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  1. #16
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    I was an exercise nut all my life, engaged in all sorts of past times: MX, sailing bushwalking, running, weight lifting caving, you name it I did it, all it got me was an early retirement because my body just said ' No More'. Now days I do no exercise at at all, not that I can anyway, you'd be surprised how much you miss having workable hands and arms. Exercise and an active lifestyle did me no favours so now I take a different path through life. Just can't wait for it to end though...

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  3. #17
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    Yes fully understand, some arthritis conditions just don't respond the same way. In my case, activities consisted of cross country horse ridding and dressage, when I could no longer do that I started water skiing, as arthritis stopped that I took up Latin and ballroom dancing to a high level, again forced to stop that and continued with lots of walking and light exercise. The key thing is that all of those were low impact and never damaged my joints, each in in own way help relieve pain and gave a little more flexibility and happiness. The thing about the knee going is that it will soon take away the enjoyment of walking and the fitness benefits that go with it, my totally stuffed shoulder means that I can't do longer do any real upper body fitness programs. This is what is really starting to get to me. Again I understand that this has already been taken from you. Without sounding to melodramatic, the only thing that keeps me going every day and fighting is the thought of leaving my precious wife alone, every day with her is precious to me.

    OK, back to happy thoughts, as they say, "worry is a wasted emotion" - and I'm directing that last line to myself.

  4. #18
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    I thought I' give an update on this issue of incontinence after Radical prostate removal.

    It's day 7 after the operation and the only thing I notice different is that with a fullish bladder there is a slight feeling of pain with the normal urgency to pee. Now this is of course expected as the urine tube, where it exited from the prostate, has been joined to the tube that exits the bladder, which was previously connected to the inlet of the prostate, the base of the bladder is stretched down slightly to make the join. Apparently robotic surgery allows a much more robust join to be made when compared to open surgery, but that's only applicable during the healing period as both heal just as strong. Also the bladder pushes down on to the area where the prostate was once located, so that's got to be a bit sore?

    I drink a lot of water, and always have, I tend to fill my bladder quite quickly during sleep. I was filling a big night bag and the leg bag during the night when the catheter was in. I was worried about waking up in a swimming pool after the removal of the catheter, however I have not spilt a drop at night. I'm woken up from being so full around 1 am, just as I used to do, I get up, release a torrent, go back to bed and sound asleep in no time. I can bend over, cough, sneeze, laugh, walk 3km at 5 kmh, soon be back at 6kmh, wife can barely keep up and she's 5 years younger, again not a drop of leakage. So it's possible to recover quickly, however most men recover with in a few weeks or months, some may take a little longer, but most seem to come good within 12 to 18 months. I still wear a small liner pad at night just to be sure until the healing is finished, about 6 weeks. I don't wear anything but by normal undies during the day. Again I was expecting the worst but got a great outcome instead. So for any one having this done, do the exercises and do them every day leading up to the operation, they help, once the catheter is out you start the exercises again. I found the simplest way to do them was while I was walking, it means that I do around 35 minutes in the morning and sometimes the same in the evening as I normally do a 3k walk mornings and a 2k walk evenings.

    When you look at exactly how snug and how close the prostate is embedded into the automatic bladder pre-release muscle (top of prostate - base of bladder) and the muscle that you have control over to pee, which is on the outlet side of the prostate, you can see why surgical skill and trauma can have a big impact on the outcome.

    There are videos and a full study on incontinence after radical prostate removal and the exercises to start a few weeks or more before the surgery. I mentioned before that I had been doing these on and off for years as it made sex better, but one is never sure if you are engaging the correct floor muscle, they often recommend you get an ultrasound done so you can see the pelvic floor muscle being pulled up to make sure. I didn't bother and it appears that mine are good, however if you look at the latest data between open and robotic surgery (there are two variations of robotic surgery) the results vary in subtle ways. Physical factors obviously come into factor as does the skill of the surgeon.

    One thing that made me feel good about the outcome is the two private hospitals I was in (one for robotic biopsy and other for robotic prostate removal) both asked who my surgeon was, in both cases the nurses lust laughed and said "you've got nothing to worry about then, he's the best" his explanation of the process and the constant feedback, text message exchanges on my post progress, ringing my wife as he was about the start the surgery, ringing her as soon as I was in post op and explaining exactly how the operation went, all of this was comforting for her.

    Feel better than when I went in, I was expecting the opposite due to my battle with autoimmune arthritis. Have to remind myself not to lift anything, mow the lawn or work on the car for another 5 weeks.

  5. #19
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    By the sound of it I should have had my prostate removed instead of a TURPS. Immediately after the TURPS it wasn't too bad but now in order to have a pee I have to work my pelvic muscles then push, work the pelvic muscles and push, ad nauseum. Takes ages to empty.

