Pain after surgery

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AP4
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/31/2010 9:59 AM (GMT -6)   
I've recently been diagnosed with prostate cancer and need to have a radical prostatectomy. I have to make a decision between an open or robotic procedure. After carefully studying both options, my decision really comes down to pain after the surgery. Can anyone please tell me their experience regarding pain after the surgery? Thank you

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/31/2010 10:08 AM (GMT -6)   
Hello and welcome.

It would help all of us, if you would included some basic info on your diagnosis. Perhaps your biopsy results, Gleason rating, a little PSA history.

I had open surgery and spent 4 days in the hospital. Most men here, that did surgery, had robotic.

Are you sure that either surgery is your only option for treatment?

This is why some more info would be handy, so that we could understand what you are facing.


David in SC
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

Ed C. (Old67)
Veteran Member


Date Joined Jan 2009
Total Posts : 2458
   Posted 8/31/2010 10:15 AM (GMT -6)   
AP4,
I had the robotic surgery done by a very well known doctor who has done almost 2000 of them. I had my surgery on Monday at 2:30 PM and was discharged on Tuesday at 12:00 noon.
My recovery was excellent. I didn't have to take any post surgery pain medication except for 1 pill for bladder spasm and precautionary over the counter medication for gas.
Two days after surgery I was walking 2 miles a day.
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
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 5 months
2 months 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 months PSA test 1/21/10 result 0.004
14 months PSA test 4/19/10 result 0.005

Purgatory
Elite Member


Date Joined Oct 2008
Total Posts : 25380
   Posted 8/31/2010 10:21 AM (GMT -6)   
P.S>

Forgot to answer the pain part of your question. For me, there were surgical complications, and I was in a lot of pain. I needed all 4 days my insurance would cover in the hospital, so that they could administer via IV's the stronger pain drugs I needed. When I did go home, we had a spare bedroom set up like a little hospital room (my wife is a nurse), and I was needing oral pain meds (prescription) pretty heavily the first 2 weeks at home, and then I weaned off of them. By the end of the first month, the pain that was directly related to the surgery was pretty well under control.
Age: 58, 56 dx, PSA: 7/07 5.8, 10/08 16.3
3rd Biopsy: 9/08 7 of 7 Positive, 40-90%, Gleason 4+3
open RP: 11/08, on catheters for 101 days
Path Rpt: Gleason 3+4, pT2c, 42g, 20% cancer, 1 pos marg
Incont & ED: None
Post Surgery PSA: 2/09 .05,5/09 .1, 6/09 .11. 8/09 .16
Post SRT PSA: 1/10 .12, 4/8 .04, 8/6 .06 11/10 ?
Latest: 6 Corr Surgeries to Bladder Neck, SP Catheter since 10/1/9, SRT 39 Sess/72 gy ended 11/09, on Catheter #21, will be having Ileal Conduit Surgery in Sept.

AP4
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/31/2010 10:24 AM (GMT -6)   
Thanks for the quick reply. Here is my situation:

Age: 48,
PSA: 2.7 (low PSA but I have a family history)
DRE: negative
MRI: Cannot be seen
Biopsy: 12 points, 4 were positive (3 -100% positive and 1- 50%) all 4 on next to each other, Gleason 3+3, T1c

ejn
Regular Member


Date Joined Jun 2010
Total Posts : 87
   Posted 8/31/2010 10:31 AM (GMT -6)   
I had robotic surgery 3 weeks ago.  The pain was more than I had planned for.  I was sent home with pain meds and I took them as directed to stay on top of the pain.  There is no point in suffering to prove anything...if you hurt..take them.  Everyone is different and some guys have very little pain and others have significant pain.  For me the worst pain was at the tops of my shoulders for 5 days as my body absorbed the gas trapped inside of me.  Make sure you eat as directed because the first few BM's can be a lottle difficult.  If you take the pain meds make sure you get some over the counter stool softeners which will help the bowel movements greatly.  Good luck in whatever choice you make and welcome.
53

Pre OP PSA: 1/2008=5.9, 2/2010=6.0 (free=9%)

Biopsy, 4/10/2010 This was my 2nd Biopsy. The Uro put me out and took 36 samples. 3 samples positive 1%, 2%, 2% no evidence of perineural invasion. T1c

