Surgery Confusion

tamsearching · New User Joined: 29 Aug 2007 Posts: 2

I was recently diagnosed with Prostate Cancer. Because of my age (53), my Gleason score (6), and a few other factors, my doctor recommends a prostatectomy. Based on ALL of the research I've done, I agree, but my confusion comes with the type of surgery my doctor performs. My doctors does a Radical Transcoccygeal Prostatectomy. He says he has better access visually and physically with this approach. Most doctors do a Radical Retropubic. I am confused and worried because I can find very little info about the approach my doctor uses. Does anyone know about this surgery and are therre any cons for this approach over the other. Please help, I am exhauseted and getting despatate.

johnw100 · Posted: Thu Aug 30, 2007 7:36 am Post subject: Re: Surgery Confusion

Assuming you prefer surgery, the most important aspect is to select the best surgeon available as that will have a great influence on your ultimate prognosis.

The method used, open surgery, robotic etc should be a secondary consideration.

tamsearching · New User Joined: 29 Aug 2007 Posts: 2

Thanks for your help. I know finding the best doctor is my 1st priority, but that gets to be a bit of a challenge too. I am satified with my doctor; he's done many of these surgeries. I just have some uncertainty around the approach he uses for the Prostatectomy and why the vast majority of the other doctor's do not.

chas036 · Posted: Tue Nov 20, 2007 1:04 pm Post subject: Re: Surgery Confusion

Choosing the right doctor and procedure makes all the difference in the world. There is a very big difference in surgeons, and I wish I did more research before I had my surgery.

I decided that I did not want open surgery becuase of the complications associated with it like adhesions, and length of recovery time after surgery, and greater difficulty for the surgeons to save the nerves that give you an erection. Therefore I decided that the robotic surgery was the way to go because ED with robotic surgery is minimal because of the precision of the instrumments used in cutting out the prostate. This added precision of the robot allows the doc to save the nerves that give you erections. When this is done by hand in an open surgery, it is easier for surgeons to damage the nerves and leave you impotent.

I picked a good surgeon in upsate New York at the University Of Rochester who had done over 900 of these robotic surgeries. I had my surgery 9/25 and I was up walking and driving after a day, and back to work after a week once the catheter was out. Also. I was getting hard erections a week after the catheter was removed and without taking any viagra. The only problem that I have is that now I am a 50 year old man who pees his pants. Yes, I am very incontinent with no hardly any ability to hold urine when standing or walking, and this is very very frustrating. You don't know how frustrating. Lucky for me I don't drip when I sleep or sit, but walking or lifting, it is as if the flood gates are open. I can fill a pad in an hour.

I am very fit, have been lifting weights since I was 18. I did 3 months of kegel exercises before surgery and still continue to do them, and I am still incontinent. Yes,,the surgeon and the type of procedure he does makes a big BIG difference in your outcome.

Now,,if I had it to do over again, I would go to this surgeon Ashutosh K. Tewari located in NYC at NewYork-Presbyterian/Weill Cornell hospital. He has done over 2000 of these robotic surgeries

But the main reason for going to this surgeon is not the quanity of his surgeries , it is because of an article I read. I just read an article about incontinence where this surgeon has developed a new technique he uses for attaching the ureatha to the bladder after the prostate is removed. This new technique only adds 10 minutes to the surgery time, but it increases your chances to be fully continent much much sooner after surgery. With this new technique 80% of the men are fully continent after a few weeks. What I would give to be able to do it over again.

Depending on where you live and if can travel ,,I would strongly consider talking to this surgeon. You don't know what incontinence is until you have it, and I can not tell you now that you should try to do everything you can to better your chances not to have incontinence, even if it means going into debt or traveling to find a surgeon. I can't emphisize this enough.
_________________
Biospy 4/2007 - 2/12 <%5 Cancer Gleason 6
RP 9/25/2007 Uni Rochester, NY
Gleason 6, Negative Margins

chrisz · Regular Joined: 09 Apr 2007 Posts: 31

Thanks chas06 for the post and the link. I probably will have to
make a decision soon and I appreciate folks like you posting
their experiences. Anyone else want to share their story ?

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