Robotic prostatectomy converted to open surgery

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New Member

Date Joined Mar 2010
Total Posts : 5
   Posted 3/17/2010 12:45 PM (GMT -6)   
Age 68. After four years of watchful waiting, Gleason Score 6, cancer in one node only, my most recent biopsy showed three places of cancer with Gleason score 7. So I scheduled robotic prostatectomy. The dr said I would be a good candidate, healthy and thin. Went to hosp for surgery Friday Mar 12. When I woke up I discovered that after beginning robotic surgery, severing the urethera and sparing the nerves, the dr found that my prostate was so large that he could not see all of it with robotic equipment and he had to convert to open surgery. He tells me that my prostate had grown arms around my bladder and someday would have choked it off. Now we know why my PSA was always in the range of 12-13. He also reported that there was little if any evidence of cancer and that the lab reports so far have been clear. Prayer works. What has surprised the doctor and the hospital is that I have not needed any pain medication at all. I refused all pain meds and am very comfortable. I came home from the hospital yesterday (post-op day four) before my bowels moved. They have moved today!. All I wonder about now is the swelling in my scrotum-- about the size of a peach. Again, there is no discomfort but I am keeping my eyes on it.

In have had a lot of prayer support and I am convinced that is why things go well so far. Now we will see what happens when the catheter comes out next week.

Veteran Member

Date Joined Sep 2009
Total Posts : 639
   Posted 3/17/2010 1:13 PM (GMT -6)   
Best of luck to you and welcome to the neighborhood.  Sounds like your doing wonderful
Age 51, PSA 08/31/2009= 6.8, DRE Neg.
Biopsy 9/24/09 =10 of 12 positive. Gleason 6. involving up to 75%
da Vinci at Wash U, Barnes on 11/02/09
Modified Pathology, Gleason 4 + 3 = 7. Gleason 7 present throughout Prostate.  Negative surgical margins
4 of 4 periprostatic Lymph Nodes Negative, 10 of 10 pelvic Lymph Nodes Negative. Seminal Vesicles tumor free. No prostate extension
Post-op PSA 12/10/2009, Undetectable
12/12/2009, Pad Free and Started jogging.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 3/17/2010 1:20 PM (GMT -6)   
Welcome to Healing Well after your strange ride. Sounds like you have had an 'unusual' journey, but am recovering nicely now. Hope you stick around and share your journey with us.
James C. Age 62
Co-Moderator- Prostate Cancer Forum
Gonna Make Myself A Better Man:
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
32 mts: PSA's: .04 each test since surgery, ED Continues-Bimix .3ml PRN or Trimix .15ml PRN

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2457
   Posted 3/17/2010 1:53 PM (GMT -6)   
I wish you a quick recovery. It sounds like despite the change in procedure, things went well. Good luck.
Age: 67 at Dx on 12/30/08
PSA 9/05 1.15; 8/06 1.45; 12/07 2.41; 8/08 3.9; 11/08 3.5 free PSA 11%
2 cores out of 12 were positive Gleason (4+4) and (4+5)
Negative CT scan and bone scan done on 1/16
Robotic surgery performed 2/9/09 Dr Fagin, Austin TX
Pathology report:
Prostate weighed 57 grams size:5.2 x 5.0 x 4.9 cm
Posterior lateral lesions measuring 1.5 x 1.4 x 1.0 cm showing focal capsular penetration over a distance of 3mm in circumference.
Prostatic adenocarciroma accounts for approx. 10-20% of the hemisphere.
Gleason 4+4
both nerve bundles removed,
pT3a Nx Mx, Negative margins
seminal vesicles clean, lymph nodes: not dissected
continent after 4 months
8 weeks PSA test 4/7/09 result <0.1
5 months PSA test 7/9/09 result <0.1
8 months PSA test 10/9/09 result <0.1
11.5 months test 1/21/10 result 0.004

Veteran Member

Date Joined Apr 2009
Total Posts : 990
   Posted 3/17/2010 2:01 PM (GMT -6)   
The swelling is very common although rather shocking. It generally clears up in 3 to 4 days.
Age at diagnosis 66, PSA 5.5
Biopsy 12/08 12 cores, 8 positive
Gleason 3+4=7
CAT scan, Bone scan 1/09 both negative.

Robotic surgery 03/03/09 Catheter Out 03/08/09
Pathology: Lymph nodes & Seminal vesicles negative
Margins positive, Capsular penetration extensive Gleason 4+3=7
6 weeks: 1 pad/day, 1 pad/night -- mostly dry at night.
10 weeks: no pad at night -- slight leakage day/1 pad.
3 mo. PSA 0.0 - now light pads
6 mo. PSA 0.00 -- 1 light pad/day
9 mo. PSA 0.00 -- 1 light pad/day ED remains

Regular Member

Date Joined Oct 2009
Total Posts : 252
   Posted 3/17/2010 2:08 PM (GMT -6)   
I had the softball sized scrotum plus swollen legs for a couple of weeks after open surgery. Shocking to look at but not painful. It slowly disappeared.
*Age 63, PSA July 2009 5.66
*Diagnosed July 2009, Biopsy: 2 of 12 cores positive, Gleason 3 + 5 = 8
*MRI and Bone Scan Negative.
*open Surgery October 22, 2009
*Prostate, both nerve bundles, seminal vessels, and lymph nodes removed during surgery.
*Post surgery Biopsy, Gleason 4 + 3; 2 positive margins
*Still slightly incontinant after 3 months - 1 pad per day (light). Dry at night. 1-2 trips to toilet.
*ED - Yes (will start Levitra possibly in January)
*30 day PSA (ultra-sensitive) .07
*90 day PSA (standard) <0.15
*01/10 - bladder neck stricture. opened during cysto exam. Cath #2 in for 5 days.
*IMRT/IGRT delayed until April pending 180 day PSA result
*03/01 - bladder neck stricture. Dilated during cysto exam. Cath #3 in place.
*03/11 - Bladder neck surgery. Cath #4 in place.
*03/15 - Cath #4 out. Great urine stream.  Unfortunately, incontinence back to post surgery level.