    I'm rowing a similar leaky boat, as my PsA got worse I was all set to leave, but then I thought of the wife. So here I still am.

  6. #20
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    Hi sacc51, my brother in law had a TURPS done around 12 months ago for an enlarged prostate, almost unable to pee, and it runs in his family. He is now having trouble again, both with passing urine and with needing to urgently go after a short time with very little in the bladder. So yes I think he is wondering what to do next as his life pretty much revolves around caring a pee jug in the car and knowing where every toilet is before he travels. Some people have good results, I guess it comes down to how fast you prostate enlarges again. After seeing how quickly I recovered he's thinking of seeing the same surgeon for a consultation, but again the cost is daunting and you get that sick feeling of revisiting the same thing over and over.

    I won't know if I got this in time until I start having blood tests, but whatever the result, at least I did the best I could and did everything you are supposed to do by having yearly PSA tests and even a biopsy years ago when my PSA first shot up and then went back down to normal, and I paid for an MRI a year after that, just to be sure that the first biopsy had not missed anything - the MRI was also clear at that time, so I'm not going to worry about it until the results come in as there is nothing more I could have done.

    Yes I often think it would be so easy to let go if there was no one left behind, I know that without her love, comfort, companionship and support and female softness I would likely be in a bad place now, as hard as it is to keep going with the pain and medical interventions, it's unbearably harder to let go of the most wonderful thing that had ever happened to me in this life, my precious wife.

    Mike.

  7. #21
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    I am on the same wagon. Prostate removed robotically some 6 years or so ago. Had all the same tests as Mandj but only cast me $4500 for the surgeons gap. (top health cover). Some small leakage which is annoying rather than any thing else. Just undies but can almost get to the embarrassing stage occasional. PSA has been undetectable since.
    Unfortunately a couple of weeks ago I noticed a slightly extended tummy. Wife agreed. No other symptoms. Off to the doc, to ultrasound, to another surgeon and a 5 hernia repair later, at the site of the robot entry point, and I am well on the way to full recovery.
    And I thought it was all going to be behind me.!

    As Mandj alluded to - it is the positive outlook that keeps us all going.

  8. #22
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    Great to hear your PSA is still undetectable, I'm hoping for the same positive outcome - if not, I won't give up. Yes the possibility of a hernia is one of the listed possible side effects. It seems that a lot of these side effects / issues also come down to how each of our bodies scar and repair, and things like weight, muscle condition and the type of work or leisure activities we are involved in, both before and after the procedure.

    I also have full ultimate hospital cover, I had no hospital out of pocket expense in either hospital, but these days some health funds only cover certain specialist equipment used in private hospitals, so the cost of using the robotic equipment differs between health funds and hospitals. Medicare don't cover prostate MRI or cutting edge Pet scans. Even the scan for checking the repair of the urinary track join and internal leakage is only partly covered, Part A was fully covered, Part B was not covered and cost $200. All were done at the normal Qscan radiology centres. Private health does not cover out of hospital expenses - at least the last two health funds I have been with don't. I plan on changing Health funds again as I have found one that does cover a lot more that the others, but that's a another story, the talking point in most specialists centres and radiology centres has been the disgusting state of Medicare rebates and different private health funds.

    Speaking of keeping a positive outlook. It's only now, post-opp, that I realise I must have been suppressing the anxiety over the rise in my PSA once again (8 years later) and the realisation of what was likely coming. I had been so focused on fighting the horrors of this loosing battle with crippling arthritis that I just felt numb, and pushed the prostate thing to the back of my mind. In doing so, I slowly lost my battle to stay positive. I was fighting two battles, arthritis and the one I thought I was OK with or resigned to - prostate cancer. Since my almost instant recovery from the operation, my mood has completely reversed, and suddenly the battle with arthritis seems easier to face, it's like a veil has been lifted - this is something I was not prepared for or even expected, it shows again how much something bad pushed into the back or our minds will subconsciously screw with our mental and emotional state without us even realising it. I think it's been there in one form or another since my first prostate scare 8 years ago. I suppressed the thoughts that one day it would come back and I would face a major operation of some kind, I guess I always wondered if they had missed the cancer back then. I have never really felt happy or positive since then, I was always trying to get my old self back, but put it down to 46 years of pain mentally beating me to a pulp, I guess I just finally resigned myself to it and thought this is how it would be. I always though I was the last person who would fall victim to depression and that I could always find or fight my way back. At least I know now that my old self is not completely lost, and I'll fight like hell to keep whatever of him is back.

