hi ron - as i read this, to me, it was a no brainer.

why you may ask???

ok, here's the breakdown.

based on the biopsy, it's probably gland contained.  at 15% involvement
in just one core, i would find it hard to believe that the pca has
escape the capsule.

now, for the reasons......

1. if you get rid of the prostate gland, you will get rid of ALL your
BPH problems.   this is not the same as for radiation treatments.  you
still can have the same difficulties because the prostate is still
there.  

2.  this is a permanent cure.  you won't have to  worry about BPH
problems for the rest of your life.

3.  you will get you bladder space back.  at 85 grams,  chances are, it
is pushing up into the floor of your bladder causing urine retention and
increasing the possibility of an UTI.

4.  your stream will be full flow.

next would be the impotence factor...

this depends on your surgeon.  ask for his track record.  not all
surgeons have the same record in this area.  some of them are very good
at saving the erectile nerves.

all the damage is done at the time of surgery and improvements happen
from then on.

in radiation, about 50% of men have some kind of impotence problems
after one year of treatment.

you ask about if the surgeon would shrink the prostate.  too slow of
process such as using proscar.  they will just take it out.

questions to ask.

- how many has RP's has he done.  

- how many has he assisted on.

- how many nerve sparing RP's has he done.

- what does he consider the complications involved in your case as
compared to others.

- ask for names of the last three to five patients - contact them - find
out how they like his handiwork.

additional comment.....

in my case, i had a piece of BPH tissue that had grown out of the
prostate muscle band and was pushing into the bladder and causing the
bladder wall to fold over and close off the output hole of the bladder
itself forcing a full rental shutdown.  my surgeon said that i was 6
months away from the table if i hadn't had the surgery.  but they don't
know until they get in there.

he said that about 5 - 10% of the cases he had seen had something like
this.

i'm sure others can add more to this thread, but that is what i can come
up with right off the top of my head.

~ curtis

knowledge is power - growing old is mandatory - growing wise is optional    
"Many more men die with prostate cancer than of it. Growing old is
invariably fatal. Prostate cancer is only sometimes so."
http://community.webtv.net/PALMER_ENT/doc

Almost 24 and no answer.  In this group, that's usually a "you stumped me!"

I dont' know either.  However, I have read that excessively large prostates
are difficult to treat, almost regardless of the method.

Also, I have read that some docs use strong antibiotics and/or hormone
treatment to reduce the prostate and/or cancer before surgery.

I wish I could tell you more.

Current posters probably won't see this, but for future searchers, I thought
I'd revisit my own thread and report what a very reputable uro surgeon told
me today.  No, for surgery, a gland swollen with BPH would not be treated to
diminish its size.  (From my reading, the opposite would be true with RT.)
Nor would its large size present any added burden for the surgeon.  Nor
would its large size contribute to penile shrinkage.  (I'd thought maybe
because I'll be losing more of the urethra, the surgeon would have to
somehow "pull more of the penis in," but it doesn't work like that.  If
anything, the bladder is puckered down more.)  Nor would the BPH be a risk
factor for incontinence above and beyond the risks associated with RP on a
normal sized gland.  (I'd thought that by encroaching on the urethra, BPH
sorta causes the sphincter to weaken by usurping some of its function, but
the surgeon says no.  BPH can restrict flow, certainly, but how well the
sphincter works after RP has nothing to do with the fact that the removed
gland was hypertrophied.)

He did say that BPH slightly increases the difficulty of laparoscopic RP or
robotic laparoscopic RP relative to the traditional open procedure.  (And he
does both open and robotic.)

This is all from one surgeon, of course, and others might have differing
views, but it does seem to gibe with my failure to find reports from others
that BPH had adversely affected their RP outcome.

FWIW.  Regards, RonL

I had BPH for 5-6 years before undergoing a TURP, which discovered my
cancer. My uro said one consequence of the TURP is that it precluded
seeding because there is not enough prostate left to hold the seeds. I
had been on Proscar then Hytrin before my RRP in 02/2002 so I have no
idea if my prostate had shrunk as a result, but 80 grams comes to mind
as my prostate size, IIRC. I was continent immediately after the
surgery and suspect having learned to "hold it" for years helped
strengthen my sphincters and make that possible. My uro said it all
depends on how much gets removed in the surgery.

Larry