April 2010


CT Scan: Negative


DaVinci: Coming up 8/11/10, Dr David Bryan, SSM DePaul-St Louis
Post Op Path:
Gleason 3+3=6
Tumor involves left lobe only
Tumor constitutes less than 5% of gland volumne
No vascular or neural invasion detected
No capsular invasion detected
Distal urethral margin of resection free of tumor
Proximinal urethral margin of resection free of tumor
Radial margin of resection free of tumor
Seminal vesicles uninvolved by carcinoma
TM stage T2a (unilateral less than 1/2 of one side), NX, MX
ALL Margins uninvolved
Extra Porsaatic extension: Absent

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 8/31/2010 10:48 AM (GMT -6)   
Welcome to the site. Sorry that you have to be here, but hopefully we can be of support to you.
 
I had DaVinci (robotic) last fall at age 56. I was kept in the hospital for four days not so much for pain, but because I had issues with balance and extreme nausea while trying to walk. It was also over a weekend, so part of the decision was the availability of immediate care if something went awry at home. There was some concern over reaction to the meds used in the course of surgery.
 
But, I will say I used the IV button and the pain meds in the first 10 days or so. Pain was significant the first few days at home, but then I never refilled the pain med prescription.
 
Over time, I think I have had "normal" pain, comparing to the comments of others.
 

rhb47
Regular Member


Date Joined Mar 2010
Total Posts : 208
   Posted 8/31/2010 11:02 AM (GMT -6)   
Hi AP4.

My husband had robitic surgery Aug. 9. Like Ed, he was in one night. He had little pain-mostly discomfort sleeping and did take meds for a few days for that. He was walking up and down the halls the evening of surgery and walks 2 miles every morning since. As I think you've seen so far on this thread it varies widely-no one can tell you for sure what your pain is going to be. My husband feels he was very fortunate-also, credits his surgeon (over 3500 da vinci surgeries) but it could be luck. Take your time to find out all you can and definately pick the best surgeon-if surgery is your choice.

Renee
Husband diagnosed 3/10
Age 56, PSA 4.7, free 7.6%

Biopsy 5 of 10 cores positve-all right side-25% to 57%
Gleason 6
DaVinci surgery with Dr. Vip Patel scheduled 8/9/10

Post Op: Gleason 3+4=7
Negative surgical margins and lymph nodes
No seminal vesicle and angiolymphaic invasion
perineural invasion present
Both nerve bundles spared

SubicSquid
Regular Member


Date Joined Oct 2009
Total Posts : 252
   Posted 8/31/2010 11:25 AM (GMT -6)   
I had open surgery. With the exception of some sharp pain a few hours after surgery, pain never was a problem. I spent two nights in the hospital and only used the pain meds provided for 1-2 days after I got home, mainly to help me sleep because the catheter was uncomfortable . I did have a problem with swollen testicles and legs for quite a while after the surgery, but it wasn't painful. Squid.
*Age 63, PSA July 2009 .66; Biopsy: 2 of 12 cores positive, Gleason 3 + 5
*open Surgery 10/22/09
*Post Surgery Biopsy Gleason 4 + 3; 2 positive margins
*03/11/10 - Bladder neck surgery for stricture
*PSA - 30 day/.07, 90 day/.15, 180 day/.21
*07/27/10 - IGRT done - 39 zaps, 70 gys

Postop
Regular Member


Date Joined Feb 2010
Total Posts : 385
   Posted 8/31/2010 12:12 PM (GMT -6)   
I had open surgery, 2 days in hospital, pain tolerable, not an issue. I probably used a half dozen percocet during the whole experience. Having a catheter in for 10 days was a bigger nuisance than the pain.

In the long term, pain isn't the issue, it's the potential for post operative complications (incontinence and ED). Your a young guy, and you want these minimized. There doesn't seem to be conclusive evidence that the risk of this is different between open and robotic surgery. The key is the surgeon, and the most practical way to pick the surgeon is by investigating their track record.

Pick the surgeon first, then accept whatever technique they are comfortable with.

phillysub
Regular Member


Date Joined Nov 2007
Total Posts : 64
   Posted 8/31/2010 12:16 PM (GMT -6)   
I had robotic surgery over 2 yrs ago.
Spent one night in the hospital. Went home the next day with a supply of meds for pain, but I didn't need to take them.
I had very little pain from the surgery itself. The biggest discomfort was from sitting in the wrong position. 
 
