Open Simple Prostatectomy Surgery

[Space1950]

Who has recently had "Open" Simple P Surgery?

Experiences?

SEs?

Wish I knew then...?

[cpcohen]

FWIW --

I understand the difference between "open" surgery, and "lapasascopic" (or "robotic") surgery.

I've never heard of a "simple" prostatectomy. The only thing I know is a "radical" prostatectomy -- the prostate, and a section of the urethra that's within the prostate, is removed.

. . . It is major surgery, with major side-effects (or "consequences", because they're so common).

I had an open, radical prostatectomy in 2007, for low-grade (Gleason 6) prostate cancer.

Since then, there have been new clinical trials, and I have an appreciation of what "erectile dysfunction" and "incontinence" really mean. If I had the same situation now, I'd pick either "active surveillance" (possible) or brachytherapy (quite likely).

I've become quite knowledgeable about ED, and the ways to work around it. It's more common, and more severe, than most surgeons will tell you. For a vision of what you're likely to experience:

"Saving Your Sex Life: A Guide for Men with Prostate Cancer" -- Dr. John Mulhall

It's impossible to say much more. A "best treatment" discussion takes into account your age, physical condition, Gleason score, and biopsy results.

. Charles

[Space1950 in reply to cpcohen]

C, the two types are Simple and Radical; Radical is complete P is taken out. Simple is the inner core is carved out - used for severely large P causing BPH - sort of carving the inners of an orange and leaving the outer skin and the inner layer next to the skin - but all the internal removed. Both can be done OPEN - cut to stomach or ROBOTIC - 2 holes for instruments; Now even some sites progressed to "Single Port" Robotic - only 1 hole for the instrument holding the several arms of the robot. My query is are the SEs similar with SIMPLE vs RADICAL surgery. Tks for your experience with R. Hope you are doing well.

ps. 69 yrs old.

[Tall_Allen]

Some periopeerative issues but equal outcomes if performed by surgeons with equal expertise. Find the best surgeon and let him decide.

[Space1950 in reply to Tall_Allen]

TA, would you be familiar with SIMPLE vs HoLEP surgeries? ie. SEs after surgery; Recoup; Incontinence; ED, flow stream, etc Considering HoLEP for 220ml size P - but, that's a lot of P to come out of instrument impacting urethra integrity. SIMPLE might be same outcome with no impact to flow in Urethra integrity. Recoup time might be same?

For size of P, both appear to be challenging.....ps 69 yrs old

[Tall_Allen in reply to Space1950]

My apologies - I was thinking radical. Why are you not taking out the whole thing if you have prostate cancer?

[Space1950 in reply to Tall_Allen]

TA, sorry, only diagnosed w BPH - size of 220g; So either HoLEP or Subpubic or Robotic Simple P Surgery; July 2019, CT did not disclose any cancer nor has DREs over the years;

QOL is impacted n time for a decision tree on which direction to go? Thinking of impact of HoLEP to urinary tract w instruments, morcellator, etc; Either selection lab analysis will be done to determine if any cancer is present; Current PSA is 6.0; 69 Yr Old...On Cipro now 14th day for bacteria infection - stagnant urine in bladder; CT also showed Bladder Stones. Would you have any comments about either of the 3 procedures? HoLEP, Robotic or Subpubic Simple P Surgery? Currently looking at Vanderbilt and Univ of Okla...

[Tall_Allen in reply to Space1950]

That's a lot of tissue to be ablated by HoLEP - does your doctor have experience removing that much tissue? I'd be inclined to go with the procedure that the doctor has more experience with.

[Space1950 in reply to Tall_Allen]

Yes, the amt of tissue to ablate n move out is concerning - but, they claim good results; Dr James Lingeman - Univ of Indiana is the pacesetter here who fellowshipped in either Denmark or Finland for HoLEP; His fellowships w good reviews are Nicole Miller - Vanderbilt; Humpheries - Mayo in AZ; another in Indiana Dr. K (spelling) who went to Mayo - MN after fellowship n now back in Indiana. All 4 have great reviews. For Robotic SPS, many URO-oncologist seems to have the most experience; Univ of Okla has 2 Drs that have very good results of rehab after surgery. I'm sure many more around country; What I like about Okla is that they are one of handful of Cancer Center designations around country by NCI. So, if lab is positive, I could continue on there - 9 hr drive from Louisiana. Just looking ahead - in case needed.. Hearing the Robotic SPS is overnight in H and release w catheter for 7 days; HoLEP is outpatient - and catheter is removed next day.

[Space1950 in reply to Tall_Allen]

TA, update for y. I did HoLEP Moses 2.0 w Dr Amy Krambeck at northwestern medical in Chicago 7/14/21 for my 231g P n bladder stones; she removed stones n 177g of P; lab back no cancer; 12/2021 PSA is .0247; in at 10:30 n walked out hospital at 4pm w no catheter. Amazing recovery.