Prostate surgery

[xylophone]

1 hour ago, offset said:

It is the doctor you need to be sure of not the method, open surgeries have some advantages the doctor as In my case can feel for other problems like in my case of hard nerves on one side and some hard limp nodes all was removed

Just out of interest I am still continent and no ED 

Congratulations on your successful prostate operation outcome, and you are quite right with regards to the experience of the doctor involved, as my surgeon told me a few years ago, and he always told me to seek out the surgeon/Dr who had "carried out the highest number of successful operations of this type".

Also you are right with regards to the lymph nodes, because it appears your cancer had spread outside of the prostate, which makes open surgery a better bet.

Where the cancer hasn't spread, I still opt for the da Vinci robotic procedure, in the hands of an experienced surgeon, because there is less bleeding, less cutting and shorter recovery times.

As regards incontinence and ED, well the early results favoured the da Vinci method, but I'm not sure that there has been any long-term analysis of outcomes.

A friend here has had the operation and not with the da Vinci machine, and he went overseas to have it done at a top-notch hospital, however it appears that they did not remove all of the cancers and he is in a bit of a quandary what to do about it at the moment.

Nevertheless, your successful outcome should be celebrated.
 

[Surelynot]

I wonder what take Intelligent design fanatics have on the prostate?.........wrapped around the the urethra, 'designed' to swell with age cutting off any chance of draining the bladder, prone to cancer due to our own hormones attacking it ,difficult to remove and when removed, possible incontinence and ED to deal with.......intelligent design my arße.

Edited March 20, 2021 by Surelynot

[LosLobo]

2 hours ago, xylophone said:

As regards incontinence and ED, well the early results favoured the da Vinci method, but I'm not sure that there has been any long-term analysis of outcomes.

Worth the cost? A closer look at the da Vinci robot’s impact on prostate cancer surgery (nature.com)

“Anecdotally, we find that recovery of continence is earlier in the robotic group, but after 12 months, there is no major difference between the two for urinary control and sexual function,” says Thanigasalam. For the cancer itself, he adds, the outcomes are the same."

Obviously you didn't read the link I kindly posted in response to your post of yesterday! ????

 

[xylophone]

19 minutes ago, LosLobo said:

Worth the cost? A closer look at the da Vinci robot’s impact on prostate cancer surgery (nature.com)

“Anecdotally, we find that recovery of continence is earlier in the robotic group, but after 12 months, there is no major difference between the two for urinary control and sexual function,” says Thanigasalam. For the cancer itself, he adds, the outcomes are the same."

Obviously you didn't read the link I kindly posted in response to your post of yesterday! ????

 

I did access the link you provided (thank you) and thought it was most informative. However I decided to do some more research and came across the following: – (EF being Erectile function, with RARP being robot assisted and ORP being open radical prostatectomy). The last para is interesting..............

When specifically comparing EF recovery across the entire cohort, RARP patients had better recovery through 24 months than ORP patients, with differences noted as early as 3 months (P<0.01). This benefit is primarily seen in the patients with D’Amico low and intermediate risk disease (P<0.01). While there is a slightly higher rate of recovery at 24 months in the high-risk cohort, it was not statistically significant (P>0.05). Importantly, in both groups, the rate of EF recovery (defined as having any mild return of function) at 24 months did not exceed 51% (51% for RARP and 39% for ORP). Potent EF recovery (defined as having erections every time) was much lower for both groups: 14% in ORP patients and 21% in RARP patients. The authors present this data as a follow-up to their own study with longer follow-up (5,6). In the original reported results with 12-month follow-up, RARP was moderately associated with improved EF recovery, but it appears that with longer follow-up, the improvement is more distinctly favoring RARP.

A unique finding in this study is the correlation between surgeon reported neurovascular bundle sparing and patient reported EF recovery. The correlation was much higher for the RARP arm than the ORP arm at all three time points, suggesting a surgeon’s ability to visualize and complete adequate nerve sparing is better in RARP than ORP. It also further supports the importance of neurovascular bundle sparing to EF recovery.

 

[Boomer6969]

On 3/20/2021 at 9:48 AM, offset said:

It is the doctor you need to be sure of not the method, open surgeries have some advantages the doctor as In my case can feel for other problems like in my case of hard nerves on one side and some hard limp nodes all was removed

Just out of interest I am still continent and no ED 

Dr. Stricker is a star in Sydney, but he helped me to twist the arm of my Thai doctor to go down the active surveillance route..

Dr. Stricker's Videos

Edited March 21, 2021 by Boomer6969