Relative had good results October 2019 with Robotic Prostatectomy!

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Hello! I haven't had new topics to post here for a while but I wanted to share some good news from a relative in his late 50s who had a very large prostate and few options for relief. He was examined for Urolift, but since his prostate was too big, he was told it wouldn't help. Then he was referrred to Dr Daniel D Eun, MD, at Temple Health in Pennsylvania, USA for a robotic prostatectomy procedure. The procedure is described as similar to "scraping out of insides of an orange" whilst leaving the outer layer (and in theory the nerves, etc) intact. The surgery is doing via laproscopic tools that go through the abdomen, into the bladder and into the prostate.

It's been a month and my relative is very, very happy with no side effects. He brags about the ability to drain his bladder completely which we all know is something we'd like to do again one day. The few days after the surgery were a bit painful and that was the only downside other than the cost of course.

I'm not sure who else in the UK or US does this surgery, but it's good to know there are options out there besides TURP, meds only, etc.

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  • Posted

    Hello, Michael:

    Your post might not be received here very well because the procedure you describe falls in the "radical" category, and men do not like that (scares the hell out of them). Our quest for BPH relief starts with magic pills, magic bands, magic beads, before it ever gets to magic removal. We (the system) treats symptoms before we solve problems. I was fortunate. I went from full-on retention to removal in one step.

    I had the same procedure (Simple Robotic Prostatectomy) done in Aug 2018 in Oklahoma City, OK. I share the same results as your relative and could not be happier. For the abdomen pain (first 4-days post surgery) I never took anything stronger than Tylenol and Motrin to manage, and I was walking everyday. I am now almost 15 months post procedure and I am still completely amazed. No supplementing with CIC, meds, etc. I do not need anything else. This was a definitely a one-and-done procedure for me and resolved my BPH problems (i.e. a very enlarged prostate).

    Have your relative get on the forum and share his experiences. This site is a repository of information for all BPH sufferers to review and consider. This procedure is not popular, but for those with a very large prostate, and it is causing you issues, it should at least be considered.

    Dave

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  • Posted

    You start by saying your relative had a prostatectomy, which is the total removal of the prostate but in the same paragraph you describe the procedure as "scraping out of insides of an orange" whilst leaving the outer layer (and in theory the nerves, etc) intact." Which was it? Was it a total removal of the prostate or a "scraping out of insides of an orange" whilst leaving the outer layer (and in theory the nerves, etc) intact"?

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    • Posted

      Hi Vernon,

      your question is the same one I had once my relative told me about the procedure, which was the "scraping out of the prostate". In effect, most of the prostate is gone with the outer layer and nerves left intact. Not the same as a full removal of the gland which I heard is done for prostate cancer patients. This is why I wanted to post the details here, it was new to me and now that my relative is so happy with the results, I wanted to see if others had considered this. (At least one person has commented which is good to know.)

      What I don't understand is why TURP is not somewhat the same procedure. I assume since the pathway to the prostate is different, a limited amount of tissue can be removed and the accuracy is removal is not as good. My prostate is not 200gms so my urologist is talking about meds and TURP, but TURP just doesn't seem to be a good solution.

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    • Posted

      Perhaps you could look into the TULSA Pro ablation. This is a more precise removal of the offending prostate tissue while cooling and protecting the urethra and colon areas. It is MRI guided so they remove precise amounts and areas of the prostate as needed without damaging surrounding tissue. It is not performed everywhere so you will have to locate where it is done closest to you. The closest to me is UCLA Medical Center in California. The larger and more well known medical facilities like Johns Hopkins and/or Mayo Clinic are more likely to perform this procedure.

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    • Posted

      I'm wondering if it "scrapes out" more than just the transition zone adenoma. And what does it do in the apical area. Sounds like it would have to be very similar to TURP except the tissue is being enucleated as in HOLEP.

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    • Posted

      Michael & Vernon - The word "Prostatectomy" implies something is being removed. However, there is a difference between a radical complete removal of the prostate for cancer patients, which includes removing the entire prostate and a surrounding margin, and a "simple" removal of the prostate for BPH sufferers. My doctor used the term "shelling out the prostate lobes like shelling out an avocado." Private message me and I will share a picture of exactly what he "shelled" out during my procedure using robotics. He removed the mass in one piece, which measured 4"x4". My prostate was 265g.

      As for TURP, to me it is like "opening" you up by going up the urethra and taking prostate tissue away that is obstructing the urethra. Kind of like a "Roto-Rooter" job. Problem is the prostate mass is still there. Just the tip of the iceberg has been dealt with and the urethra has been disturbed, and possibly sphincters. Definitely a difference between a TURP and a Simple Robotic Prostatectomy.

      The way I look at it is when it comes to controlling the beast (i.e. enlarged prostate), it boils down to either attempting to shrink it with meds and beads, squeezing it with bands, or removing parts or all of it with instruments, while at the same time desiring to protect/preserve the bladder neck, urethra, sphincters, and prostate nerve bundles.

      Dave

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    • Posted

      Hi Russ - Using robotics to "shell" out the prostate is amazing. PM me and I will share a picture of exactly what was removed from my enormous prostate, all in one piece.

      Dave

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  • Posted

    this is exactly the procedure that Dr. Edward Karpman in the northern California bay area performed on me using green light laser, aka GLEP. As you described it been done with the robot Dr. Km did it by hand with a laser As you described it been done with the robot Dr. Km did it by hand with a laser and a macerator. You can search for my thread from late last year I talked about the amazing amazing recovery that I had.