  9. #23
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    Jun 2016
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    Adelaide
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    Yes, Keep looking on the bright side Mandj. I look at each event as a challenge to hustle in to, to get over and move on beyond, rather than an impediment to be mulled over. There is just to much to do, things to make, place to see, wood to be fashioned into whatever.
    Keep hanging in there mate. Lots of shavings still to be made.

  10. #24
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    When I had the TURPS the catheter they put in place was enormous and I thought thy must have dome 'some' damage. When next I was in hospital having a hip replaced the nurse wanted to insert a catheter as I hadn't peed for a day or so, I resisted initially but in the end gave in. What a mess she made of it, bled like a stuck pig and she couldn't get the ting in. Eventually the bleeding stopped and I was discharged. 24 hours later I went for a pee and out poured strait blood and it wouldn't stop. The amount I was losing I didn't consider sustainable so got the wife to call the ambulance and I wrapped myself in a plastic bag. Spent most of the night at hospital and finally it stopped, they were considering a blood transfusion, such was the blood loss. Lesson learn't, stick to your guns and never let a nurse touch you. I have raging arguments with nurses every time I am admitted, always about diabetes and how much insulin to inject. In two minutes they, apparently, can deduce how much insulin I need. It's taken me years to work this one out. Small wonder my BGLs are always up around the 20s when under their care. When I control it its around 5 or 6.

    Not a nurse fan, as you can gather!

  11. #25
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    Yes I am the same. I demanded to know the name of every tablet I was being given and why. I asked if the Surgeon had authorised the blood thinner injection I was give 5 hours after the operation and the following morning. Most importantly the surgeon made it very clear that he, and he alone, would remove the catheter. I was fully aware of the ignorance around this simple procedure (see below). My uncle was diagnosed with advanced prostate cancer, it was I who made him go and get it checked after he confided in me that he had been having trouble peeing for years, and it was getting worse.

    By then his cancer was out and advanced, they did a TURPS to give some relief, when the dumb nurse pulled the catheter out she didn't deflate the internal bladder holding ring, just ripped it out, he bled like a pig and was back in surgery. Poor old guy didn't deserve this utter stupidity and incompetence. He only lived another 4 years despite all the drugs and other typical cancer treatments. If only he had mentioned it years earlier to me or a doctor, but living in a small country town didn't help back then. His wife is still trying to come to terms with loosing her soul mate to something so cruel.

  12. #26
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    FYI: I found a simple slide show that has most of the relevant information, I thought it might help answer some questions as it covers almost everything in one simple slide show with short to the point descriptions. Especially useful is another explanation of how the Gleason score is calculated, although it does miss one small point in summing the two values.

    https://www.medicinenet.com/prostate...ow/article.htm


    Also this for enlarged prostate condition - non cancerous BPH:

    https://www.medicinenet.com/enlarged...ow/article.htm

  13. #27
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    Default Progress update

    It’s 15 days since the operation, 9 days since having the catheter removed. The slightly raw feeling in the urinary tract has finally subsided, it was especially noticeable at the site of the join where the prostate once resided, and to a lesser extent from having the catheter inserted and removed. Today I've just realised that I have completely forgotten about bladder control, everything feels close to what it was prior to the surgery. I've said before that I was expecting to have some problems and expected having to work for months or longer to hopefully regain reasonable control. Once again I was caught out by a huge sneeze, it came on so fast that the only thing I had time to do was to grab stomach and bend forward to make sure I didn't cause a problem with the 6 stitched incision sites – as in a hernia from the still weakened muscles, I had a pretty full bladder and again not the slightest indication of any possibly of losing control in any way with the sneeze. Been out shopping for hours on numerous occasions from the day of the catheter removal without a problem, Even though I drink a lot more water that my wife, in the past day or so she is now back to having to look for a restroom long before I have any need to go.

    I would say the only thing that reminds me that I've had the prostate removed is the slightly annoying feeling of clothing touching and moving over the 6 stitched incisions, fortunately not itchy (yet) and the slight redness around the cuts has now faded, all have a nice formed small scab. The largest cut was just above the belly button, that’s the site where the prostate is removed through (saw a video – yuck) and it looks like the site where some type of larger equipment is attached to.

    BTW: As suggested by the surgeon and others, I've been drinking Cranberry juice as an extra precaution to help guard against any urinary tract infection, however I had a real hard time finding one that is not made from a concentrate with added water and this stupid moronic need to add friggin sugar to everything it and make it sweet or a soda pop – even from health food stores. Anyway, I finally found one that is 100% pressed juice at the Chemist Warehouse, but of course they only had one dam bottle left, after finishing that I'm still waiting for more to come in, the thing is, it helped take away a bladder sensitivity that I've had over the past few years with certain foods, especially some fruits.

