two inch incision with RRP?

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New Member

Date Joined Dec 2009
Total Posts : 8
   Posted 3/1/2010 3:51 PM (GMT -6)   
I'm recovering from RRP that was done about 10 days ago. In my pre-surgery research, I read that there would be 5 small incisions in my abdomen, the largest being above the belly button. This is where they pull the prostate through, I guess. Anyway, I have 6 incisions. The "surprise" incision is about two inches in length and cuts horizontally on my right side, very low, below my belt line. My wife is the one who noticed it and the doctor acts like it is normal to have. It seems to be healing OK.

Anyone else have an "extra" incision? I plan to press the doctor for a better explanation.
Diagnosed at age 46

9/09 PSA 5.7 DRE negative

10/30 PSA 7.1 referred to Urologist

12/09 Biopsy 2 of 12-LLM Cancer GS 3+4 20% involved and LLA Cancer GS 3+4 30% involved

02/18/10 Robotic Laparoscopic Radical Prostatectomy (Bi-lateral nerve-sparing)

02/24/10 - Post-surgery pathology report shows cancer was organ-confined, margins clear.

Forum Moderator

Date Joined Jan 2010
Total Posts : 6853
   Posted 3/1/2010 4:24 PM (GMT -6)   
I had an "extra" as well, although I only know it by count, as we didn't go in to exactly which hole was which (except the large one - yes, that is where they pull out the prostate, but it seems to be the one the camera uses as well). The doctor explained that in the "standard" DaVinci scheme, one port is shared between the equipment and the nurses passing in suture materials. He follows what he says is an alternate but accepted practice of an additional port for the nurse's purposes. In theory it makes life easier for the surgeons & nurses, speeds the surgery, and lowers risks.

Veteran Member

Date Joined Aug 2009
Total Posts : 652
   Posted 3/1/2010 5:00 PM (GMT -6)   
Horton, I have the "extra" one as well, right where yours is, but mine is probably a little longer yet. I had a monster of a prostate (60g), and my doc said as much. My understanding is that is the opening it came out of, and it may be a function of how large your gland is. My battle scars are the least of my worries. You might ask how large the prostate was, and if that had any bearing on that cut.

Good to hear (presumably, by lack of comment) you are no longer having the clot troubles. Hope the rest of your recovery goes more smoothly.
Gleason, 3+4; PSA, 7.9
Robotic Prostatectomy, March 2008 (Age 48 then), nerves both sides spared, post surgery analysis confirmed 3+4 Gleason,
pT2c, prostate 60.2g, margins: negative; perineural invasion: present; lymphatic invasion: present; 3 lymph nodes removed, clear; seminal vesicle invasion: absent; Gleason 4 comprises 5-10% of carcinoma
PSA consistently <0.1 since surgery until Oct 09, 0.1; retested Oct 09, <0.1,
Jan 10, 0.2
retest Feb 1 confirmed 0.2
CT scan, bone scan Feb 10 both clear

Heavy Leaker
Regular Member

Date Joined Feb 2010
Total Posts : 63
   Posted 3/1/2010 6:55 PM (GMT -6)   
I have 6 holes. 1 large one above the belly button & 1 to the left of it. Then 4 in a line below these 2. This is what my surgeon told me in advance & the end result was as he said.
4 biopsies over 4 years starting in 2006, 4th biopsy showed 5% of one core Gleason 3+3=6.  PSA in 2005 6.0, rose to PSA 18 shortly before surgery.  Chose surgery over radiation due to conflicts in PSA versus biopsies.  PSA 18, Gleason 3+3+6, Age 58, Rising PSA since 1999, Biopsy 5% of one core
Robotic surgery 10/26/09  T2B Tumor 30% of prostate  involving left & right lobes  NOMX Gleason 3+4=7  Urethral Resection margins &  resection surface clean Seminal vessicles clean.

In This Together Wife
Regular Member

Date Joined Dec 2009
Total Posts : 135
   Posted 3/2/2010 9:30 AM (GMT -6)   
Bear was expecting 5 also, but has 6 with the placement same as heavy leaker. 
(Bear's stats) Age 49
 8-4-09    Family Practioner for back pain  PSA 4.9
8-20-09  Consult with urologist                PSA 4.89
9-2-09    Biopsy          3 cores positive 7% 3+3 (6) gleason
11-13-09 DaVinci
11-23-09 Cath removed  Path report cancer contained neg. margins
Feb 2010 wil be followup PSA

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2209
   Posted 3/2/2010 10:27 AM (GMT -6)   
I was expecting five and had six

"Lights camera Action!" perhaps

I have one big one above the navel.
On the far left and far right I have symmetrical scars that are below where my belt comes and almost as far to the side as the bone of my pelvis
plus one on the left and one on the right that are just above where my belt comes and a coupe of inches nearer the mid line
plus and one on my right to the right of my navel.

