Colonoscopy After RP - Any extra concerns?

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Regular Member

Date Joined Sep 2008
Total Posts : 78
   Posted 4/7/2010 1:25 PM (GMT -6)   
I had my RP in August 08. I haven't posted in a while but have been checking in often.
My Doctor recommended that I now get a colonoscopy. I am wondering....
Does the RP thin the rectal wall where the prostate once was? Is there more of a chance of a puncture through the rectal wall during a colonoscopy? I know it's been almost two years since the surgery but I am still concerned. Does anyone have any knowledge about this?
I appreciate all your posts. Thanks.

Rising PSA 12/06=1.6 12/07=2.1 5/08=2.6
Biopsy 6/4/08 12 core 4 Positive 15%,15%,8%,3%
Diagnose @ Age 51 Gleason 3+3=6
Bone & Cat Scans Normal
Lapro Surgery 8/18/08 at Memorial Sloan Kettering
Pathology report stage T2c organ confined with positive apical margin Gleason 3+3 = 6 (with tertiary grade 4)
Catheter removed 8/26 - reinserted 8/29 - removed 9/2
No continence or potency problems from the get-go.
First post op PSA 10/2/08  < 0.05
2nd  post op PSA 12/30/08 < 0.05
3rd  post op PSA 3/30/09 < 0.01
4th  post op PSA 6/25/09  0.01
PSA 9/25/09 0.01
PSA 12/28/09 0.01

John T
Veteran Member

Date Joined Nov 2008
Total Posts : 4269
   Posted 4/7/2010 1:47 PM (GMT -6)   

You can get one without any issues. Just be sure that you make it absolutely clear to the doctor that there should be no biopsy of any area that has had the affects of radiation as this will cause a fistula and serious problems that will not heal. The doctor should already know this but it is prudent to make this very clear to him.


64 years old.

PSA rising for 10 years to 40, free psa 10-15. Had 5 urologists, 12 biopsies and MRIS all neg. Doctors DXed BPH and continue to get biopsies yearly. 13th biopsy positive in 10-08, 2 cores of 25, G6 less than 5%. Scheduled for surgery as recommended by Urological Oncologist.

2nd Opinion from Dr Sholtz, a Prostate Oncologist, said DX wrong, pathology shows indolant cancer, but psa history indicates large cancer or metastasis. Futher tests and Color Doppler confirmed large transition zone tumor that 13 biopsies and MRIS missed. G7, 4+3, approx 16mmX18mm.

Combidex MRI in Holland eliminated lymphnode mets. Casodex and Proscar reduced psa to 0.6 and prostate from 60mm to 32mm. Changed diet, no meat and dairy. All staging tests indicate that tumor is local and non agressive. (PAP, PCA3, MRIS, Color Doppler, Combidex, tumor reaction to diet and Casodex, and tumor location in transition zone). Surgery a poor option because tumor is located next to the urethea and positive margin is very likely; permanent incontenance is also high probability with surgery.

Seed implants on 5-19-09, 3 hours door to door, no pain, minor side affects are frequency and urgency; very controlable with Flowmax and lasted 4 weeks. Daily activities resumed day after implants with no restrictions. Gold markers implanted with seeds to guide IMRT.

25 treatments of IMRT 6 weeks after seed implants. No side affects at all.

PSA at end of treatment 0.02 mostly the result of Casodex. When I stop Casodex next week expect PSA to rise. Next PSA in November. Treatments and side affects have greatly exceeded my expectations. Glad to have this 11 year journey finally conclude.


Tony Crispino
Veteran Member

Date Joined Dec 2006
Total Posts : 8128
   Posted 4/7/2010 3:27 PM (GMT -6)   
Hi Hangin'
I have pretty much retired from my role as a moderator at HW but I did want to check in on your post. It's a good question that just recently came up in our UsTOO meeting in Las Vegas. You should be healed from your August surgery to the point that a colonoscopy is not an issue, but mentioning it your history to the doctors before you move forward is probably a good thing. Unless you had issues around the rectum in your surgical report I would think you'll do fine. Your question about thinning the rectal wall is also interesting. I don't think there is rectal thinning, even in my case where the surgeon did indeed spend a great deal of time working in the rectal area because of my advanced disease. But I know that I had radiation after my RP and certainly my rectum received low doses of radiation, but my colonoscopy went with out a hitch. Good luck on the procedure, and great job for your progress against prostate cancer...

