Posted 3/1/2010 7:11 PM (GMT -6)
Three weeks ago tonight, I was lying in my hospital bed when my night nurse decided to check out my "package" after my open prostatectomy. She found what appeared to be some plastic gauze stuck at the bottom of my scrotum. I didn't know of its existence until she told me, so I reached down and felt it. I began to wonder if a lymph node had been harvested from that area and the gauze was just plugging a hole in my skin. I was tempted pull this plastic gauze off. I'm glad I didn't. The nurse contacted my doctor who told her it was a "bolster." I don't know if my doctor invented this technique, but its a way of adding tensioning stitches to the anastomosis. (where the urethra is sewn together) Evidently, the bolster also serves as an alignment tool, and helps with urinary continence after surgery. If this is true, it certainly worked for me. I have no idea if use of a bolster is widespread, or if it can be used during robotic surgery. I'm just glad I had it done, although it did cause quite a bit of discomfort until it was removed one week after surgery. If you google, "prostatectomy bolster" you can read some references on this subject.
1996, Age 48, Stage III Colon Ca, Colon Resection followed by 18 chemo treatments.
2000, Colon Ca Metastasis to upper left lung lobe. Lung lobe surgically removed. 24 chemo treatments scheduled. Took 1, declined the rest.
9/08 PSA is 2.8, 12/08 PSA is 4.56?? Chalk it up to prostatitis due to urinary retention after Nissen Fundo Surgery. VA docs prescribe 30 days of Septra. Prostate feels normal. PSA hovers around 4.1. VA docs want prostate biopsy but can't seem to get me into the schedule. Continue through Spring and Fall of 2009 thinking I have prostatitis. Bacteria cultures are always neg. PSA drops to 3.1 10/09.
12/09 Prostate Biopsy performed
3 of 10 cores positive, 5%, 25%, & 35%, 3 + 3= Gleason Six with perineural invasion.
Doc wants CT Scan due to prior Colon Ca. Findings: "The seminal vesicles are irregular & there is nodularity in the periprostatic fat such that local extension cannot be excluded. Shotty lymph nodes in both groin measuring 2.3 cm."
Doc wants Endo-rectal MRI (OUCH!) Findings: Mild central zone BPH, no discrete focus of carcinoma is identified, no evidience of invasion into the periprostatic fat or seminal vesicles. Normal size iliac chain lymph nodes.
2/08/10 Open RP surgery. Findings: Gleason Six upgraded to Seven. 3 + 4, Stage pT2c, Bilateral w/perineural invasion, No pos lymph nodes, margins uninvolved, no extraprostatic extension, no seminal vesicle extension, 39 grams, blood loss 1200 ml (didn't want a transfusion & didn't get one) nerve bundles spared bilaterally. current age-61