If I do the "tool" count then I get the following:
prostate removal

Which makes seven so two must have been combined: I think the lights are on the camera arm.

I was told they would all be small holes until they were ready to remove the actual prostate etc then they would make one of them bigger, depebnding on which was the easiest route to remove it, but it was most likely to be the hole by the navel that was made bigger.
You sound like you have been given an "appendix" scar Horton.


Regular Member

Date Joined Jun 2008
Total Posts : 407
   Posted 3/2/2010 10:31 PM (GMT -6)   
I had/have 6 holes, also.  After 1.5 years, all but the one over the belly-button has disappeared.  I, too, was surprised with the 6, post-op, after reading, pre-op, there'd be 5.

Age:  60 (58 at diagnosis - June, 2008)

April '08 PSA 4.8 ("free PSA" 7.9), up from 3.5 year prior

June '08 had biopsy, 2 days later told results positive but in less than 1% of sample

Gleason's 3+3=6

Developed sepsis 2 days post-biopsy, seriously ill in hospital for 3 days

Dr. recommended robotic removal using da Vinci

Surgery 9/10/08

Northwestern Memorial Hospital, Chicago, IL

Dr. Robert Nadler, Urologist/Surgeon

Post-op Gleason's:  3+3, Tertiary 4

Margins:  Free

Bladder & Urethral:  Free

Seminal vesicles:  Not involved

Lymphatic/Vascular Invasion:  Not involved

Tumor:  T2c; Location:  Bilateral; Volume:  20%

Catheter:  Removed 12-days after surgery

Incontinent:  Yes (1/2 light pads per day)

Combination of Cialis and MUSE (alprostadil) three times weekly started 9-27-08

Returned to work 9-29-08 (18-19 days post-op)

PSA test result, post-op, 10/08: 0.0; 12/08: 0.0; 4/09: 0.0; 9/09: 0.0


Regular Member

Date Joined Feb 2010
Total Posts : 385
   Posted 3/3/2010 12:49 AM (GMT -6)   
Gee, I had an open prostatectomy, and have one 4 inch midline scar below the belly button, and a small scar to one side where the drain was. I was in the hospital for 48 hours. Had a total of about 6 percocets for post op pain. So, what's the advantage of RRP? 5-7 incisions doesn't sound so good.

New Member

Date Joined Dec 2009
Total Posts : 8
   Posted 3/3/2010 1:10 PM (GMT -6)   

I am wondering that myself. I heard all the hype about the speedy recoveries from RRP. I'm now on day 13, still with a catheter and a belly that looks peppered with birdshot. All in all, I am rejoicing that the operation was a success in ridding me of cancer, though.
Diagnosed at age 46

9/09 PSA 5.7 DRE negative

10/30 PSA 7.1 referred to Urologist

12/09 Biopsy 2 of 12-LLM Cancer GS 3+4 20% involved and LLA Cancer GS 3+4 30% involved

02/18/10 Robotic Laparoscopic Radical Prostatectomy (Bi-lateral nerve-sparing)

02/24/10 - Post-surgery pathology report shows cancer was organ-confined, margins clear.

Veteran Member

Date Joined Nov 2008
Total Posts : 696
   Posted 3/3/2010 1:34 PM (GMT -6)   
I think the key grip, gaffer, best boy, and chief lighting technician all had their holes in me. :)

The incision where my prostate came out (above the navel) was longer than I had expected too, about 2". The others have pretty much faded away, or have been stretched into oblivion by all the fat I've added.

My navel came out of the procedure a lot wider than going in, and a couple of people (not doctors) suggested it might be a hernia. But my doctors haven't said anything like that. No pain or discomfort there, but it's something I'm keeping an eye on.

Which brings me to another point--I have some odd lipoma-like structures in a few places near, but not right on, the incision points. One of them is a chord like structure, a few inches long, and feels about the diameter of a shoe string.
I say they're like lipomas because I've long had a couple on my sternum--painless, and they can be moved a bit. My radiation doc checked them out (as well as my primary care doc) and both say they are not sure what they are, but they are not attached to anything and are not in areas that would signal something serious. (The ones on my sternum are definitely lipomas, according to my primary care doctor).

I don't think this is scar tissue. My guess is that it's just a bunch of lipomas, and I would have gotten them there whether I had surgery or not, but has anyone else developed lumps or bumps in their abdominal fat after prostatectomy?

Dx Feb 2006, PSA 9 @age 43
RRP Apr 2006 - Gleason 3+4, T2c, NX MX, pos margins
PSA 5/06 <0.1, 8/06 0.2, 12/06 0.6, 1/07 0.7.
Salvage radiation (IMRT) total dose 70.2 Gy, Jan-Mar 2007@ age 44
PSA 6/07 0.1, 9/07 and thereafter <0.1

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