Prostate removal. Open or robotic

Have you discussed this with your urologist yet? When I was diagnosed with Prostrate cancer two years ago my first reaction was to get it removed but in the end I opted for HT and RT. I had a good outcome and the last test showed a very low PSA count.

Have you considered all the implications of surgery such as loosing length of your penis?

Good luck

Richard

Jam,

Please tell us your PSa and Gleason score.

Every individual case is different. Some have had great success with removal of Prostate. If you are an older person jyour Urologist will probably tell you removal is not an option.

I had EBRT for my cancer, and have had good results. Side effects were bothesome, plus 43 fractions of treatment was not so bad, after they are done and over, you tend to forget them.

G'Luck,

Roger

If you have made the decision to have surgery then there is no question that Robotic is the choice to take. With robotic surgery ou have significantly less neuropraxia (nerve damage), lower chance of incontinence and faster recovery. If bilaterally nerve sparing, you would have a much higher chance of recovery of erectile function (rarely as good as before the operation though). If unilaterally nerve sparing then with open removal you probably have no chance at all of recovery of erectile function but with robotic surgery there is a fair chance as long as you oxiginate the penis very early on (within the first month) and continue doing so until recovery even if it takes 2 years! (ie with a Vacuum Erectile Device ideally twice/day and daily Cialis 5mg).

Let us know the PSA and Gleason score. Make sure that you explore all your treatment options. If you are certain that removal is best for you, then Robotic is the way...  you may have other options rather than surgery. I had Brachytherapy just over a year ago. All is well at this point. With all treatments, there are side effects, but they are tolerable. Wishing you the best. Charles

You have not mentioned your Gleason score or PSA.

On that basis I agree with Roger and and Romney, with one proviso.

The expected result from surgery is a function of the experience of the surgeon.

I would rather an open surgery by someone who has performed hundreds of these in preference to robotic surgery by someone new to the technology and limited experience.

Ideally you want someone with a lot of robotic experience if you choose robotic surgery. I chose someone who has performed hundreds of such operations. My reasoning was simple: using a robot makes the job easier for the surgeon. And the easier it is on him or her the better the expected outcome for the patient.

But if I couldn't find an expended robotic surgeon there is no question in my mind that I would have opted for a highly experienced open surgeon. The literature indicates that in the hands of a highly experienced surgeon, the medium to long term outcomes between the two groups of patients is similar.

Note, Romney's point that robotic surgery replay in quicker healing ( it did in my case) and lower rate of incontinence  ( or as I prefer to call it ' a shorter time of

incontinence', three months in my case. 

I went robotic assisted. Only spent one night in hospital. Minimal pain.

When I researched my options I felt it was the best way to go.

Usual advice is to make sure the surgeon has experience without screw ups.

I am completely in line with Barney with regards to the experience of the surgeon. I too made sure of the experience of my surgeon on the robot and would not have gone ahead without knowing that he had performed well over 100 such procedures. I was fully continent within 5 weeks. With open surgery there is a very significant percentage who never regain continence. This may of course partly be because only experienced surgical teams are given new toys such as a da Vinci surgical robotic system!