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Medical Forum / Diseases and Disorders / Prostate Cancer / July 2006

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8 months post robotic RRP

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chrisp - 31 Jul 2006 03:47 GMT
I scanned the recent postings, but have seen nothing regarding complications
following a robotic RRP - has anyone had any?
First the really good news; PSA zero, also zero incontinence. Now the bad
news; three bladder infections so far, and recently diagnosed with ostitis
pubis (inflammation around the pubic bone right above the penis).  I'm
finally in physiotherapy, but actually doing some serious exercise seems
like a long way off, and captain midnight only occasionally wakes up (I can
be patient on that score, just want to be able to run and swim again!).
I'm 50, had a gleason score of 7, PSA of 5.9 I think when diagnosed at 49.
Da Vinci surgery was done at Uof Washington, Seattle.

Thanks guys!
KenA - 31 Jul 2006 06:04 GMT
Hi Chris!
IIRC, we had our LRRP's within a few weeks of each other, but mine was at Swedish
hospital in Seattle.
Sounds like you're doing better than I am in both the usual areas, but I've escaped
the bladder infections and ostitis pubis.
I hope these get resolved in the near future for you.
Can't say much other than I'm generally taking my (continued) recovery one day at a
time, but sometimes do wish it would progress faster.
KenA
>I scanned the recent postings, but have seen nothing regarding complications
>following a robotic RRP - has anyone had any?
[quoted text clipped - 8 lines]
>
> Thanks guys!
Prospector - 31 Jul 2006 14:31 GMT
> I scanned the recent postings, but have seen nothing regarding complications
> following a robotic RRP - has anyone had any?
[quoted text clipped - 8 lines]
>
> Thanks guys!

Hi Chris.
I had my Robotic RRP on June 21st.. and consider myself very fortunate.
I am 62, very active, and thankful that my GP referred me to a
urologist after a slightly elevated PSA.. My urologist recommended a
biopsy even though the DRE indicated only a slight firmness of the
prostate.
As to complications, I did have a serious case of Roids develop, which
caused more discomfort than the operation.
As well, I had a bladder blockage which required emergeny surgery to
re-open the bladder to urethra passage. This was performed under
general anasthetic to cut the scar tissue that was blocking the
opening, with an overnight stay. Also required a catheter again for 6
days.. The second catheter was more uncomfortable than the first.
I understand this complication occurs in about 5% of operations..
either open or robotic.
It usually occurs much later than the  3 weeks post op that I
experienced. The pain associated with not being able to urinate was
greater than either post op..
In general, my prostate cancer experience has been one of
inconvenience, with little pain, some discomfort, and a sense of
gratitude to the medical profession. There have been a few bumps in the
road, but I am fortunate to live in Ontario, with a universal health
care program, a supportive wife, friends and company. My biggest
challenge is being patient with the recovery.. best put by my urologist
who said it would take 90 days to get to 90%.. as to impotence and
incontinence.. time will tell.. keeping in mind what my urologist said
"you can't have sex from a coffin"
Having found this discussion group.. perhaps a seperate thread for the
stages of diagnosis, treatment and recovery, with what to expect, and
the little tips that you can't find in books.
As to the laproscopic method, I had very little blood loss, no
transfusions, and no complications attributable to the method. My
neighbour in the hospital had open surgery, with some complications
with bowel blockage, with a hospital stay of 4 days to my 2. He also
had his catheter in for over 2 weeks, rather than my 9 days..
I did have a urinary tract infection after the catheter was removed,
which cleared up just before my emergency surgery for the blocked
bladder.
On a humorous note, I did manage to put on my depends inside out, which
had interesting complications.. the only time I had a leakage outside
the depends. My initial incontinence was almost licked at week 3 until
I underwent the second surgery for the stricture.. now after having the
second catheter removed, the recovery of bladder control goes a little
slower, but improveing as I do my Kegel exercises.  the muscle gets
tired at the end of the day.. and the leakage increases as well.. but
OK overnight.
My "stream" is better than it ever has been..
OK, so I'm rambling, but I have found a comfortable place on my
recliner, with my laptop.. which reduces the leakage.. and I can
practice my Kegels as I make my hourly trip to the John.
Have a great day, and stay positive.. I now know where the term
"patient" comes from.. a lot of waiting interspersed with periods of
boredom.

