new diagnosis 5/22, S/P Robotic removal 9/22

Wife#1, sounds like a lot of good research went into your decision to move forward with surgery. I went the radiation route to tackle my PC. I am sure the veterans on here will give their suggestions on how to move forward to alleviate the side effects and to quickly recover. My best to you and your husband going forward as we are all brothers and sisters here.
Jack

Welcome and good job getting the 2nd opinion, exploring the treatment options, and (IMO) going with an RP in light of the serious BPH! If you'd like to post the post-op pathology results when you get them, we'll be happy to comment.

What you want to see is an "undetectable" initial PSA test ,<0.1 on the standard test usually done for all men for their first PSA test in the 6-12 weeks post op. You doc will let you know the time interval he/she likes when you have the catheter removed and discuss the post-op path results. Keep in mind that one's PSA nadir does not usually occur immediately following surgery; however, you do want the first PSA reading to be below 0.1.

Ideally you would like to see no Gleason upgrading and no adverse findings on the path report, but the latter may not be the case for the majority of men with biopsies above Gleason 6 (3+3).

Depending on the number and extent of any adverse findings, I would discuss with his docs the utility of following his PSA with an ultrasensitive PSA test (IMO Labcorp's uPSA is the best). In addition to more accurate/sensitive PSA tracking, Labcorp's 3-decimal test will capture your husband's PSA nadir, whenever it occurs. Statistically speaking, in terms of risk of recurrence, a PSA nadir of <0.030 is good; <0.010 better.

Best of luck with recovery and the report! Remember to follow all discharge instructions, especially about lifting. Walking is your best friend. Use stool softeners and diet to avoid constipation. If you do need a laxative, first consult your doc about which one and dosage. Don't overdo anything--think of the RP as an investment to protect

Djin

Wife#1…Mostly I’m a radiation guy; however, BPH can be debilitating and removal can be a very good choice. It appears you guys have done sound research and made the best choice for your situation. An informed decision is always best. No matter the treatment choice, remaining physically active will help with recovery. Best wishes for a full and quick recovery. Terry

Thank you for all the great advice. I really appreciate all the support and advice.
Day 4, after surgery and he is doing okay but in pain due to catheter. He is not a complainer and we expected discomfort but not as much pain. Incisions are good and only pain is his penis tip. I checked it and a bit swollen but nothing else unusual. We are following all the Doctor's instructions and all the advice from everyone here. We have lidocaine too. He has tried shorts, boxers briefs and just a robe. He said it is just too painful for anything to touch it. He has no fever but is cold all the time. I made him call the Doctor today and the suggestion was hot or cold washcloth, not happening as he can barely touch it. Basically, the advice was everyone complains about it. They are supposed to call back tomorrow with something. Walking is so important, and he tries but it hurts too much. The tube is really not moving around, and he just uses night bag as we are staying home. His urine is not bloody, and he is drinking a lot of water and it is working fine.
I know everyone experiences something different, but I never thought it would be this bad. We cannot wait for Oct 4th to get here.
As the wife, I hate to see him so uncomfortable and I am bit pissed at Dr. for acting like it's no big deal, it is common.
Minor setback but I will be happy when he feels better.

Stool softeners, and a shot of MiraLAX every day and all was well today. He is just starting some solid food and he has been trying to walk as much as possible but not nearly enough. My rule, he must lap the LR, DR, FR and kitchen every time he goes up or down the stairs.
He is really struggling with catheter and pain.
Thank you for listening and the support.

The pain in the penis tip is IMO referred pain from catheter irritation in the bladder--I had it very briefly every once in a while (I had my cath for 2 weeks) and that is what my uro/surgeon confirmed it was at a later visit. A bit of lubricating cream on the cath where it enters the urethra should prevent any pinching from dryness if that is contributing to the discomfort. Hopefully most of the discomfort will stop when the cath comes out.

If your husband is having intense bladder-spasm pain, there are prescription medications that you can try--unfortunately they often don't do very much. The smooth muscle in the bladder doesn't really respond to opioids (and they are a wonderful way to become super constipated). I assume you have tried over the counter pain relief--perhaps it can take the edge off.

Djin

Post Edited (DjinTonic) : 10/1/2022 10:23:35 AM (GMT-7)