the hands of an experienced surgeon, makes so much difference too.
Age: 57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.3
3rd Biopsy: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3
Open RP: 11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09
Path Rpt: Gleason 3+4, pT2c, 42g, 20%, Contained in capsule, 1 pos margin
2009 PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/09 met 2 rad. oncl, 7/09 cath #6 - blockage, 8/09 2nd corr surgery, 8/9 cath #7 - out  38 days, 9/14/9 - met 3rd rad. oncl., agreed to start radiation, does not rec. HT at this time, mapping on 9/21/9


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 9/20/2009 3:18 PM (GMT -6)   
I never knew I had a pee shut off choice. Why wasn't this in the manual?
I do know that for the past 8 years my stream has been slow. I was always the last guy to leave the urinals after a meeting - and it wasn't because I was slow getting started. A typical visit was 50 seconds - enough time to write my name, phone number, and address in the snow. (Northerners know what I mean.)
I blasted my perineum for 40 minutes around 1:00 with the TENS and was so exhausted after, I had to take a nap. On the other hand I am still on the first pad I put in today at 12:30 pm. Look like I'll keep this one until 9:00 pm and put in a clean one for bed. That is 2 pads per day! I saved 28 cents toward my retirement!

Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 9/21/2009 12:13 AM (GMT -6)   
Jim I also watched a video of a Robotic operation and I agree with what you say but it must give the experience open surgeons a big advantage to be able to feel in his hands how tight to put to close the gap so no leaking occurs
 
 
Age 64 From UK now in Thailand Baby boy born 2/14/2009
 First PSA was showing 9.73 on 1/21/09.   on 5/7/09 PSA 9.78  Free PSA 0.83   Free:Total  PSA 0.08 
1/28/09 Biopsy carried out 12 core results show no adenocarcinoma
5/15/0924 Core biopsy results Gleason'S Grade 3+2=5
Involving approx 30% of one out of 12 cores on each side no perineural or angiolymphatic invation identified
One side PIN High Grade Bone scan clear 
Open surgery 7/27/09
Prostate Gland weighting 34 grms
Gleason upgraded to 3+3 Tumour not closeto prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
 


jacketch
Regular Member


Date Joined Apr 2009
Total Posts : 179
   Posted 9/21/2009 5:54 AM (GMT -6)   
wd40 said...
I have wondered if a big factor could be where you stopped-started peeing. That is if you used the valve in your prostate as the main shutoff then when its gone you have to retrain yourself.

Although I agree that the surgeon's skill is a critical factor, I think that wd40 may correct in thinking that an individuals longtime use of the lower urinary sphincter may have a strong bearing on the continence outcome.
62yo
V10.46 Dx Feb-09
RRP 5-5-09
No adverse SE
PSA 6-19-09 -0-
 
Thriving, not just surviving!
 


Worried Guy
Veteran Member


Date Joined Jul 2009
Total Posts : 3732
   Posted 9/21/2009 7:35 AM (GMT -6)   
What the ?!? Are you telling me for 56 years I had a choice on how to stop my flow?!?! Did you guys actually say "Oh I think I'll use my lower sphincter today. I've been using my upper these past two days." ?!?! I didn't know I had a choice! And where exactly did you switch over? Do you pull out and rotate your drain pipe 180 degrees like a Delta faucet cartridge?

I'm kidding about the cartridge concept but I am serious about the other stuff. If I've been doing it wrong for 56 years years I want to tell my two sons about this now while they still have the walnut. So, anyone out there with the aforementioned skill please enlighten me. Is there a manual?
Maybe we can practice during the GFMPH weekend - oh wait... The only choice the attendees have now is: Tena or Depend.
DX Age 56. First routine PSA test on April 8th: 17.8.
May PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, Gleason 6=3+3. Bone scan and C/T scan negative.
----------------------------------------------
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7 Tumor size: 2.5 x 1.8 cm location: both lobes and apex. No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Extraprostatic extension present; Perineural invasion: present, extensive
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
----------------------------------------------
Post Surgery Status:
Potency - 9/17 2 months, Still no activity
Incontinence - 8/20 4 full pads per day
. 9/7 3-4 full pads per day (I'm going to try cutting down on fluids. Bad idea. I know.)
9/17 2 months: Still 3 pads per day. At this rate I'll be fine in 2011.
Post Surgery PSA - 9/3 6 weeks - 0.05


engineer55
Regular Member


Date Joined May 2009
Total Posts : 121
   Posted 9/21/2009 5:00 PM (GMT -6)   
My surgeon was doing studies on cooling the prostate during surgery.  So far he found no difference in ED but average incontinence was reduced by 1/2 with the cooling procedure.  Went from about 2 months to 1 month which is about where I was.
 
That would be the biggest advantage to holding off on surgery, they will obviously keep getting better at it.
Dx'ed 5/08 one core 2%  out of 12  3+3 gleason
DREs all negative
PSA was in the 3-4 range then jumped to 7
I have the enlarged prostate, on the order of 100cc.  After taking Avodart for 3 months  my
PSA was cut in half.
I did Active S for a year but concluded that I didn't want a life
of biopsies and Uro meetings.
DaVinci on 6/24/09  UCI Med Center  Dr Ahlering, long surgery based on size and location
Final was 5% one side all clear, but had a huge 90 grm prostate
Now we work on pee control, ok at night but sitting is a big problem.


Worried Guy
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Date Joined Jul 2009
Total Posts : 3732
   Posted 9/21/2009 6:51 PM (GMT -6)   
Hey engineer, I am in a very similar situation. I can last all night but as soon as I sit up - out it comes! Also I can also sit just fine but stand up and the flood gates open. I try and kegel before standing up for as long as I can (one minute max). that gives me just enough time to get to the outside and then let fly. This is not a procedure suitable for office use or mixed company.
How about you? Same?
I start incontinence therapy tomorrow. Will let you know what they do and if it works.
Have you done this?
Jeff

Jake T
Regular Member


Date Joined Mar 2009
Total Posts : 44
   Posted 9/21/2009 8:06 PM (GMT -6)   
Hey Ed, great topic, before surgery, ( like  Purgatory) i could hold my bladder all day and never got up at night. April 2009 i had a very skilled top surgeon who has been doing robotic surgery since 2001, and i started with 8 -9 pads a day,( he did do a great job on sparring the nerves for the ED department). Incontinence gettin better very very slowly down to 1 pad a day and 1 @ night after almost 5 months, started physical therapy August 23,  Going tomorrow for the 2nd psa.

Age 56 > DRE 12/22/08 > PSA 3.4 on Jan 09 > PSA 3.8 on Feb 09 > Biopsy 3/9/09 3 out of 12 positive > Gleason 7 > cat scan neg > divinci robotic surgery 4/23/09 at Mount Sinai NY > Dr. Samadi > Chief Division of Robotics > both nerves spared > margins and nodes clear > catheter out in 7days 4/30/09 > 6 week post surgery PSA 0.01 on 6/ 09/09 > incontinence (getting better) started bio feedback  8/23/09    1-pad a day 1 @ night 

 

 

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