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Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/25/2010 3:50 PM (GMT -6)   
When I had DaVinci surgery last November, the surgeon removed my left side nerve bundle and left the right side nerve bundle as the tumor was on the left. As it turns out, my margins were completely clear and cancer had not spread as pathology confirmed. I have heard conflicting outcomes from this where one doctor said that if they take one bundle they might as well take both; and also I have heard there is no more than a 10% drop off in probabilities to regain erections, albeit probably with ed's. I'm looking for posts from those who have had 1/2 of theirs taken and results, or opinions on this matter.
 
Thx
 
 
PSA  3/2009 4.2  8/2009  5.6 gleason 8
Biopsy 2 cores hit, 2 suspicious
DaVinci robotic surgery 11/2009 Gleason 8
Pathology cancer contained completely and subsequent PSA now undetectable
 

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/25/2010 4:11 PM (GMT -6)   
Redman,

My left bundle was removed, as all the cancer was left sided. The right side was left intact, and the surgical notes stated that the right side appeared damaged.

Being such it were, I have had zero ED right from the start. Even with just the right bundle intact. I have been able to achieve full and pre-surgery sized natural errections all along, with no sex pills or no pumps, etc. Consider myself one of the fortunate few in that category. Even my surgeon won't take the credit, he thinks is amazing that I have needed nothing.

Sure you will find answers to your question all over the spectrum.

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% 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: 1/10 .12
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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time

Post Edited (Purgatory) : 1/25/2010 2:17:10 PM (GMT-7)


mikey1955
Veteran Member


Date Joined Dec 2008
Total Posts : 673
   Posted 1/25/2010 4:13 PM (GMT -6)   

Hi Redman55,

Welcome.

If your 55 means you were born in 1955, we're the same age.

My surgeon saved both nerve bundles. I'm 9 months post-surgery and have ED. It is being helped with injections. ED oral drugs didn't do much for me. I suspect that it's not only "sparing" the nerve bundles, but what damage was done to the hugely vascular region around the prostate (the blood vessels that feed the area)...and your physical condition before surgery (ED or no ED, good general health)....IMHO. We're all different and will respond differently.

Others will offer more experiences, soon.

 

Mike


-Nov/Dec 07, March 08 and Dec 08: Severe perineum pain . Septra/Bactrim for 8 months for diagnosed prostatitis.
-PSA start of 2008: 5.3..... PSA June of 2008: 7.3
-14 DRE all benign or nothing felt
-TRUS Biopsy Nov 08: 5 of 8 cores positive GS 3+3 or 6. 30-65%. Perineural invasion.
-General Health: pretty good, 5' 10", 180 lbs, slim.
-Open RP surgery: May 09 both nerve bundles spared. Bilateral lymph node dissection performed. Discharged 48 hours after surgery.
-Post Surgery Pathology: pT3a N0 MX, extraprostatic extension (EPE), stage III prostate cancer, lymph nodes clear, seminal vesicles clear, Gleason upraded to 3+4 GS 7. EPE within surgical margins. Other than prostate and EPE, all tissue removed negative for cancer involvement.
-Bladder control within 48 hours of catheter removal
-ED ongoing but improving significantly with Trimix at 7 months post-op. Oral ED meds didn't do much.


NewspaperLover
Regular Member


Date Joined Sep 2009
Total Posts : 311
   Posted 1/25/2010 4:19 PM (GMT -6)   
I also had DaVinci surgery in early November.  Before I had undertaken independent consults with three surgeons, and all indicated they would take the left bundle because of the location of the cancer.  So I knew going in.  My post surgery pathology was the same as yours -- clean margins, no sign of cancer outside the gland.  I get my first post surgery PSA test next week, and that will tell the rest of that tale.  Regarding other outcomes, I never had any incontinence and stopped the pads after two days.  Very lucky there.  As far as erections go, nothing good enough yet for intercourse, can get sort of a soft erection with Viagra.  I have learned, however, that it is possible to orgasim without an erection.  In my case, the retrograde orgasim causes a lot of urine to ejaculate.  Not the most elevating experience of my life, but defintely better than canned corn beef.   Other men on the forum report the same phenomena with urine.  That may subside in time, I am told.
 
So, at my age of 66, and with one bundle gone, I am not optimistic about a full recovery in the ED department.  Best wishes to you.
 

NewsPaper Lover

 

Age 66

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. No incontinence.  Stopped pads after two days.

 


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/25/2010 4:36 PM (GMT -6)   
Guys, thx for the replies. Purgatory...that is encouraging, and Mike, yes I was born in 1955. I have heard that recovery to any sort of getting back in the game is 4 months to two years. I'm doing the ed pill gig, pump and just started on trimix. we shall see. Again thanks.

PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable


James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4463
   Posted 1/25/2010 4:39 PM (GMT -6)   
Redman, your 'heard' estimates are probably right on the money. Seems you are doing the full regular routine for ed recovery with the 3 P's (pump, pill and prick), so you probably gotta just let time work on the problem...
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP 110gms.- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
24 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN

Post Edited (James C.) : 1/25/2010 2:45:01 PM (GMT-7)


Steve n Dallas
Veteran Member


Date Joined Mar 2008
Total Posts : 4848
   Posted 1/25/2010 4:42 PM (GMT -6)   
I too had half the nerves saved/removed...Pretty much dead on the ED front but Trimix does the job...
Age 54   - 5'11"   205lbs
Overall Heath Condition - Good
PSA - July 2007 & Jan 2008 -> 1.3
Biopsy - 03/04/08 -> Gleason 6 
06/25/08 - Da Vinci robotic laparoscopy
05/14/09  - 4th Quarter PSA -> less then .01
11/20/09 - 18 Month PSA -> less then .01
Surgeon - Keith A. Waguespack, M.D.


