RP update

[Northcaptain]

Writing for my hospital bed, had robotic RP + ePLND at 8:00am this morning. About four hours in OR and two hours in the awakening room, a little confused but no pain. A lot of wire and tubes though. No CO2 pain, i've been told to drink about a pint of juice the night before.

Dr said surgery went "very well" and he spared entirely the left side and about 30-50% of the right side were the two lesions (G7 and G9) were located. i have a side drain that shall be removed later. And a foley catheter for 7 days.

I don't sleep well (it's 2 am) with the compressive socks, a sleep small bouts of 30 minutes. I got a pleasant surprise when waking up from a small bout around 11pm, a 30-40 %hard penis!!!! It arrived about 3-4 time since. Given the circumstances... this is an incredible tribute to the hability of the surgeon by not damaging much tissues. I'm quite happy because it means for me the surgeon has taken his time to do the job.

Now start the waiting for the prostate and lymph node pathology and the overall rehabilitation.

Update:

Pain control : About coming back home the next day i had been prescribed Dilaudil in case of pain. Sat in my salon chair i was confortable ... until the first gas (my instestine restarted after 48 hours) was so painfull to pass ! I could imagine the intestine flex and it was so sensible... But that lasted 10 seconds. Caughing the first day at home was forbidden. The second day i started to be able to cough with restrain. Finally i didn't use any Dilaudil. The first day at home i had to take a few advil and it was ok the second day i was without any pills.

Jackson Pratt drain: this is bothersome but essential. Uro told me we will remove when you have less than 30 ml per day. I had regular 100 ml per day but over the time the color changed from deep blood red to almost water like with some tint in it. I still have today 100 ml per day and i have been told it could stay for 3-4 weeks, the time needed for the lymphatic system to find new way of absorbing fluids (i have maybe 30 lymph node lacking)

Catheter management: At the moment of updating i have been on urethral catheter for 12 days. Why not 7 ? Urologist want to minimise the risk of stenosis which can occur not in the early stage of cicatrization but later. Tomorrow (after 13 days) i'll have it removed. But it is so annoying. I have discovered it is very important that the tube is very well aligned with the penis opening because otherwise it create a stress and after a few hours it hurts bad. I also discovered that a little bit of vaseline everymorning limit the sticking of the tube to the penis (painful also). Washing every day with water and soap is the key.

Bladder spasm : I didn't have for the first 7 days... after i had a complete day with loss between the tube and the penis. Had to put pads. Talked with the nurse she told me i was not drinking enough. She was right, i started drinking 1.5 liter per day systematically and 90 % of the spasms disappeared. Only time i still have spasm is when i go on the toilet. Seems to be some kind of reflex. I just breath calmly and it goes away. The good news is that spams means the bladder want to close itself also... which is need for continence. Just be patient.

Sex with catheter ? : Well the penis being flacid with a tube is not that sexy but sex is in the brain as they say and the brain is still 100 % capable of having excitability and orgasm and sensibility had not gone away with surface nerves of the penis and local area. I was able to have new kind of orgasms while still having the catether on either by manual manipulation or lingual. Sorry i didn't want to be gross but just wanted to share my experience to others so that it can inspire.

Catheter removal planed for tomorrow with a cystography to assess the waterproofing of the anastomosis of the urethra to the bladder.

Life is precious, take care.

[JamesAtlanta]

Congratulations! Walking during recovery is key. I walked 2-3 miles a day - nothing too strenuous. Really helps get your energy back and seems to speed recovery. (Feels a little weird carrying the Foley catheter bag in a shopping bag while you walk...but you do what you have to do...)

Good luck!

James

[HonuHonu]

Glad to hear that the surgery went well. I think you’ll be surprised how quickly you recover and feel better. Please keep us posted with regard to the pathology results.

[j-o-h-n]

You should have had your wife take a picture of your 30-40% hard penis. (for memory sake)

Good Luck, Good Health and Good Humor.

j-o-h-n Saturday 03/02/2019 8:05 PM EST

[Northcaptain in reply to j-o-h-n]

Hi John I'm not bragging about this because I know others (friends of mine) who weren't that locked. I just found the event quite surprising giving everything we hear and read - that the body has it's own way of dealing with a situation. Surgeon removed my prostate but didnt reprogram the endocrinal system. Everything else still work as usual. That is for the theory. Went you exit the operating room full of tubes, catheters and drains the perspective change. I have much more faith though to the immense complexity of life...

[j-o-h-n in reply to Northcaptain]

I wish you well... and many many more vertical experiences. Keep posting here, this is a great site.

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 03/03/2019 10:38 AM EST

[snoraste]

Glad it's behind you now. Focus on recovery. It's over before you know it. I did my RP about a year ago. bladder is now 99% of where it was.

[Shooter1]

Lucky man. When they got into me they found all scans were wrong and had to take everything, nerves and all. Life goes on, but I had 18 mo. of hell before reaching other side of chemo/Xtandi. Now in remission, but hard-on a thing of the past. Injections, even on both sides and at over dose rate only partially effective. Pills, creams- nothing. Pump just bleed off to fast. Fingers partly numb, so even they don't do great with my much younger wife. Life and love goes on, just not much sex.

[Northcaptain in reply to Shooter1]

Dear Shooter,

So sad when i read someone like you who was caught of guard at the advance stage I don't know your exact story but my uro told me that the important is not the let the penis calcifie - which arrive in a few months without erection. So he prescribed me 5 mg of Cialis every day to start as soon as the catheter is removed and a daily routine of penile pump to get some blood in to prevent calcification. This for months.... until the neuropraxia of the nerves resolve by themselves. It can take almost a year but the daily maintenance of the penis with the pump since to be the key to preserve the natural (or induced) erection later.