Definitely go for nerve-sparing if you can. I had RRP a year ago and
with the help of Levitra  can achieve full penetration again. My
recommendation is Dr. Mark Litwin at  UCLA Medical Center in Westwood
area of LA.

I assume by RRP you mean Robotic Retropubic Prostatectomy.  Just about
all doctors who do this surgery and all prostate surgeries try to spare
the nerves.  I interviewed Dr. Brooks at Stanford and neither he nor
Dr. Carroll at UCSF do the robotic stuff.  Dr. Brooks felt (at least
two years ago) that the robot tends to be used by surgeons who feel
more comfortable learning the laparoscopic technique with the aid of
the robot.  That was confirmed by my own surgeon who had done his first
40 laparoscopic surgeries with the robot and abandoned the robot
because he felt he could do a better, faster job with straight lap
surgery, no robot.   I was his 126th lap patient and I'm two years out
and still have some incontinence and a limp Willy - so go figure.
There are a number of doctors in the Bay Area (I assume you're from
around here if you've heard of Brooks and Carroll) who do the robot/lap
surgery and I can give you a couple of names, but if you decide to go
with regular surgery, you can't go wrong with either Dr. Brooks or Dr.
Carroll.  Good luck in your search.  
Dave Perry

Chris, this a classic example of how there are no stupid questions.  I
cannot answer emphatically enough that the nerve-sparing version is
absolutely what you want (if you want RRP).  There is only a very small
chance that your cancer has spread, so if you have surgery you need a
surgeon who can identify and not damage those nerves.  Ask for his track
record in that regard before you agree to the operation.

jimhoney
nerve-sparing RRP at Johns Hopkins in Baltimore age 52, cured, no
significant aftereffects

Chris,
My numbers were very much like yours when I had Robotic RP. At 18
months post op, I'm PSA-not-detected, dry, and my sex life is
excellent. I'm in CT, and stayed here for surgery. I went completely
nuts when I got the bad news. Life was sweet again soon after the
surgery. Good luck.
Steve U

Welcome to the group Chris.

You definitely want nerve sparing.  My surgery was conventional, two years
ago.  I was 55 at the time.  I left the OR about 11:30 A.M. Friday, got up
to walk the first time Saturday 9:30 A.M..  Did not walk far, but was
surprised that I could get out of bed unassisted (the nurse manned the IV
pole though).  By that night I was walking around the entire floor and I
went home 10:00 A.M. Sunday.  The point being, do not be afraid of the
conventional surgery option.  I am not recommending that though because I
have had hernia repair and gall bladder removal laparoscopically and think
highly of that alternative.  Whatever path you chose you want a doctor that
is experienced.  If the doc is shy about talking about his record, find
another doctor.

I was PSA 5.0, PSA Free 6%, and Gleason of 6.  My surgeon was well trained
and experienced and came very well recommended.  Two years out I am still
incontinent and impotent.  But, they got the cancer, and that is what this
is all about.  I do not report this to be negative or to scare you.  Just go
in with realistic expectations about the outcome and side effects.  As you
will see here, there are guys who have erections with the catheter still in
and there are men in their 70's who have a return to normal sexual function.
Most guys are continent by three months or so and many are before that.  You
need to talk about these things with your doctor and get information on his
record in this regard.  You will not know about the incontinence and
impotence until after the surgery.  We are all different.  I expected to be
with the majority that return to normal sexual function and continence, but
reality had a different result for me to deal with.  But, again, the point
is that the cancer is gone.

Good luck to you.  This is a very good group.  I hope you stick with us.

David S.

I am 47 and had very similar numbers on diagnosis (earlier this year)
to you.

James Brooks did my RRP at Stanford on 7/7 this year. I was up and
walking around the same day (about 80 yards pushing my own drip stand).
I had very little pain and went home on 7/9. I was continent as soon as
they removed the catheter (on 7/22). I am still mainly impotent, but
there are some some "signs of life" and Dr. Brooks is pretty confident
things will start working again after a while. My post-op pathology was
excellent.

I considered robotic surgery, but to get to someone with lots of
experience doing that procedure would have meant travelling (Wilson or
Kawachi at City of Hope in LA are the nearest I would trust, but we
also considered Mani Menon in Detroit). We live an easy 20 minute drive
from Stanford, so I traded travel for being near to home/friends/etc.
plus easy follow-ups. In the end, my open surgery experience was very
close to what others have described from the robotic in terms of blood
loss (very little), discomfort (ditto), recovery, etc.

If you live near Stanford, I would strongly recommend James Brooks.
That doesn't mean that others don't do a good job, just that I know
what a good job Dr. Brooks and his team at Stanford did for me.

Hello Chris, and I am glad you found out early considering prostate cancer,
and I know the news is very hard on one.
I had the same diagnosis at the same age in 1999.
Yes, Dr. James D Brooks does nerve sparing and he is a prostate cancer
specialist.
Peter Headland was most recently his patient and I was his patient in 1999.
I had one nerve spared and everything works fine.....
I would definately see Dr. Brooks. and if you have any questions we can
talk.
Dr. Brooks is a very caring Dr. who is a real pro!
Again sorry for the news, but feel good that early detection is better.....
You will be fine.
John Loomis

Welcome to the club!

Yes, you want nerve sparing and many, many doctors do it.

By "the usual books" if you mean Dr. patrick Walsh's Guide to Surviving
Prostate Cancer and or Steven Strum's APrimer on Prostate Cancer, then I
agree those are "usual".  In any case, read them cover to cover.  You have
time and they will answer many of the questions you have.

Thanks everyone for some great information - your messages have been very
reassuring.  I'll keep you posted as the surgery happens.

Best wishes to you all.

Chris.

Chris,

I had nerve sparing Robotic Laparoscopic Radical Prostatectomy 17 months ago
at UCSF.  Surgeons were Christopher Kane and Marshall Stoller, who I highly
recommend.  My age at time of surgery was 67.  I have been totally continent
since surgery.  Erections require the help of trimix and I expect age is a
significant factor there.  I just had my fifth PSA test since surgery, and
the count is still undetectable.  I can't ask for more than that.

Best of luck in whatever you choose.