TURP and Prostatectomy

[LandManager]

I am looking at a prostatectomy, but I had a TURP 8 yrs ago. How does this change the risk factors and my potential quality of life for a prostatectomy? If I did radiation therapy, they would like me to have another TURP to remove some of the prostate that is growing into the bladder before starting radiation but after starting hormone treatment. The surgeon is happy to remove the entire prostate, even the protrusion into the bladder. The surgeon would do his work in September. Going the Radiation route, I could start hormone treatment in September, get a second TURP in September or October and then start Radiation in January or so after the TUrP has healed. Any thoughts on my decision making? Gleason score of 9 on one of 15 cores of a biopsy, 71 yrs old and otherwise in good health.

[Tall_Allen]

What is the risk of incontinence after surgery?

[LandManager in reply to Tall_Allen]

Apparently, not significantly different from Radiation.

[Darryl Partner]

have you had a second opinion from a different pathologist at a different lab (re your biopsy samples )

[LandManager in reply to Darryl]

No. Is this biopsy analysis not routine and consistant? Is it more like a 14 yr old umpire calling balls and strikes at a little league game?

[Dont08759 in reply to LandManager]

I had a Biopsy 5 years ago at the small hospital in Key West with a 4 out of 5 on the right hand side as a Gleason 8. The slides were sent to the Rutgers University pathologist and then to the NYU pathologist, they read them as a Gleason 9 and my oncologist of 30 years (stage C rectal cancer) freaked!

[Darryl Partner]

1. Mistakes (innocently) happen in all arenas 2Pathology is an interpretation 3pathogists vary in quality and experience 4your pathology report informs your treatment choices and 5 getting a second opinion is a relatively simple effort with an important payoff in your treatment choice confidence and quality of choice making

[prostaticduct]

There is a slightly higher rate of post op incontinence in men who have had a previous turp. If you need another procedure anyway then it’s an option. And you keep radiotherapy as a back up secondary option. Make sure you get a psma pet scan pre op to check to disease outside the prostate.

BC uk urologist

[LandManager in reply to prostaticduct]

Thank you for your advice, BC il urologist. It is very helpful. How much is slightly higher?