In the 13 months since I had my
open surgery, my uro/surgeon and I have talked about
many thing including the whole subject of nerve sparing operations. He rarely does them himself, even though he is very experienced and accomplished. He values the importance of being able to have errections as much as the next guy, but his primary goal, is to eradicate cancer. He said even in the nerve sparing ops, they have to "shave" so close to the nerve bundles, that they effectively may be severed. Plus he said the nerves we are talking about
are so tiny, that its kind of hit and miss on the best of days.
He still thinks my natural ability to have errections and not to experience any ED after surgery with just one bundle left behind is a freak thing. He still won't take surgical credit for it. He said, I should be having problems, but also stated that each "body" is so uniquely different than the next.
My point, I think the nerve=sparing aspect is something that is oversold. No doctor can guarantty results even if you choose to go that route. There are other factors involved.
My own surgeons expertise is on the Incontinence front, he said that is where good surgery can make a big difference. While he has no objection to robotic surgery, they do it at his practice, he is 100% and
open surgery surgeon. He said he can make a good argument for the tactile feel case over the increased magnification advantage of robotic. I am sure this is something that surgeons hash over in their spare time. He said an experienced surgeon can feel things with his fingertips and that its just not the same with robotic probes. That may be subjective, as none of us are surgeons.
Just thought i would share his thoughts on the subject
david in sc
57, 56 dx, PSA: 7/07 5.8, 7/08 12.3, 9/08 14.5, 10/08 16.33rd Biopsy
: 9/08 - 7/7 Positive, 40-90% Cancer, Gleason 4+3Open RP:
11/08, Rht nerves saved, 4 days in hospt, on catheters for 63 days, 5th one out 1/09Path Rpt
: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos margin
Incontinence: 1 Month ED: Non issue at any point post surgery
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Latest: 7/9 met 2 rad. oncl, 7/9 cath #6 - blockage, 8/9 2nd corr surgery, 8/9 cath #7 out 38 days, 9/9 - met 3rd rad. oncl., mapped 9/9, 10/1 - 3rd corr. surgery - SP cath/hard dialation, 10/5 - began IMRT SRT - 39 sess/72 gys ,cath #8 33 days, Cath #9 in 35 days, 12/7/9 - Cath #10 in place