After the catheter was removed the first time--a day after my surgery--I could not urinate. The floor nurse refused to call in my urologist, who was in surgery. I was in agony with a full bladder until a resident came in and catheterized me again and emptied my bladder. We went through this same exercise the next day; then I was sent home with a catheter. By week's end, after my wife (an RN) had removed the catheter for a third time, I still was unable to urinate and was, at that point, passing blood. We contacted my surgeon who called me back into her office. There, she (finally) determined that the twin-cuff AUS had "eroded" my urethra. I underwent immediate surgery to remove the device.
In addition to being incontinent, the prostate surgery left me totally impotent. I had been able to have intercourse prior to my surgery quite successfully. I obtained a vacuum erectile device, commonly called "the pump," again via mail order (these cost between $140 and $200, depending on the device), and this has enabled me to resume sexual relations with my wife--although with some obvious preparation involved.
I'm not sure what the moral of this tale is. I suppose it's this: Make certain that your surgeon not only knows what he or she is doing but has gobs of experience in the procedure. Fifty or even 150 successful procedures apparently is not sufficient. My brother and a good friend of mine had "open" (retropubic) prostatectomies at other facilities. Both regained full continence--my friend immediately following removal of the catheter and my brother in a matter of a few weeks. The da Vinci method may very well be better in the hands of a very experienced surgeon, but the method itself is no guarantee of improved rates of continence or sexual potency.
In a few months, I plan to revisit the issue of possible incontinence treatment at a major medical facility (apparently Hartford, Connecticut, does not attract the best and brightest of the medical profession) with a longstanding reputation of success. Even if it means some inconvenience, I'd suggest those facing prostate surgery seek treatment in a world-class facility, provided your health insurance will cover the treatment there. I'd hate to have anyone else go through what I've had to endure.
I will get through this, but no thanks to the surgeon who removed my prostate or to my urologist, in whom I had great confidence based on reports from other patients.
You wrote a great message of caution in July. How are you doing presently, sir? I had robotic in September and have total incontinence at this point as well. My surgeon had done about 150 procedures and was on-staff with a regionally excellent university urology department. I figure it's a crap shoot of sorts. I think you'll agree? Hopefully, you are improving? If not, there is always more surgery that appears to help. Any comments would be appreciated from a fellow sufferer. Best Wishes,
Thanks for the well written report. I also had the robotic 3 weeks ago. researched 3 major hospital because a urologist golfing friend told me to only go with maximum experienc...your point exactly. My urologist said we were going for the trifecta...Cancer, incontinence and erection. I have only slight incontinence and signs of sex (maybe my imagination) but bad news on the cancer...it had spread to the lymph...Chemo on the horizon...good luck guys...Tom
Hello, Mike
For some reason I had not seen your earlier post from 2008. Just today I had my artificial urinary sphincter activated following implant surgery at Johns Hopkins in Baltimore. It works great! No more catheters, diapers or leg bags!
My surgeon had done about 50 robotic prostatectomies--not nearly enough in retrospect. Then my own urologist added insult to injury (same hospital) by screwing up my first AUS implant. It took the surgeon at JH an hour and a half to get through the scar tissue to fit the second implant back in January.
So, I hope you're doing better now. I sure am, and I agree with you that it is a bit of a crap shoot. It also tells you something about the state of health care in the US, I suppose.
Best wishes!
DE
Hi, Tom
It was good that you did your homework.
See my reply to Tom, above. The artificial urinary sphincter (AUS) is the way to go if you do suffer from chronic, severe incontinence. As for sex, I found the vacuum erectile device (VED), better known as "the pump," a reasonable and economical approach, although it can be a bother too. There are various devices on the market; check the Internet.
I had a penile implant, which is a good deal more expensive (esp if your insurance declines to cover it).
I'm sorry to hear that you had some metastasis, and I hope it responds well to chemo.
Best wishes!
DE