Nix that!   BIGGEST discomfort was from "my friend" (the catheter!)
Overall, it actually went smoother than what I thought.
 
The best decision that you have made so far is finding this website........it was so helpful in my days leading up to my surgery and after.

Phillysub.

Age: 52
Last PSA before diagnosis: 2.9
Diagnosed: Oct 2007 (age 51)
Gleason: 3+3=6
RALP surgery: Jan 23, 2008 (Dr Costas Lallas @ Thomas Jefferson Hospital in Philadelphia)
1st Post-op appt: Feb 1, 2008 (negative margins, cancer contained within the capsule)
1st PSA post-op: May 23, 2008 - <0.1 undetectable
2nd PSA post-op: August 28, 2008 - <0.1 undectectable

James C.
Veteran Member


Date Joined Aug 2007
Total Posts : 4462
   Posted 8/31/2010 12:33 PM (GMT -6)   
I had open RRP, spent one night in the hospital and had a fairly pain free recovery. I usee very little over the counter pain meds and quickly recovered from it. It has to be emphasized that each man is different and will react differently to either of the surgery choices, so we can only tell you our experience. What you get from either procedure will really be individualized. One thing, though. My doc said that his 5 1/2 inch long incision was at best the combined length total of the robotic and in some cases smaller length. For what that's worth.
James C. Age 63
Gonna Make Myself A Better Man tinyurl.com/28e8qcg
4/07: PSA 7.6, 7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS3+3=6
9/07: Nerve Sparing open RRP, Path: pT2c, 110 gms., margins clear GS6
3 Years: PSA's .04 each test until 04/10-.06, 09/10-.09- Uh-Oh, reoccurance?
ED continues: Bimix- .3ml or Trimix- .15ml

April6th
Regular Member


Date Joined May 2010
Total Posts : 264
   Posted 8/31/2010 1:01 PM (GMT -6)   
Robotic surgery on June 1, 2010.

I was relatively pain free once I was in the position I wanted to be in (sitting, standing or laying down). But moving from one position to another was a little painful the 1st few days. My stomach muscles hurt when flexing. The only thing that maybe even rated a 3-4 (out of ten) on the pain scale was sitting down on the toilet and standing back up (the actual BM was not that big of a deal, it was getting into position that hurt). For 2-3 days after surgery that was a little tough. A plastic toilet seat riser would have fixed that problem if I would have had one

I was in the hospital about 33 hours and after I left I just took only Tylenol even though I was also given a Rx for hydrocodone (heavy duty stuff).

After 3-4 days virtually pain free.

I would rate the whole pain aspect a low 2 (out of 10).

Good luck!
Here are some of my stats:
Age:54
Father diagnosed with PC at age 72 - wasn't contained to prostate when found in 1992.
My PSA rose from 3.2 to 5.1 over the course of 1.5 years with Free PSA at 25% for the last two tests.
DRE showed no evidence of tumor but Uro thought my prostate was a little large for someone my age
PCa diagnosed 4/6/10 after biopsy on 4/1/10
1 out of 12 biopsy samples was positive with 5% of biopsy sample cancerous
Gleason 3+4
Da Vinci surgery on 6/1/10
Pathology report shows cancer confined to prostate and all other tissue clean
PSA tested on 7/15/10: Zero Club membership card issued (trial membership with 90 day renewal)

spottydog10
Regular Member


Date Joined Dec 2009
Total Posts : 345
   Posted 8/31/2010 1:14 PM (GMT -6)   
I had a robotic on the saturday and was out monday lunchtime, walked 5 mins to the train station.
(London's a pain in the arse to drive in)
I didnt use any pain meds, worse pain was wind and once I had a bm that eased greatly.
Felt a bit pained up for a week stomach muscle-wise but was walking regularly through all that time.
As other people say the cath was pretty uncomfortable but hey, you can drink
what you want and still get a good nights sleep.
Good luck mate,
Mike

fertree
Regular Member


Date Joined Jun 2010
Total Posts : 118
   Posted 8/31/2010 2:49 PM (GMT -6)   
I had an open RP. I was in the hospital for 3 days. I had very little pain in the hospital. I had an issue with the intubation during the surgery, but it would have been the same had it been an appendectomy, or anything else. After surgery, while at home, I took an occasional tylenol, and that was it. Like everyone else, I hated the catheter, which I had for 2 weeks. Good luck.

daveshan
Regular Member


Date Joined Jan 2010
Total Posts : 363
   Posted 8/31/2010 3:03 PM (GMT -6)   
open surgery on March 1 of this year, in at 0600 on Monday out of hosp' at 1800 on Tuesday. Minimal pain, I only took 2 (one whole and 2 halves) of the Oxy' I was prescribed.

