Of all the information I reviewed while considering my course of action (and also consulting three surgeons, a radiation oncologist, and a general medical oncologist) the referenced study and article below from the New England Journal of Medicine (March 2008 issue) was by far the most helpful to me.
The study followed 1200+ men and their partners for two years. Interviews were conducted before surgery, and at 2, 6, 12, and 24 months. Respondents were asked to guage their "degree of satisfaction" with "Changes in Quality of Life After Primary Care Treatment" in five areas, including Sexual Satisfaction and Urinary Incontinence. The results are graphed out nicely in Figure 1 in the article referenced below; you can keep clicking on Figure 1 it to get it to readable size.
I found the results more than interesting, and not that surprising from what I had learned anecdotally on this Board and other locations.
For example, the men undergoing Prostatectomy were divided into Nerve-Sparing and Non- Nerve Sparing groups. After two years, 40% of the Nerve-Sparing group reported they were sexually satisfied; only around 20% of the Non-Sparing group reported satisfaction. The two groups were much closer on satisfaction levels with urinary continenece, roughly 80% and 70% were satisfied.
My personal choices, because of my situation, came down to Non- Nerve Sparing Prostatectomy (one bundle removed) or a combination of Radiotherapy + NHT (hormones) for six months. Surprisingly (at least to me), the Radiotherapy + NHT group reported about the same level of sexual satisfaction as the Non- Nerve Sparing prostatactomy group (roughly 20%) after two years. That helped tilt things for me towards surgery as I decided radiation had its own problems, and that I would still be leaving behind a diseased, albiet now "burnt" organ.
Also, I have tried to keep in mind that as unpleasant as these consequences can be, the primary, indeed overriding goal, is to get rid of the cancer.
Here is the artilce from March 2008, New England Journal of Medicne.
PSA: 6.0 on 07/31/09 having risen from 4.2 on 12/02/08. Free PSA 23.5%.Other PSA History: 4.3 on 05/01/08; 3.3 on 11/15/07; 3.1 on 05/20/07; 4.0 on 11/30/06; 3.40 on 09/01/05.
Biopsy: 09/04/09 13 snips; two positive. Right Mid 4+3 = 7 and 15% of the total volume. Right Lateral Mid 4+3 = 7 and 20% of the total volume.
DaVinci robotic surgery: 11/05/09. Post surgery pathology: margins clean, no invasion of seminal vessels, no upgrade of the Gleason scores, no evidence of cancer outside the prostate capsule.
Cathether removed one week later: 11/12/09. Very minor dribbles for two days. Stopped using pads after three days. No pads or incontinence either by day or at night.