Prostate Cancer Forum Co-Moderator

Veteran Member

Date Joined Jul 2009
Total Posts : 1267
   Posted 4/7/2010 3:30 PM (GMT -6)   
My surgeon gave me the green light about 3/4 months after da Vinci.

However, no one should contemplate this procedure without first reading:

This is critcal reading. Please, please, please read this important information first.

Sheldon AKA Sleepless
Age 67 in Apil '09 at news of 4 of 12 cores positive T2B and Gleason 3 + 3 and 5% to 25% PSA 1.5
Re-read of slides in June said Gleason 3 + 4 same four cores 5% to 15%
June 29 daVinci prostatectomy, Dr. Eric Estey, at Royal Alexandra Hospital Edmonton one night stay
From "knock out" to wake up in recovery less than two hours.  Actual surgery 70 minutes
Flew home to Winnipeg on July 3 after 5 nights in Ramada Inn  ---  perfect recovery spot!
Catheter out July 9
Final pathology is 3 + 4 Gleason 7, clear margins, clear nodes, T2C, sugeron says report is "excellent"
First post op PSA Sept 09  less than 0.02
PSA on Oct 23 test again less than 0.02
PSA on Jan 8 less than 0.02  
Oct 1st 09 -- dry at night, during day some stress issues.
Oct 31st padless 24/7 
Feel free to email me at:    

Forum Moderator

Date Joined Jan 2010
Total Posts : 7089
   Posted 4/7/2010 4:29 PM (GMT -6)   
Good article. My Colo-rectal guy had a different approach. I had some other issues, and at the last of my treatments with him, he said I should get a colonoscopy. He handed me a photo of some really gory tissue - looked like third - degree burns - and said "you don't want to wait for that". I joked a little, and said what was it - he replied the colon of the guy who was walking down the hall with his wife, both sobbing in tears, both 10 years younger than me, as I came in. That patient's best hope was a bag, if he lived to see it.

I waited the suggested year, and got it done. No big deal except the flush and the drugs. And having the guy at the door at Sam's recognize me, then recognize the jug, and come over to wish me well. Could have done without the pity in his face, made me think I was headed for a different type of throne.

Have three more years before the next one.

Ed C. (Old67)
Veteran Member

Date Joined Jan 2009
Total Posts : 2461
   Posted 4/7/2010 7:45 PM (GMT -6)   
I had a colonoscopy 5 months after my robotic surgery. No problem.
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

Regular Member

Date Joined May 2009
Total Posts : 476
   Posted 4/7/2010 11:47 PM (GMT -6)   
My surgeon said three months after RP is sufficient before colonoscopy. I had one done with no problems.
Father died from poorly differentiated PCa @ 78 - normal PSA and DRE
5 biopsies over 4 years negative while PSA going from 3.8 to 28
Dx Nov 2007, age 46, PSA 29, Gleason 4+4=8
Decided to participate in clinical trial at Duke - 6 rounds of chemo (Taxotere + Avastin)
PSA prior to treatment 1/8/2008 is 33.90, bounced on 1/31/2008 to 38.20, and down at the end of the treatment (4/24/2008) to 20.60
RRP at Duke (Dr. Moul) on 6/16/2008, Gleason downgraded 4+3=7, T3a N0MX, focal extraprostatic extension, two small positive margins
PSA undetectable for 8 months, then 2/6/2009 0.10, 4/26/2009 0.17, 5/22/2009 0.20, 6/11/2009 0.27
ADT (ongoing, duration TBD): Lupron started 6/22/2009
Salvage IMRT to prostate bed and pelvis - 72gy over 40 treatments finished 10/21/2009
PSA 6/25/2009 0.1, T=516, 7/23/2009 <0.05, T<10, 10/21/2009 <0.05, T<10

Veteran Member

Date Joined Jun 2008
Total Posts : 1804
   Posted 4/8/2010 5:41 AM (GMT -6)   
There should be no problem with a colonoscopy. My husband was originally scheduled for a colonoscopy about 5 months after his surgery and was told by the urologist that it would not be a problem. As it turned out, he didn't need the colonoscopy but will have one this July.
Husband diagnosed in 2/2008 at age 57 with stage T1c. Robotic surgery performed 3/2008. Stage upgraded to T3a (solitary focus of extraprostatic extension). Perineural tumor infiltration present. Apex margin, bladder neck and SVs negative. Final Gleason 3+4. PSA: 0.0 til July 2009. August 2009 - 0.1, September 0.3, October back to 0.0, December 0.0, March 2010 0.0. Next PSA in 6 months. Thank you God!

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