Veteran Member

Date Joined Jan 2010
Total Posts : 2832
   Posted 3/17/2010 2:29 PM (GMT -6)   
wishing you all the best
- a good thing to do for the scrotum swelling is, when resting -snug underwear to keep scrotum snug and have legs raised up on pillows - so the fluid ( mild lymphedema) drains back into the body and dissipates - mine were 4 x their normal size - drained out at day 3 -
-take care
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 - girth back to normal -but not much length - will go for trimix in April when I see doc
Incontinence: 3-5 pads/1-2 clothes changes/day- finally seeing improvement - March 3, 2010 - week 14 after surgery -
location: Peteborough, Ontario, Canada
Post Surgery-PSA: to be announced - April 8, 2010

New Member

Date Joined Mar 2010
Total Posts : 5
   Posted 3/17/2010 5:54 PM (GMT -6)   
Thank you my brothers. Your comments are indeed VERY helpful and encouraging. I am enjoying keeping in touch.

Cajun Jeff
Veteran Member

Date Joined Mar 2009
Total Posts : 4069
   Posted 3/17/2010 6:52 PM (GMT -6)   
Wow what story, Hope you continue doing so well. Swelling is common and that will go down. Do keep us posted.

Cajun Jeff
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1 pre cancer core
10/08 Nerve-Sparing open radical
Surgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clear

3 month: PSA <0.1
6 month: PSA <0.1
10 month:PSA <0.1
1 year: PSA <0.1
16 month:PSA <0.1

ED - Started Cialis at 3 months, tried all 3, 6 months added pump, 9 months Tried MUSE (YUCK) Bad experience.
1 year mark Found new Urologist visit was at 14th month post surgery
Started Injections, Caverject! (Success)
17 month: ED making improvements : Oral Meds gets me 85%

Worried Guy
Veteran Member

Date Joined Jul 2009
Total Posts : 3730
   Posted 3/17/2010 6:59 PM (GMT -6)   
My scrotum turned into a purple Osage Orange. A rubber donut cushion worked wonders. It took about 4-5 days for the swelling to go down.
Now the fun stuff begins.
Welcome to the neighborhood.
Married 34 years, DX Age 56. First routine PSA test on April 8, 09: 17.8. Start 2 weeks of Cipro to rule out protatitis. May '09 PSA: 22.6, 3 weeks later: PSA: 23.2.
Biopsy 6/10/09: 7/12 scores positive, 20%-70%, Gleason 6=3+3. Bone and C/T scans neg.
RP DaVinci -7/21/2009 @ Univ of Roch Medical Center
Left nerve gone, right partial spared.
Catheter removed - 7/31/2009 Pathology report received:
Gleason 3+4=7, Tumor size: 2.5 x 1.8 cm, location: both lobes and apex.
Extraprostatic extension present; Perineural invasion: present, extensive.
No Malignancy in Seminal Vesicle, vasa deferentia, lymph nodes 0/13
Prostate mass 56 grams. Pathologic Stage: pT3aN0MX
Post Surgery Status:
Potency - 12/11 5 months, Still no activity, zip. Using pump daily since 11/11. No effect with 20 mg of Cialis or 100 mg of Viagra. Shots next See Uro 1/22/10 Trimix #1. Try 0.08- 25%, 0.12-25%, 2/26/10 try 0.16 First Success! 90%.
Incontinence - 8/20 4 full pads per day
.. 9/7 3-4 full pads per day (Try cutting down on fluids. Bad idea. I know.)
12/11 5 months: Still 3 pads per day. 400-450ml/day
2/26/10 7 months: Still 3 pads but leak is now 320 ml (5 day avg.)
Post Surgery PSA - 9/3 6 weeks - 0.05; 10/13 3 months - 0.04, 1/14 6 months - 0.05.

Forum Moderator

Date Joined Jan 2010
Total Posts : 6849
   Posted 3/17/2010 7:18 PM (GMT -6)   
Two surgeries for the price of one - take that to Congress. Anyway, they do always warn us about that possibility.
I was so swollen, and willie was so pulled up, that my catheter seemed to emerge from a pile of grapefruit. I had no clue what was going on, and was a bit panic stricken. The nurse who took out the cath said it was not unusual. I suggested that I didn't feel very usual.
Welcome to the other side -

New Member

Date Joined Mar 2010
Total Posts : 5
   Posted 3/18/2010 8:23 AM (GMT -6)   
Thanks to you guys I remembered yesterday that about 25 years ago when I had hernia surgery the same thing happened to my scrotum. I had forgotten (I wonder why?) It helps indeed to know I have been there before and all is well. Thanks so much for helping me remember. This is a really wonderful group and I am blessed. So far today looks good.
I can see that when I go back to my urologist I will have to ask him for the technical details of my prostate cancer history so I can share them better with you. I have a lot to learn about myself.
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