I had open surgery, and had no regrets about it. At the time of my surgery, robotic was too new in my area, and I didn't want to be one of the "learning curve" patients. As it were, they discovered that I had an unusually deep and narrow prostate bed, even if I had chosen robotic, it would have been aborted. As far as bleeding, that's not much of an issue anymore with a good open surgeon, they bank 3 units for me, and never needed a drop, even though my surgery drug on due to complications. The one incision isn't that big anymore in length, compared to the old days. Ten days after surgery, the staples came out, and the actual incision wasn't a big issue either. As far as magnification, my surgeon assured me that they use the latest technology in the operating room, even with open surgery, and he has high tech magnifying glasses on as well as a large screen in front of him to see things close up. The real advantage in my opinion, is that the surgeon actually has his real human fingers in you, and with live tactile feel, my surgeon still feels its better than any kind of simulated touch between the surgeon and the "fingers" on the robot. That part I am sure varies greatly from surgeon to surgeon. Yes, a bit more hopspital time, but I have seen robotic guys here need 2 days in the hospital, and some open guys ready to go home after 2 days. In my case, I needed all 4 days due to complications.
An open surgery is not the way it use to be even 20 years ago. The incision is much smaller, and as mentioned, bleeding is rarely an issue. As far as which is better for ED and incontinence issue? I don't think there is an accurate way of judging that. Just from our pool of men here at HW, the results are all over the page.
Glad you are taking your time deciding. That's the most important part. With your stats, you have that luxury, and don't let any doctor or practice push you into something you don't want to do.
To be honest, you still sound like you would be a good candidate for "seeding". When I first was dx. with PC, that was my choice, but my stats quickly ruled it out as a choice.
Please keep us posted.
David in SC
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, no problem post SRT
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, next one: July
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 same time, 2/8-Cath #11 out - 21 days, 3/2- Cath #12 out - 41 days, 3/2- Corr Surgery #5, 3/6 Cath #13 out - 4 days, Cath #14- 27 days, Cath #15 - 26 days, Cath #16 - 31 days, 5/24 put in Cath #17