Some interesting differences in treatment in Germany and the US

As you can see in my profile, I’m an Australian living in Germany, now 6 weeks post-op and doing very well. I only found this site after my surgery, but it has been very interesting and helpful. I thought long and hard about whether to set out my success in my profile as I know a lot of guys are suffering out there and I want to be sensitive to that, but I genuinely hope that my story gives hope, especially to younger guys terrified of the surgery and what it will do to their “quality of life”.

I’m still planning to write my experience in detail, but there is one issue I want to address in this topic: the apparent differences between treatment here in Germany and in the US. Of course, I only have anecdotal information to go on (the few dozen stories I’ve heard here in Germany and the cases I’ve read here), so this isn’t a scientific comparison, but there do seem to be a couple of significant differences in the treatment regime.

I was in hospital for 9 days – 1 night before the surgery, the day of the surgery and 7 days post-op. They generally keep you in hospital here as long as the catheter is in, give you the colored-dye test on day 7 and remove the catheter and release you the next day. The hospital system here is very well funded and there is no pressure to get out quickly. I hear stories on this site about leaving hospital after a couple of days and I really couldn’t imagine it given my energy levels and need for nursing attention in the first week, but I guess you adapt to the reality of the system you are in and there are pros and cons both ways. Being in hospital for so long was a pain, but I could really rest and concentrate on getting well. Having catheter removal as the pre-requisite for leaving hospital here means that there is some pressure from patient and hospital for this to happen as soon as possible (usually Day 7 or 8). I read some stories on this site about people having the catheter for up to 2 weeks or longer, which seems a very different approach not to say a nightmare. I can’t help wondering as a lay person whether getting the tube out a bit earlier helps things like continency and potency on the basis that the systems spend less time in an unusual state and might kick back in faster … Just my 2c worth.

The other major difference I see is the “preventative” treatment for ED. Maybe I am missing something from the posts, but it seems to me that a lot of members on the board start work on the ED issues some months down the track, perhaps once continency issues are improving. I read some cases where the patient had to ask their urologist for Viagra/Levitra/Cialis some months after surgery. Here, the so-called “Kiel Method” (small doses of the drugs each day in the 3 months immediately following surgery or until natural erections kick in) is well-known by urologists and widely practiced. As they said to me, this is keeping the tracks in order even though the trains aren’t running at the moment! I got my first Levitra with my pre-op meds and then it arrived every day with my evening meal in hospital and taking it was the highlight of my day! (I woke on the first night after removal of the catheter with the painful beginnings of an erection and had to get out of bed to make it go away, but I was the happiest man on earth. And satisfying sex was possible less than 3 weeks post-op. I'm relatively young and both nerves were spared, so maybe I would have had the same result without the early meds-intervention, but hey it can't have hurt.)

I realize that my basis for comparison of the 2 approaches is very narrow and maybe I have got my facts wrong about what is normal over there across the Atlantic. Sorry for the long post and please understand that I am not saying one approach is better or worse, just that there are interesting differences which some members here might like to debate.

Hi Andrew

I just noticed your post, it seems to have slipped down a bit.  You bring several very interesting ideas that I think deserve comment. In the good old USA we have been told for the past several decades or so, that it is good to get out of the hospital quickly and on our own so we can really recover. I think we all know that that thinking has been promoted by the greedy American insurance companies and their Republican law maker stooges. It also might be right.

I must admit, that I screamed and clawed to get out of the hospital at the earliest possible time.  However, I think there is something about being "taken care of" that might be better for all of us. It would be interesting to explore the difference between being booted out in 24 hours to being taken care of for a week.

The fact that you are apparently suffering few of the continence and sexual side effects of prostate surgery should at least suggest that we examine the difference.

Thanks for your post