new info on preventing incontinence

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dave perry - 21 Mar 2007 15:23 GMT

I talked to my surgeon yesterday and while he had no idea why I was
still dripping, he did mention a recent change in surgical procedure
that could affect continence. It seems when I had my surgery in 2003,
the protocol was to remove the prostate using cauterization. Some
urologist made the hypothesis that the heat of the procedure might be
causing some damage, not visibly obvious, to that last precious
sphincter muscle that preserves continence. As a result, the accepted
procedure now is to use more conventional techniques (the old
"knife"?) around the apex which is adjacent to the muscle and
cauterization for the remainder of the prostate.

You newbies looking forward to surgical treatment may want to ask your
surgeon about this. The techniques are the same for open, daVinci,
and regular lap surgeries.
Dave Perry

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ron - 21 Mar 2007 15:32 GMT

> I talked to my surgeon yesterday and while he had no idea why I was
> still dripping, he did mention a recent change in surgical procedure
[quoted text clipped - 11 lines]
> and regular lap surgeries.
> Dave Perry

Hi Dave...Which type of RP did you have? I was under the assumpition
that "open" surgery used a traditional surgical scalpel, but that
"robotic" used electronic cauterization, not sure about lap. Anyone
know for sure?...Best wishes and good health, ron

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dave perry - 21 Mar 2007 17:04 GMT

Ron, I've been led to believe they use cauterization for all three. A
few years ago when I asked another uro who does only open surgery
about positive margins and "slicing" through extensions with a
scalpel, he mentioned as an aside that they use cauterization rather
than the traditional scalpel. He didn't indicate if it was used for
the entire prostate removal nor if it was used by all surgeons. I've
had the layman's and undoubtedly naive impression that the prostate
within its capsule is "peeled" away from the surrounding tissues using
cauterization as a tool to reduce blood loss and that scalpels are
used to actually cut through things such as the urethra at the bladder
neck. Maybe a surgeon can chime in with something definitive. I had
regular laparoscopic surgery.
Dave Perry

> > I talked to my surgeon yesterday and while he had no idea why I was
> > still dripping, he did mention a recent change in surgical procedure
[quoted text clipped - 16 lines]
> "robotic" used electronic cauterization, not sure about lap. Anyone
> know for sure?...Best wishes and good health, ron

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