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 1/25/2010 8:04 PM (GMT -6)   
I had one side removed and Jan 19th. was 5 months out for me. Muse will make me plump out but it pretty much only gets to about 50% which isn't close to useable. Viagra is just now starting to show some signs of life but at this point isn't even close to what the muse does. I am batting 1000 with tri-mix and .175ml lasts for about 2 hours. I was told it would take between 1 to 2 years. I will diligently continue to use the 3 P's at least until 2 years out. I am still amazed at the number of guys who aren't willing to make the effort. Even if they are older then I am. Guess I'm more stubborn then most..
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
4 month PSA .003 12-18-09


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 1/25/2010 8:06 PM (GMT -6)   
ahhh, as a side note... If you have used Muse and can deal with it the trimix isn't nearly as annoying or uncomfortable to use.
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
4 month PSA .003 12-18-09


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/25/2010 8:27 PM (GMT -6)   
t40, for curiousity sake, to you find inserting the Muse difficult at times, or do you have it down to a science?
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% 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: 1/10 .12
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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


Redman55
Regular Member


Date Joined Jan 2010
Total Posts : 87
   Posted 1/25/2010 8:38 PM (GMT -6)   
T40 I've gone two rounds with the trimix. .1 ml and then .17. Better but still not there. I have read posts where using 30 to 50 mg of viagra etc allows you to get results with lower trimix dosages. Any comments?
PSA 8/2009 5.6 Gleason 8
DaVinci surgery 11/2009
Pathology - totally contained in margins -one bundle spared
PSA now undetectable


tatt2man
Veteran Member


Date Joined Jan 2010
Total Posts : 2845
   Posted 1/25/2010 8:44 PM (GMT -6)   
David - maybe the real reason for no ED is your wife !!??
-maybe you could bottle her and sell it on ebay - "eau de errectione" ( I know it ain't french)
hugs
BRONSON

P.S. I believe I have one nerve bundle left ( forgot to ask what he left in) - but since I can get chubbie but not long or hard - would expect that something is going on that can be affected by cialis and such - do you guys have a preference for the alternatives? - muse - trimix - bimix .. bimix seems to be the winner from the posts I have read..
.................
Age: 54 - gay - with spouse, Steve - 59
PSA: 04/2007- 1.68 - 08/2009 - 3.46 - 10/2009 - 3.86
Confirmation of Prostate Cancer: October 16, 2009 - 6 of 12 cancerous samples , Gleason 7 (4+3)
Doctor: Dr. Mohamed Elharram -Urologist / Surgeon - Peterborough Regional Health Centre
Radical Prostatectomy Operation: November 18, 2009 , home - November 21, 2009
Post Surgery Biopsy: pT3a- gleason 7 - extraprostatic extension - perineural invasion - prostate weight - 34.1gm -
ED Prescription: Jan 8/2010 - started daily 5mg cialis
location: Peteborough, Ontario, Canada
............


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25393
   Posted 1/25/2010 8:48 PM (GMT -6)   
Bronson, will being married to a delightful natural redhead does have some plusses and built-in incentives. We are realistic though, at 57, PC or no PC, no longer a stud muffin, not sure I ever was ,lol.

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% 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: 1/10 .12
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 43 days, 1/10 - Corrective Surgery #4, and Caths #11 and #12 in at the same time


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 1/25/2010 9:52 PM (GMT -6)   
I would consult my doc before using viagra in conjunction with trimix. You are asking for a bout of priapism if you aren't careful. Doc told me to try up to .2 and I did and it worked great. Then scaled to .17 which seems to do the trick just fine.
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
4 month PSA .003 12-18-09


T40
Regular Member


Date Joined Oct 2009
Total Posts : 103
   Posted 1/25/2010 9:54 PM (GMT -6)   
Purgatory,

I have it down to a science. The injections still don't bother me nearly as much.
Age 40
Pre-op PSA was 5.8 from wellness test on May 19, 09
Follow up test from uro was 4.6 with a 9.3% free psa
Gleason 3+3 in one core, 3+4 in second core of 12 samples taken
Surgery performed August 19th, 09.
One side nerves spared. Nerve graft on other side.
Six weeks incontinence almost over. ED a work in progress but seeing some response.
4 months no longer using pads. ED using trimix with positive response.
Post op October 2nd, 2009 All margins were negative. PSA results in a few days.
Post op pathology 3+4 PT2A NOMO
6 wk PSA .004
4 month PSA .003 12-18-09


Colin45
Regular Member


Date Joined Feb 2009
Total Posts : 216
   Posted 1/26/2010 7:04 AM (GMT -6)   
Redman

I to lost one bundle because the surgeon felt that one side was a bit hard cancer was found to be contained no problem with ED from the day I had the catheter removed
 
 
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
5/15/09 24 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 lost one nerve bundle
Gleason upgraded to 3+3 Tumour not close to prostatic capsule Seminal Vesicles not involved by Tumour 6 Lymph Nodes negative for Malignant cells
First PSA Nov 2009 was 0.06 Continence 99% occasional stress dribbles no ED from first day after catheter removed

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