Open Prostatectomy Bolster

New Topic Post Reply Printable Version
[ << Previous Thread | Next Thread >> ]

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 3/1/2010 6:11 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


Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25364
   Posted 3/1/2010 6:22 PM (GMT -6)   
I had open surgery, and have never heard of that. Got me curious now.
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, 1/19 - Corr Surgery #4,  Caths #11 and #12 in at the same time, 2/8-Cath #11 out - 21 days


Old Sailor
Regular Member


Date Joined Aug 2009
Total Posts : 207
   Posted 3/1/2010 7:51 PM (GMT -6)   
Sunbird, I had the bolster from the same surgeon and hospital you had it from and I too was wondering what was down there and even thought about removing it!! (as you know, it comes out in one week) They need to tell the nurses at Mayo why the bolster is used.  The PAs at Mayo told me that with the bolster, less than 2% of the RRP guys have continence problems.  I was dry as soon as the catheter came out and have remained dry since (8/09).  Several other RRP guys have told me the same thing.  The Old Sailor

defender3
Regular Member


Date Joined Nov 2009
Total Posts : 98
   Posted 3/2/2010 7:04 AM (GMT -6)   
Is this only done at Mayo, and if so, which one?

Sunbird
Regular Member


Date Joined Apr 2008
Total Posts : 140
   Posted 3/2/2010 8:39 AM (GMT -6)   
Hard to say, but mine was performed at Mayo Hospital, Jacksonville, fL
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

New Topic Post Reply Printable Version
Forum Information
Currently it is Thursday, April 19, 2018 1:11 PM (GMT -6)
There are a total of 2,953,240 posts in 323,984 threads.
View Active Threads


Who's Online
This forum has 162059 registered members. Please welcome our newest member, TS0625.
404 Guest(s), 7 Registered Member(s) are currently online.  Details
journey2health, tcf5010, Girlie, Sean.scott256, garyi, 1hopeful1, joee