    I've also been taking a High dosage Vitamin C along with Curcumin/Turmeric, Boswellia, a vitamin D complex and a Zinc complex. I was taking these long before the operation for my arthritis and inflammation markers. I cut out Turmeric and Boswellia (and anything that thins blood) one week before the operation and the others a few days before. I hit the vitamin C the day after the opp and the others a few days later. I found a number of surgeons recommending high dosage Vitamin C and taking Zinc prior to and after the operation to help in surgery shock and wound recovery, so I really didn't need to change anything.

  14. #28
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    Default Following on from my last post:

    Random thoughts and FYI a link or two.

    I've been looking at medical sites to understand the two Urinary sphincter muscles but also found these two images on wikipedia:

    1: External -> https://en.wikipedia.org/wiki/Extern...f_male_urethra
    2: Internal -> https://en.wikipedia.org/wiki/Intern...hral_sphincter

    It looks like the bladder sphincter is almost buried in the top of the prostate, it makes we wonder how this could be spared when removing the prostate. I guess that’s why the surgeon placed such emphasis on doing the pelvic floor exercises leading up to the operation in order to gain maximum control of the external sphincter. The external sphincter muscle is activated by the pelvic floor muscle exercises and it appears to be located at or in the pelvic floor cradle.

    Apparently the internal sphincter (the one that is NOT under your control) is also responsible for retrograde ejaculation control. It also is what stops you from peeing if you suffer from the condition that stops you from peeing if someone is watching, or even if you think someone may interrupt you. I guess if you have that common condition it would be a way of seeing if there is any function in that muscle post surgery. Like they say, for various reasons it can take up to two years for some men to regain full control of even the external sphincter muscle and/or erections if the nerves have been spared.

    I note that the most frequent complication from a TURP (for enlarged prostate) is that it damages the internal sphincter and causes retrograde ejaculation.

    Different treatment options for those that suffer incontinence.
    https://www.webmd.com/urinary-incont...ntinence-men#3

    The one I was interested in: Foods that can irritate the bladder.
    https://www.webmd.com/urinary-incont...adder-triggers

  15. #29
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    Not wanting to scare anyone, and I refused to look at anything like this before my operation, however here is a fabulous site that pretty much covers everything.

    What I really like is that there is a high quality video of the various stages of the operation and description by the surgeon of each stage and what exactly he is doing. It's not gore or blood, it's a fascinating insight and makes you realise the skill level needed. The image of the incision locations is the first one I have found that shows the exact same position for the incisions made by my surgeon. A lot of useful info here including downloaded PDF books covering most questions regarding pre and post surgery.

    Robotic Nerve-sparing Radical Prostatectomy » Department of Urology » College of Medicine » University of Florida

    BTW - Hope I'm not supplying to much information or make the more sensitive reader cringe but - hydraulics are starting to work There is more I could add, but lets just say the rest is pretty dam good as well.

    Anyway, unless any problems surface, I'll likely leave this thread as is unless there is a specific question or comment down the track. All the best for anyone facing this problem and the decisions that go along with it. I would like to say again that the operation and recovery was nothing like I was expecting, in reality I would describe it as "a walk in the park" when compared to the operation I had for sinus four years ago.

  16. #30
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    Default Small Update

    It's just under four weeks since the surgery and yesterday I noticed a piece of nylon thread (looks like fine fishing line) sicking out from the incision that was used to pass the drainage tube through the stomach wall to remove any internal blood following the surgery, I guess it would likely indicate any internal bleeding post opp as well.

    Now the drainage tube was removed the morning after the operation, there was a separate stitch that held the drainage tube in place and the rest of the incision was sewn up against the tube with dissolving stitches. The nurse had some trouble getting enough purchase on this single holding stitch in order to cut it and release the tube. After cursing for a while she finally cut it and pulled out about 200mm of the tube that was inside me, I had to look didn't I anyway, she must have left a piece of thread behind and it only popped up when a small scab popped off. The other surgery incision points were all closed with dissolving stitches covered with water-proof glue to seal them, no other coverings and sure makes having a shower easy and no need to have anything more done.

    I managed to get straight into my local doctor and it took him only a few seconds to pull it out, it was just the end of the stitch knot that was embedded in the flesh, felt nothing, while he was there he suggested that I should let him remove the small scabs and fake skin that was still covering them as it's been almost four weeks, so a few seconds later they were gone and again they just popped off. If anyone is wondering why I just didn't pull the stitch out myself - well I wasn't sure how far it went in or if there was still a knot DEEP in the flesh, as things are going so well I was not going to take even the slightest chance of doing something stupid.

    So it was yesterday that I had the above doctors visit, and this morning when I showed my wife the wounds, well, I didn't get any sympathy at all as she had to look twice to even see where the incisions had been made, two of them have almost vanished, the others are only small 1 cm pink lines

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