Update: 3 weeks Post Davinci Surgery

[jimbay]

Hey Everyone, Second post here. An update with a couple of questions.

First of all background: I'm 52, had a PSA of 8.9 (steadily rising from 5.3 in the last two years). Two clean MRIs. Two biopsies. The first clean. The second biopsy showed one core 3+4. Had slightly favorable Prolaris and Decipher scores. Two-thirds of doctors told me to wait. I didn't.

The post-surgery result was: upgraded to Gleason 4+3, but clean margins, no other involvement, etc. So I'm glad I went forward with the surgery.

I've been moderately continent right after catheter removal, but have major ED at this point. Taking Cialis. I also have continuous aching in my groin area which is lessened with Advil.

Some Questions: 1. Is that aching normal? 2. Id there anything else I can do for ED? 3. What's an average ED recovery timeline? 4. Should I get the pathology looked to ensure it is correct?

Thanks, Jim

[dentaltwin]

Whoa--three weeks is awfully early to be looking for technology. Were you given any information about how effective the "nerve sparing" was?

[jimbay in reply to dentaltwin]

This doctor is known as being very competent, but gruff. I asked him several times how effective the nerve-sparing was -- each time hoping for a story or confirmation. He would just say "it went fine".

[dentaltwin in reply to jimbay]

Oooh, I hate that. My doc isn't gruff--very well-reviewed, but he just smiles a little too-much. He'd told me pre-op that he'd be able to spare the nerves on one side, but not sure about the other. I was told post-op by the PA that he'd managed to spare nerves bilaterally. I'm somewhat older (66) but needed pads for 8 weeks. Still leaking a few times a day, but there is gradual improvement. I don't remember groin pain, though my scrotum was plenty swollen for several days. The only real pain I had was at the site of scope insertion (lateral to my navel). I suspect the symptoms are a little different for everyone.

As far as penile "rehab", all I got was a prescription for sildenafil (generic Viagra). It helps a little. I'm sure I could pursue other avenues (my brother, who had a RP about 7 years ago, was told to use a pump). I'm not expecting miracles, nerve sparing notwithstanding.

[Tall_Allen]

1. Is that aching normal?

It may be a lymphocele, an inguinal hernia, or a nicked pudendal nerve. Ask your urologist.

2. Id there anything else I can do for ED?

You can follow a penile rehab program:

amazon.com/Saving-Your-Sex-...

Daily Cialis may slow your continence recovery - on demand may be better. Pumping and occasional trimix may help too.

3. What's an average ED recovery timeline?

Most guys who are going to recover will within a year, but some take longer.

4. Should I get the pathology looked to ensure it is correct?

It's hard to make a big mistake when they've got the whole prostate to look at. But if it gives you comfort, you can send to Epstein.

[jimbay in reply to Tall_Allen]

Thanks Allen, your very knowledgeable this helps.

[jimbay in reply to jimbay]

*you're

[Dreamweaverman]

Hey Jimbay, I am going through similar experiences. However, I a, seeing progress on the ED. I visited this doctor for my ED issue and have provided a link for you to view. Hope it helps youtube.com/watch?v=ie8NkOu...(Not working as expected?)

[Dreamweaverman in reply to Dreamweaverman]

I just realized Tall Allen sent link to his book. Good doctor.very candid and straight to the point.

[Jeff85705]

First of all, I'm glad you went ahead and got the surgery, especially with a Gleason 3+4 on 2nd biopsy, and 4+3, clean margins, postop. That was my situation. Surgery and the resulting dissection of the removed prostate gives a more accurate diagnosis. In your and my cases, the actual Gleason showed a more aggressive cancer than biopsy alone. So congratulations on doing the right thing.

Immediate ED is the most obvious and traumatic result of the surgery. Even if you had "nerve-sparing" surgery, the trauma to those delicate nerve bundles is enough to render you with total ED temporarily. That was my case. The 'good' news is that, over the next few months your ED should diminish. Even with 100mg of Viagra I had no response for months. Now, over a year postop, the Viagra works well enough to attain a fairly normal erection. You just have to be patient. Just keep in mind that those powerful erections of youth are possible only with all those tiny, delicate nerves working! Be patient. It can take up to a year or more to get back a full response--if then. It took me 1 1/4 years to get a good erection with Viagra (but not without; I am 69). Libido is often another side effect. Lack thereof. For months I had little to no libido or interest in sex. In addition, the appearance of the penis changed for me, smaller when flaccid. This is partly due to the removal of part of the urethra surrounded by the prostate. It shouldn't affect the length of erection when (if) it returns.

It can take 2-3 months to eliminate incontinence. That was my case.

The aching in the groin is not normal, and you should contact your urologist. The pain relief from Advil is just symptomatic, not curative.

Best wishes and good luck to you!

[jimbay in reply to Jeff85705]

Thanks so much, Jeff.

[DanWinters]

After only three weeks aching is still normal. My testicles ached. You are fortunate to have most of your continence back at this point. ED is another matter. I would not expect any return for several months even with nerve sparing. The nerves get bruised and take a while to heal. My uro didnt suggest pump till 8 weeks and said if anyone said they had an erection at that point he would say they were not being truthful. I will continue using Sildinadil as well as pump and hope nerves finally repair. At some point you may be offered Trimix injections. At this point the pdi meds are more for blood flow and healing to assist nerve repair. They usual wait several months to see your response to the ED meds. I would say take your meds. Pump when released to do so. It will still be pleasurable but different. Dont let yourself get down.

[jimbay]

Thanks Dan, this helps too. I will talk to my urologist/surgeon on Monday about the aches, but its good to hear I'm not the only one in the same place.

[David1958]

Do not let anyone fool you on the length issue. If the prostate has been removed, the remaining urethra has to be stretched back towards the bladder and reconnected to the bladder. That stretch has to come from somwhere, and that somwhere is your dick. I was 52 when PC hit me. I am 7 years post op. Still have ED. I have tried every treatment under the sun except implantation. The pump was probably the best, but it is such a buzz kill. I know that I am not the only person who has had this procedure and still has ED. You would not know that by the posts you see on this forum. I guess all the ED guys are laying low.