Robotic Prostatectomy Experience

[windsor...@gmail.com]

Hi All,
Please tell us about your experience of robotic prostatectomy.
Thanks,
Marc Laniado

[f.j...@hotmail.co.uk]

Hey Mr Laniado!

I had my robotic prostatectomy on 5 August 2008 at Wexham Park
hospital, near Slough. I was the second to be 'robotised' on Wexham's
new da Vinci machine and I'm glad to say the procedure went as well as
I had been led to believe it would.

There was a little pain after the operation, but it was nothing
compared to the back pain suffered due to the uncomfortable hospital
bed! I was discharged on 7 August and I only experienced sharp pain
when getting in or out of a car (as a passenger) and when occasionally
sneezing: fortunately holding my stomach firmly with both arms
minimised the latter discomfort. These two minor after-effects
gradually disappeared with time and I was driving comfortably after
four weeks and the sneezing pain had gone by six weeks. The other
minor problem of not being able to sit down on a hard chair, eg at a
table, took about six weeks to cease being a problem, but during this
period this was minimised by alternating the sitting position between
left and right buttocks.

My major problems were the inability to have an erection and serious
incontinence. Three months later I still cannot get an erection,
although feelings are returning to the sensitive areas so hopefully
the future looks bright. The incontinence problem had a much greater
effect on my daily routine. From the onset I would wet myself whenever
I stood up or bent/knelt down, which meant that most of my time was
spent lying down. At the end of the first week at home I felt well
enough to wash the alloy wheels on my car (it's a petrol head thing);
it took 20 minutes and I was totally soaked from my waist to my knees
(it's a 'I've started so I'll finish' scenario). Another tricky
situation was being unable to hold back Number 1s for more than 10 to
15 seconds when needing the toilet, so when out in the car (with my
wife driving) I had to always take a screw-top bottle with me. Am I
the first to have had a pee at 60mph in the centre lane of the M40?
During the first week at home, Number 2s were very problematic and
there were a couple of misses and several near-misses when requiring
to reach the toilet pdq. Number 2s could NOT be held back and I was
therefore unable to leave the house until my bowels had been emptied.

I started pelvic floor exercises while I was still in hospital and I
continue with them still. The bowel problem was over within two or
three weeks and the incontinence has steadily improved; the length of
time I could hold off urinating started to increase from about three
weeks and is currently almost back to normal. I am still wearing a pad
in my briefs, but now that the leakage rate is much reduced I can cut
them in half (it also saves on cost and reduces the bulge in my
pants!). The stains on the pads at the end of each day are now only a
fraction of what they were back in August and recently there has been
the occasional day when they have been totally stain free; so much so
that I am contemplating trying a day without a pad. The main leakage
(which is only a slight dribble) comes after urinating, but I am
conditioning myself to tense the pelvic floor muscles immediately
afterwards. I also sometimes get a random squirt for no apparent
reason, but I am hoping this will disappear with time and the
exercises.

In terms of quantity, on average I would say I get a very slight leak
after urinating about four times a day plus the odd random leak about
twice a day. This contrasts starkly with the period immediately after
the operation when the frequent and heavy leaks caused me acute
discomfort plus the need to regularly change the pad I was wearing. I
also used to put a thick wad of toilet paper in front of the pad in an
effort to prolong their useful life.

In summary, my Robotic Prostatectomy experience has been a whole lot
less traumatic than with the pre-robot manual procedure:

1. I was home after three days instead of 14 (with one of the 14 being
a full day in intensive care).
2. Due to the computer control of the machine, the surgeon's cuts are
much more accurate, thus enabling removal of the prostate with minimum
nerve damage.
3. My six small 'keyhole’ scars (which are now quite faded) are not as
obvious as a huge single vertical scar across my stomach.
4. The residual pain after the operation was minimal.
5. I was driving after four weeks.
6. Having checked out a few things on the internet before the
operation, I ascertained that you and your team obviously knew what
you were doing, so I felt totally confident that you were going to
achieve your objective to the satisfaction of all parties. And for
that I am extremely grateful.

Regards

Frank J Ogden

[marcl...@gmail.com]

Hi Frank,
As you had a TURP and a TURBT of a tumour by the bladder neck before
your robotic prostatectomy, it's not surprising that it took longer to
achieve continence than other patients having robotic prostatectomy
without a prior TURP or TURBT! Hopefully, all will be better soon like
the majority of our patients (TURP transurethral resection of the
prostate, TURBT=transurethral resection of bladder tumour). I am very
grateful for your comments. Please see the section in the files on
sexual function and continence.
Regards,
Marc