Prostate Procedures Information

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Hello All

Can't sleep so was going through some information on Nerve Sparing Surgery.

I learned something new today. We have always talked about the nerve bundle when they do any of the prostate procedure especially a Radical Prostatectomy.

I learn that there is not 1 set of nerve bundles but 2 set that control erections and urine function. The Alnasauit Nerve bundle controls the first response to the penis. And the Somatic Nerve bundle will finish the erection so you can have sex. Also if this set is damaged it can cause incontinence.

I'm writing this because if you guys are having these types of surgery you should be told everything by your doctor.Sometimes they do not explain it all.A good doctor and all the information is key to a good outcome. No matter what anyone tell you on this site you have the right to have whatever procedure you feel that is right for you.

I read that when they do a Radical Prostatectomy they have to peel the nerves away from the prostate and it is hard to know where they are because once they take it away from the prostate they have a hard time finding them because they are so small.

Most doctor that do the Da Vinci Robotic Surgery they have been using a nerve monitor to see where the nerves are so they do not damage them. Because removing the nerves from the sides of the prostate will traumatize the nerves and they will not work for a period of time.This is why you end up with erectile problems ( Age & Health have a lot to do with healing and getting you erection back )

This procedure Nerve Sparing came about from men complaining about there sex life after surgery. Most of the time before 1982 you lost it and never got it back because the nerves were damage. A lot of men are having surgery at earlier ages. 40's and 50's. It was developed for this reason and the first one was done in 1982

I hope this helps some of the men on here. Nerve sparing is what a man need to keep his sex life in tact. I'm talking about The Radical Prostatectomy mainly. If you are having one of the other procedures make sure he does not touch the outside of the prostate and damage the nerve bundles.

I hope this help someone. We learn something new everyday. Trust your doctor but it is always good to get a second opinion if you are not sure.

Good luck to all and God Bless...............Ken

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  • Posted

    Hi Ken:

    While my uro surgeon never called his procedure the "Da Vinci," it was robotic and he assured me he was not going to touch the nerve bundles (both of them) because they are on the outside of the prostate and he only worked on the inside shelling out the 200g+ prostate (you saw the picture) in one piece.

    What you have shared is very important for all of us to know regarding nerve bundles and the difference between radical and robotic. We should also acknowledge that with radical there is also a risk with the bladder neck and the two sphincters being disturbed. With robotic, neither were disturbed/touched.

    I am now 4-months post my "Simple Robotic Prostatectomy" and could not be happier. If I get up at all at night, it might be once. I actually slept through the whole night last night and never got up. I do not have any signs of incontinence. As for erections, no problem. And best of all, my stream is very strong and it amazes me each time I pee how strong the stream is and how quick I void my bladder. I lived years with a weak stream and standing at the urinal forever, and probably never completely emptying my bladder.

    I should add one more thing. I do not take any medications for anything. At 61 years old, I am very fortunate and the Simple Robotic Prostatectomy gave me my quality of life back. I know, I am the odd duck on this forum. I went straight from peeing one day (although weak), to full retention, to surgery, and skipped being enticed by pills and less invasive procedures. I count this as a blessing. How I got by with an enlarged prostate (265g) for so many years is beyond me. Kind of like our vision as it goes bad over time and we never noticed until we have to. It just creeped up on me and hit me from no where.


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    • Posted

      I have PC and spent a great amount of time talking to Consultants and reading about the possibilities. I thought I had discovered something effective when was told about nerve sparing but was put off by the risks. If there is one slip or the surgeon makes a decision while you are under the anasthetic you have no chance of agreeing or not. I thought it was too risky and settled on "Pencil beam" proton therapy. I'm in the UK and it does cost, but very few side effects, so far. Finished the course 4 weeks ago.

      Just read Dave's comment about the surgery removing the inside of the Prostate. I had never heard of it but it sounds very interesting. I guess that it depends on where the cancer is within the prostate?

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    • Posted

      Hey Dave.

      Yes we can go from being fine one day to being a mess. I am happy that your procedure worked well for you.

      I hope it continue. As the Simple Robotic Prostatectomy you had the inner's of the prostate removed and he did not touch the nerve bundles which is good.

      There is so much to learn before you go and have a surgery because it is going to change your life in some way......

      All the best......Ken

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    • Posted


      I'd like to hear your story. I'll PM you my cell #

      My uro does open prostatectomy - he feels he has better outcomes than those achieved robotically. He told me he can go in and do a partial prostatectomy - that is, to core out the inside and leave the capsule intact.

      He cautioned me to do that as a last resort because it's major surgery.

      My prostate is also large, somewhere in the 150-175 cc range. Median lobe.

      Last night I got up once. Two nights ago I got up four times. Varies all over the place.

      Yesterday I voided 420 cc, and 3 hours later voided another 420 cc. Woke up this morning and voided 300 cc.

      No rhyme or reason. The bad nights are very bad - can take 10-12 minutes to dribble out my bladder. It's those nights - and the inability to sit for any length of time - that makes me think of just getting the surgery. I'm still cautious (suspect) of PAE despite talking with Dr Bagla. But PAE may be my choice if I don't steel up the courage to do the open prostatectomy - which I know will do the job but runs additional risks and has the longest recovery time.

      Am very glad to hear of your good results!

      The $64,000 question: How do you prevent (slow down) the prostate tissue from growing back? Benign prostatic hypertrophy does not "switch off" when tissue is removed.


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    • Posted

      Hey Michael

      Have not heard from you for a while. That's fine I know your a busy man with work and your family.

      It seam like your under control somewhat. There are some men on here that would love to be able to do that. They have to do CIC But we all do what we must.

      If you have to on the days that you have the problem try to use the tricks to try to get yourself to pee. Warm water, Hot shower maybe just running the water. Used them all when I had that problem. It does worked sometimes.

      PAE is a good start. Dr. Bagla is a good doctor. I have got e-mail from him. He always fines time to answer questions. He did say that in a large prostate he has seen a temporary reduction in the ejaculation in less then 3 % of his patients. If that is a concern

      That question is a very important one. They wish they could come up with it but no luck yet. Some men's prostate grow faster then others. They have been working on it. Maybe one day we will have the answer.

      Take care......Ken

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    • Posted

      Hi Lester:

      Great question. Let's see. My issue was a large 265g prostate pushing up into my bladder. I am 61 years old. We can assume my growth happened between the ages of 25-61 , or over a 36 year period. If I was to repeat the very same cycle, I could anticipate another 265g prostate when I am 97 years old. An acceleration (or deceleration) of this is anyone's guess. I am not sure this is predictable, or if the same person has exactly the same experience.

      I can add that I would definitely do it all over again in a heartbeat if I had to versus not being able to freely pee. Plus, I do not wish the use of a catheter on any man as a way of life and feel for those that are confined to it.


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    • Posted

      I agree with you. Any kind of catheter whether CIC or Foley is an jnconvenient crutch. At age 85 I had Green Light Laser. A bloody mess for 8 months. 3 years later I was involved in a car accident which caused retention for another 8 months. My uro ordered a years supply of CIC catheters. I have not used a single one as my system sprung back to near normal.

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