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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2005Do prostate nerve bundles rejuvenate themselves after a PC operation?
Do prostate nerve bundles rejuvenate themselves after a PC operation? In December 1993 I had my first PC operation using iodine uranium seeds. I had no erection problems at all. Eleven years later, at the age of 77, I had my second PC operation in January 2005. This time I had cryosurgery (where they freeze the prostate with probes), the doctor told me that he thought he could save one third of the prostate including some of the nerve bundles. Now for the question: Do prostate nerve bundles rejuvenate themselves after a PC operation such as mine or not? Thank you, Russ. > Do prostate nerve bundles rejuvenate themselves after a PC operation? IIRC, no. If they have been destroyed, that's the end of the story. > In December 1993 I had my first PC operation using iodine uranium > seeds. I had no erection problems at all. Eleven years later, at the > age of 77, I had my second PC operation in January 2005. This time I > had cryosurgery (where they freeze the prostate with probes), the > doctor told me that he thought he could save one third of the prostate > including some of the nerve bundles. It appears that this was a "focal cryotherapy" procedure, if Russ describes it properly. Well, did it work? Since Russ is inquiring, I would have to conclude that it did not. What's the PSA? Duke Bahn et al. published a study of men aged at least 71 whom they had treated with cryoablation. Ninety-five percent sustained impotence. What proportion was simply due to age I dunno. See, http://www.prostate-cancer.org/education/localdis/bahn_cryoablation.html About the only accurate/truthful thing I was told by my damned uro prior to his botched attempt at cryoablative surgery in November 2003 was that it was certain to make me impotent. At the time, I was 67. It never ceases to amaze -- and disappoint -- me that men come to support sites to ask questions that a competent and caring medic should have answered for them. Perhaps it has something to do with the report that medics typically spend no more than twelve minutes with a patient during an office visit. That's why we must each of us study, learn, and *take charge*. Regards, Steve J "'MD' does not mean 'Medical Deity.'" -- Stephen B. Strum, MD I would think that once the nerves are destroyed, that's the end of the story as Steve has stated. On the other hand, Katz from Columbia Presbyterian in the FAQ of his web site, http://www.nycryotherapy.com/faqs.html, states the following: " Even if cryosurgical ablation is required and complete ablation is performed, there has been regrowth of nerves in this area and a subset of our patients have had return of their sexual function, especially when using oral agents such as Viagra, Levitra, or Cialis. " I certainly wouldn't want to rely on my being one the select group of patients. Maybe they happen to be the ones for which cryoablation was not entirely successful. But I am confused by Russ's comments since it would appear that his uro was going to do a focal cryotherapy, and for this type of procedure the Duke Bahn et al article seems to indicate that he and Onik were between 80 and 87% successful in "Potency Preservation". See Table 3. Am I reading this table wrong? Dan >> Do prostate nerve bundles rejuvenate themselves after a PC operation? > [quoted text clipped - 38 lines] > "'MD' does not mean 'Medical Deity.'" > -- Stephen B. Strum, MD Thanks Steve and Dan, you both help a lot. In July 2004 my PSA was 4.7. In December my PSA was 6.4. My biopsy: 3 out of 18 was cancerus; Gleason Index: 2+2, I guess that is why the doctor said he is going to do a two thirds freeze and thaw of the prostate. I hope he was right. Is that what they call a focus cryosurgery? Thank you gentlemen, Russ Russ, Focal cryotherapy is generally used to describe cryotherapy that focuses on the cancerous portion of the prostate in contrast to cryoablation which is generally used to mean freezing of the entire prostate. On the Katz web site which I cited previously, he says the following: "The concept of focal cryosurgery is to freeze that area of the involved prostate gland and leave the other side unfrozen. This has the potential advantages of causing no urinary or sexual dysfunction, but may leave unfrozen prostate cancer on the other side. Even if the biopsy did not reveal cancer, there can still be areas of small cancer that were not detected on biopsy." I assume that all 3 of the samples that had cancer were in one lobe of the prostate. If so, you have a very low Gleason score and a relatively small number of the 18 samples were involved, so you could be a good candidate for focal cryotherapy as long as you recognize that there is a risk that not all of the cancerous tissue will be removed. Best of luck to you. Let us know how well it turns out. Dan > Thanks Steve and Dan, you both help a lot. > [quoted text clipped - 6 lines] > > Thank you gentlemen, Russ >Best of luck to you. Let us know how well it turns out. Dan Thanx Dan, shall-do. russ
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