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    • Posted

      Hello, Rick:

      Not sure if I would call GLEP, HOLEP, and Simple Robotic Prostatectomy all the same procedure. Yes, all is attempting to remove parts of the prostate, but I question the difference when using laser, steam, or an instrument to do the removal. To me there is a difference in the techniques of liquidating, dissolving, versus actual intact tissue removal, plus the approach to accomplishing each varies. In other words, what access points in the body are used to perform the procedures. Lastly, is the patient waiting for the body to absorb the removal or is the prostate tissue actually removed and taken out of the body during the procedure. Mine was carved out with such precision using robotics that the mass was removed in one piece, leaving the lobes intact. My bladder neck, sphincters, urethra, and nerve bundles were not disturbed. PM me if interested and I'll share the picture. Absolutely amazing.

      Dave

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  • Posted

    I need to report my success with Simple Robotic Prostatectomy . I had a 220g prostrate and have done all the pill process, most of which have horrid side effects at least for me. I was determined on having a holep operation. I live in north county San Diego and no doctors I could find does that operation and going to Phoenix AZ was way out of my insurance area. After reading DaeCanPee I looked into SRP and found a very experienced robotic surgeon that mainly works on cancer patients but also does the SRP operations. July 15th this year I had 208g of my prostrate removed all in one chunk. Recovery was a piece of cake, only one incontinent occurrence the first day home. I went through a week of getting up multiple times each night to pee but soon it has become one or two times a night and sometimes all night not getting up. I have to report that I had a bad anesthesia reaction that added a few days to my hospital stay. Being 75 years old and numerous prior operations caused that not SRP.

    The real test of whether this is something I would recommend to others is the test "would you do it again knowing what you know now", the answer is YES, but way sooner, I suffered with pills and peeing for so long. Going hours between pee times and complete emptying my bladder is a pleasure I forgot existed.

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    • Posted

      Feral, I just had REZUM therapy. Six weeks out and I'm not impressed by the results. Still have small stream, get up four times a night to pee (at least) and only pee 100mil of urine at a time. The only benefit is that when I do get up at night to pee, I can actually pee. Prior procedure, I stood for a good five minutes before anything came out and then it only started with a dribble. I don't think I emptied my bladder completely and I still don't think I do, even after the REZUM procedure. I was wondering...is the simply prostatectomy a removal of the inside of the prostate but leaving the urethra and outside of prostate intact? Is it like hollowing out an avocado, as one other person on this post explained it? Also, if there is cancer in a lobe of the prostate, does a simply prostatectomy remove the tumor? Thanks, Vern

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    • Posted

      Hi Feral - Glad to hear the SRP worked out well for you. Every day it keeps getting better. It is amazing to empty your bladder in a matter of seconds, and then not have to go again for hours, and drink what you want when you want. Just last night I slept for a straight 8-hours without getting up. Thanks for sharing.

      Dave

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    • Posted

      Yes I retained the outside shell of my prostrate. The lab had the entire inside of the prostrate to find cancer cells and did not find any. I cannot speculate what would happen if there was cancer, my doctor and I never discussed it. There was no nerve damage or other negative results to deal with. I am better off now than when this all started 10 to 20 years ago. The meds to fight this gave me RE now that is gone and I do ejaculate good volume but very thin consistency. I chalk it up to a vasectomy many years ago.

      I give DaveCanPee credit for bringing this operation to my attention. I don't expect to have to undergo another procedure in my lifetime. Truly one and done.

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    • Posted

      Feral, read your experiences w Robotic Simple P Surgery. I am also faced with 'doing something'; Presently w a UTI due to stagant urine not voiding completely; On Cipro for 14 days now; N still on Silodosin nightly. I need to do a Robotic Simple OR a HoLEP surgery....but w a P of 220g; I am leaning to Robotic SPS, since that is a lot of mass to remove thru the pecker.....concerns me..

      How are you doing now?

      How long did you have to have the catheter in?

      How long in the hospital?

      Any regrets?

      Any man, wish i would have known that?

      Appreciate any comments....Thank you

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    • Posted

      I am doing great now with regards to my prostrate and the whole peeing thing. I can't remember when I last had any pain or difficulty with the SRP but it was no more than a couple of weeks and very mild.

      Catheter was in about a week as I was in the hospital recovering from a bad reaction to the anesthesia so the surgeon just left it in.

      No regrets unless it is how long I let myself suffer before having it done. It became an necessity, almost an emergency, when my right kidney was getting damaged from urine backing up into it from retention.

      I ended up having my GP send me to I think 5 urologists before I found the surgeon that can do the procedure. I think my success was very much tied into his experience in doing SRP. The other urologists all wanted to do TURP which my prostrate turned out to be too large for hat procedure.

      If you have red this board you will find people that have had success from a multiple of procedures and those that have had less than satisfactory results from the same procedures. DaveCanPee and I are the poster boys for a successful SRP procedures.

      Good luck with what you choose to do. I found the process of getting through all the junk deciding the hard part, once I decided it was a piece of cake.

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    • Posted

      I have decided to call Monday n make an appt w at Univ of Okla. Its a 9 Hr drive from LA and it is one of the 13 Cancer Center designated by the Nat Cancer Institute in case a lab would chase me to another step. I've talked to Univ of Illinois, Vanderbilt n Boston Medical Centers. All were very helpful in my questions about Robotic SPS and Laser surgeries; also spoke to Univ Medical Center in Finland about TulsaPro - this was a no-go as they limit to 100g size for success. Mine is 220.

      Hoping i can get an appt soon see if i qualify.Been battleling a bacteria infection for 16 days now - on cipro. No bleeding until 14th n 15th day. with fever n fatigue . Went to uro friday n they sent off for a culture to see if i have to change meds monday. So, this has made my mind up. Time to act! This stagant urine is getting to me. Thank y so much for sharing your experience. I will keep y and Davecanpee up with my quest. Mike in Louisiana

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