Cliff
james_wv@hotmail.com - 31 Jul 2006 15:08 GMT
Prospector - you're the only one I've seen on here with a problem
similar to mine.  I had my RRP on 7/25/05.  I had the catheter with no
problems for 3 weeks.  After removal the stream gradually diminished
until I was unable to urinate at all within 24 hours.  The doctor was
able to get a catheter back in there and I self-cathetered (coude tip)
for a few days.  Then he did a scope in his office and decided I needed
the Foley back for a few weeks.  He said the stitches hadn't healed
completely.  After that one was removed I closed up again in about 24
hours.  I self-cathed for 2-3 months and they hoped it would improve.
I gradually was able to go more and more on my own but it closed up
again around Christmas and I was 100% on the self-cath again.

In January I had a urodynamics exam which found no bladder or nerve
problem.  In February my uro did what he called a 'filliform and
follower' procedure which seemed to do the trick.  I also switched to a
straight catheter instead of the coude tip at that time.  From about a
week after that I've been able to empty enough that I haven't had any
problems.  I still used the catheter before bedtimet to see what was
left and once I established I was empty except for 40-50 ml or so I
stopped using it at all.

My urinating now is not what you'd call normal.  I can't urinate at all
sitting completely down and it doesn't flow well standing up at a
urinal.  The best results are when I crouch or hover over the toilet.
The urine seems to drain out in a decent stream but without a whole lot
of pressure, and bearing down doesn't increase the flow.  After the
initial urination, I usually can do more a minute or 2 later with a
little bearing down.  To get completely empty I usually can bear down
after a few more minutes and get a third period of flow.  So an
almost-complete voiding takes 7-11 minutes.  If I'm in a hurry I can
empty probably 60% or so with the first voiding in about 2 minutes but
I'm likely to have to go again in about an hour depending on my fluid
intake.  After a complete voiding I'm good for 3-4 hours or more.

I sometimes take 15 minutes or so just before bed to make sure I'm
completely empty, and I usually am and can make it through the night
with no need to get up.

But I can live with that......

My uro was VERY reluctant to try a further surgical procedure unless it
was absolutely necessary, due to the risk of some level of permanent
incontinence.  I'm glad he was cautious.

BTW I'm 49 now.  Pre-surgery my PSA was 4.7 and my Gleason (pre and
post) was 6.  I've had 2 clean PSA's and my next one is in September.
Prospector - 31 Jul 2006 15:25 GMT
> Prospector - you're the only one I've seen on here with a problem
> similar to mine.  I had my RRP on 7/25/05.  I had the catheter with no
[quoted text clipped - 42 lines]
> BTW I'm 49 now.  Pre-surgery my PSA was 4.7 and my Gleason (pre and
> post) was 6.  I've had 2 clean PSA's and my next one is in September.

James.

"But I can live with that..."
A really great way to look at life..
It amazes me that only when faced with life changing situations, do we
appreciate what is important.
My original LRP was in Toronto because we only have 2 sites in Canada
with robotics.
The emergency surgery was done in Ottawa by a very capable urologist.
His prognosis was that I may scar down again.
My surgeon in Toronto has been very proactive about my treatment.
The opening of th stricture had risks associated with damaging the
sphicter.
To big a cut would compromise my continence.
A little at a time sounds like a sound treatment path.
My initial PSA was 4.2.. Gleason 6 and T1c
Remain optomistic.
My first venture into the Group.. impressed

Thanks.
Cliff
Steve Kramer - 01 Aug 2006 00:00 GMT
>I scanned the recent postings, but have seen nothing regarding
>complications following a robotic RRP - has anyone had any?
[quoted text clipped - 7 lines]
> I'm 50, had a gleason score of 7, PSA of 5.9 I think when diagnosed at 49.
> Da Vinci surgery was done at Uof Washington, Seattle.

I really happy to hear you have a zero PSA after your RLRP.  When you posted
last August, you mentioned a Gleason of 3+3=6.  I assume your post-op
Gleason was 7.  Was it 3+4 or 4+3?

I did not have RLRP, so I'll hang um and listen to your reply.

Signature

PSA 16 10/17/2000 @ 46
Biopsy 11/01/2000 G7 (3+4), T2c
RRP 12/15/2000 G7 (3+4), T3cN0M0 Neg margins
PSA  .1  .1  .1  .27  .37  .75
EBRT 05-07/2002 @ 47
PSA  .34 .22 .15 .21 .32
Lupron 07/03 (1 mo) 8/03 (4 mo), 12/03, 4/04, 09/04, 01/05, 5/05, 10/05,
2/06, 6/06
PSA  .07 .05 .06 .09 .08 .132 .145
Casodex added daily 07/06
Non Illegitimi Carborundum


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