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Prostate Cancer (Expert Forum)
Is my post robotic protatectomy surgery condition normal?
Answered by
Ash Tewari, MD, M.Ch. - Prostate Cancer, Robotic Prostatectomy, Urology, Oncology, Surgery
Weill Medical College of Cornell University
New York - NY
This forum is for questions about: Advanced or Metastatic Prostate Cancer, Biopsy, Bone Scan, Blood in Urine or Semen, Benign Prostatic Hyperplasia (BPH), CT Scan, Cystoscopy, Erectile Dysfunction, Hormone Therapy, Incontinence, Pain (abdomen, low back or hip), PSA Test, Prostatitis, Radiation Therapy, Rectal Exam, Recurrent Cancer, Risk Factors, Screening, Staging (Tumor size; Metastasis), Surgery, Transrectal Ultrasound, Urinary Difficulty or Burning, Urinary Urgency (Leaking), Watchful Waiting.
Is my post robotic protatectomy surgery condition normal?
by ekofoto, Jul 24, 2007 12:00AM
On March 19th,2007, I had robotic protatectomy surgery performed. I was told the proceedure was difficult and took several hours to perform. Now, 4 months later, I am still incontinent and have not been able to achieve an erection since the surgery. When I do have an ejaculation I ejaculate urine. The condition does not seem to be improving. Is this a normal side effect of this surgery? If so, how common is it and what are my prospects for a return to normalcy?
Doctor's Answer
by Ash Tewari, MD, M.Ch., Jul 25, 2007 12:00AM
, Jul 25, 2007 12:00AM
Urinary incontinence after robotic prostatectomy is usually a temporary phenomenon
in the vast majority of the cases and during the first postoperative year a significant improvement could be expected.
You have not provided the operative details of the procedure i.e whether it is nerve sparing surgery or not. Sparing of the neurovascular bundle during the surgery has a impact on the recovery of both incontinence and potency.
Recent studies mention that neurovascular bundle preservation can improve postoperative continence [1] . After a minimum 1-year follow-up the urinary continence rate of upto 87.4% can be expected [2].
Getting some details about the surgery (i.e whether nerve sparing on one or both sides) may further help us in predicting the recoverability.
References
1) Graefen M, Walz J, Huland H: Open retropubic nerve-sparing radical prostatectomy. Eur Urol 2006; 49: 38–48.
2) Walsh PC, Quinlan DM, Morton RA, Steiner MS: Radical retropubic prostatectomy. Improved anastomosis and urinary continence. Urol Clin North Am 1990; 17: 679–684.
AT
in the vast majority of the cases and during the first postoperative year a significant improvement could be expected.
You have not provided the operative details of the procedure i.e whether it is nerve sparing surgery or not. Sparing of the neurovascular bundle during the surgery has a impact on the recovery of both incontinence and potency.
Recent studies mention that neurovascular bundle preservation can improve postoperative continence [1] . After a minimum 1-year follow-up the urinary continence rate of upto 87.4% can be expected [2].
Getting some details about the surgery (i.e whether nerve sparing on one or both sides) may further help us in predicting the recoverability.
References
1) Graefen M, Walz J, Huland H: Open retropubic nerve-sparing radical prostatectomy. Eur Urol 2006; 49: 38–48.
2) Walsh PC, Quinlan DM, Morton RA, Steiner MS: Radical retropubic prostatectomy. Improved anastomosis and urinary continence. Urol Clin North Am 1990; 17: 679–684.
AT
Based on this information, would it be your opinion that I can sexpect a full recovery over time? Or that the incontinence and urine ejaculations are permanent?
Thank you
Thank you