Best of luck whichever route you choose
Dave in Durango CO

AP4
New Member


Date Joined Aug 2010
Total Posts : 3
   Posted 8/31/2010 3:16 PM (GMT -6)   
I agree with Phillysub, I'm so glad I found this website. All of you have been great. Thank you.

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 8/31/2010 4:49 PM (GMT -6)   

I had robotic surgery on a Tuesday; released the next day. Significant pain when moving from sitting to standing. Also, really bad pain if I had to cough.

 

Overall, pretty much pain free. They gave me strong stuff, but I didn't take any. I think I took a total of maybe 4 regular tylenols.

 

Mel


PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. Next PSA late Sept.

Cajun Jeff
Veteran Member


Date Joined Mar 2009
Total Posts : 4106
   Posted 8/31/2010 5:16 PM (GMT -6)   
Everyone has a different level of Pain. I had open surgery and was shocked that I was in almost no pain. Dr wanted to discharge me after 1 day and I told him I would stay an extra night. Surgery was on Tuesday. On Saturday yes 4 days later i was at a house party watching and LSU game on TV with a group of my firends. A couple of them asked. Didn't you have surgery this wk. I said Yep taken care of. I enjoyed the game. I did have the nice comfortable chair for the evening.

I think the more important question is find a GREAT Dr.

Cajun JEFF
9/08 PSA 5.4 referred to Urologist
9/08 Biopsy: GS 3+4=7 1 positive core in 12 1% cancer core
10/08 Nerve-Sparing open radicalSurgery Path Report Downgrade 3+3=6 GS Stage pT2c margins clea
r3 month: PSA <0.1
19th month: PSA <0.1
Only issue at this time is ED

142
Forum Moderator


Date Joined Jan 2010
Total Posts : 6949
   Posted 8/31/2010 5:30 PM (GMT -6)   
Seems the meds are getting a better detail rundown than I gave. My Norco prescription was for 30 pills, I think I took 12, mainly to sleep at night.
 
The bladder spasms were ugly, but ended with the cath removal.
 
I forgot the sneezing. My mind had blanked that out. A good sneeze, and I had several a day, will generate a 10 for a few seconds on anybody's pain scale. But that will not vary between open and robotic. Just do everything possible to not catch a cold or have sinus issues just before or for a few weeks after surgery.

NEIrish
Regular Member


Date Joined Aug 2010
Total Posts : 245
   Posted 8/31/2010 5:35 PM (GMT -6)   
Husband had open RRP July 6. Incision was about 4 1/2 inches, and the 2 nights in the hospital he hit his pain med button constantly. It wasn't the surgical incision so much as bladder spasms (had to receive meds for it, had to stand every 2 hours the second night and on the way home we had to pull over to the side of the road twice during the hour drive. The cath was uncomfortable, but not painful - I was religious about the bacitracin recommended for penile tip) The rectal pain was a real pain in the a@#$ (pun intended) however and he had difficulty with the bm (colace and senna used as much as was allowed) so the oxycodone, which was the scrip given for pain, was discontinued (his decision) in order to avoid the constipating side effect. Tylenol handled discomfort okay. Sitting was vry uncomfortable for 4 wks, reclining the best. Still having a problem with the incision tenderness since it opened up after he did some light physical work after 8 wks. post surg. Still wasn't up to it. First question the surgeon asked on his first visit 6 wk. post op (after the cath had already been removed at 8 days post surg)was "how are your energy levels?" Probably because that's a huge complaint at 6 wks. - men still tired out from the surg....And he still is feeling the fatigue.
Husband 60yrs., no symptms: PSA 10/04 2.73, 12/06 3.64, 5/09 3.9, 10/09 4.6, 1/10 5.0w/ free PSA 24
6 core biop 4/1/10 path rept: rt mid: adnocarc. G=3+3, 5% of core; R apx v. susp. minute ca, R base bnign w/ mod. atrophy, L side atrphy only; 2nd opnion JH confrmd
MRI - 15mm nodule
BiLatRP surg 7/6/10, path: T2c, nodes, sem.ves, extra caps. neg., adenoc both sides G=3+3 cntinent, Viagr-8/27 ED

mvesr
Veteran Member


Date Joined Apr 2007
Total Posts : 823
   Posted 8/31/2010 5:37 PM (GMT -6)   
Hi AP4
 
