Hello, and welcome to our little neck of the world. In my opinion and experience, a good surgeon can't make that decision ahead of time. The prime purpose is to eradicate the cancer. In the classic sense of prostate surgery, the surgeon works to rid the body of cancer, then try to minimize incontinence problems, then to preserved erections. But never worry about
ED as opposed to ridding one of the cancer.
That was the approach my
open surgeon used. As a fellow Gleason 7, I went into surgery expecting a non-sparing surgery. In the end, he left the right side alone (noted that it appeared damaged), and removed all the left side nerve bundles. In the end, despite only having one set of nerves, I have experienced no ED at all post surgery. One of the lucky few, I admit. I also had very little problem with incontinence, less than a month.
You need to find a really skilled surgeon, with sufficient experience to do the best job he/she can do. But there are no guarantees in surgery, you get what you get in the end.
Please keep us posted.
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
Post SRT PSA:
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 - 11/27 IMRT SRT 39 sess/72 gys ,cath #8 33 days, Cath #9 35 days, 12/7 - Cath #10 in place