I had open surgery a little over 3 years ago.  Had the surgery early on Wednesday morning and was discharged at noon on Friday.  I had no paid meds after the day of surgery and none since.  the catheter was the only problem for a few days.  If surgery is what you have decided on, I would not be afraid of the open.  Cannot even seen my scar now.
 
Mika
age at dx 54 now 58
psa at dx 4.3
got the bad news 1/29/07
open surgery Duke Medical Center 5-29-07
never more than 2 pads
ED is getting better
the shots work great, still can't give them to myself
three years of zero's
Retired again after 36 years February 1, 2010

compiler
Veteran Member


Date Joined Nov 2009
Total Posts : 7205
   Posted 8/31/2010 6:06 PM (GMT -6)   
Just adding to my comments:
 
Folks here mentioned fatigue. I had no fatigue. In fact, I pretty much had normal energy (maybe adrenalin the first 2 days!).
 
Also, at first it looked like 7 nasty stab wounds (maybe just 5 or 6 -- not sure). Within a few weeks you could not tell that I had surgery!
 
Mel (robotic surgery)
PSA-- 3/08--2.90; 8/09--4.01; 11/09--4.19 (PSAf: 24%), PCA3 =75 .
Biopsy 11/30/09. Gleason 4+3. Stage: T1C. Current Age: 64
Surgery: Dr. Menon @Ford Hospital, 1/26/10.
Pathology Report: G 4+3. Nodes: Clear. PNI: yes. SVI: No. EPE: yes. Pos. Margin: Yes-- focal-- 1 spot .5mm. 100% continent by 3/10. ED- in progress. First post-op PSA on 3/10/10-: 0.01. PSA on 6/21/10--0.02. Next PSA late Sept.

RCS
Veteran Member


Date Joined Dec 2009
Total Posts : 1247
   Posted 8/31/2010 6:28 PM (GMT -6)   
I was DaVincied.  Pain from the incisions wasn't as bad as I had thought it would be.  I moved slow ... but with the catheter who could move fast?
 
However, the pain from the gas they blew my abdomen up with was bad.  The gas migrated up to my clavical area and hurt like heck for about two days post-op. It went away by the third day. 
PSA 2007 - 2.8; 11/24/2008 - 7.6; PCa Dx 2/11/09; age at Dx 62; RLP 4/20/09

Biopsy - Invasive moderately differentiated prostatic andenocarconoma; G 3+3=6; PT2C; No evidence of Seminal Vesicle or Extraprostatic Involvement; Margins clear; Tumor identified in sections from prostatic apex. 70 gram prostate. Continent after removal of cath.

ED - Trimix works well; levitra @ 90%
PSA - 7/31/09 <0.06; 12/1/09 <0.06; 3/29/10 <0.06; 8/4/10 <0.06

An38
Veteran Member


Date Joined Mar 2010
Total Posts : 1148
   Posted 8/31/2010 7:23 PM (GMT -6)   
My husband did a Da Vinci surgery on the 20th of August.
He was on pain meds for 4 days. He was in a little bit of pain for the first two days and especially when he tried to get out of bed. The biggest pain was his first bowel motion four days after surgery - and that was preventable if he had not eaten the rich food the hopital gave him.

He did end up with some lung problems from surgery which gave him a band of pain across his chest for a few hours but once they diagnosed what it was, he needed do some simple breathing physiotherapy to fix it.

The only other paid was pain of sitting in a chair for the first 9 days. A donut cushion solved the problem.

My husbands experience of the surgery was very good. The pain was minimal. His scars are small and healing well. He is back to walking 1.5miles/day. He was fully continent from the time the catheter came out. And he is already starting to get close to his normal erectile activity back in the mornings. We credit our surgeon with much of this and he has done about 500 robotic surgeries.

However this is only my husband's experience of the surgery. There are many people here who have vastly different experiences.

Good luck with it all.

An
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)

Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4. Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
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