Prostate Removal

[mike]

Can prostate removal for prostatitis really offer a cure for suffering men?

[Nik]

Hi Steve.

My incontinence improved dramatically at the 6 week point when the stitches joining my urethra to my bladder dissolved. The stitches can have a tethering effect preventing the sphincter from going through its full range of motion. Almost 6 weeks to the day I went from 5 pads a day to 1 light pad per day. It took a further 6 weeks to feel confident enough to stop wearing a pad altogether, but most of the time that 1 pad was still dry at the end of the day. Now I can exercise, lift heavy objects etc with no leakage at all. Very occasionally if my bladder is full and I lean back at a certain angle on the couch I can loose a few drops causing a damp patch on my underwear about 10mm across. Its nowhere near enough to even soak through to my trousers and cause any embarrassment. On average this takes place around once a fortnight.

As for orgasm, I have learned to control my sphincter even at climax so I can prevent leakage then too. When you have a prostate you tend to relax during orgasm to release semen as a natural reaction. You re-learn that without a prostate you need to make a conscious effort during climax to contract your sphincter at the same time. It soon becomes habit and orgasms are still good. A helpful tip here is to have a pee before intercourse. The less in your bladder the less chance of any leakage.

 I was in a lot of pain after surgery and personally would allow around 6 weeks off work. I still needed Tramadol for about a month after surgery. My pain diminished gradually over 3 months and continued up to  6 months to around a 70% reduction from what it was before surgery. My CPSI has gone from 34 to 10 overall. That average 10 can fluctuate between 12 and 8 depending on the day.

 At 11 months post op, erections are full and normal upon awakening in the morning *without* pills just like before surgery. I only take a pill now if its late and I am very tired before intercourse. Even then I could probably manage without, but it helps speed things up a bit!! Luckily in the UK our health system pays for Viagra or similar. If I had to buy them I would probably suffice without.

[Steven F]

Nik - thanks again for taking time to write back and share your post-op experience.  It's interesting to note how different your and Dr. Muff's experiences are with regard to post-op pain and incontinence.  It basically shows me that I have to proceed at my own risk - there are no guarantees.   Kind of like life, in general, when you think about it. 

Unfortunately, I'll be unable to take 6 weeks off, but again, I appreciate your insights.  I'll be lucky to take two weeks, including the surgery.  And no narcotics.  However, I can work from home when I'm not on the road, so I'll be able to work in a diminished capacity at first. 

I'm happy that you're doing well, and appreciate all the detail you provide.  It's very helpful.  Best regards, Steve

[Hunter G]

I've lived with this hell for half my life now & I'll admit that the incontenance & erection issues still scare the hell out of me. Dr. Muff, you mention that your case (incontenance) is unusual but do you know the approx. percentage of patients that end up being incontenant or impotent from LRP after more than 3,000 procedures by Dr. Krongrad? I'm only 38 (healthy - not considering prostatitis) & I've had 6 surgeries & all kinds of procedures throughout the years but for some reason the LRP surgery still scares me to death. I believe the odds are on my side but I'd really like to see some statistics concerning the side/bad effects vs good effects of having LRP after about a year. I'm looking really hard at having this surgery very soon but I just can't seem to make a final decision. It's either take my chances with the surgery or suffer with prostatitis for the rest of my life. 

[Arnon Krongrad, MD]

The likelihoods of erectile and/or urinary dysfunction vary with many factors: age, illness, previous prostate surgery, and others. For this reason, no single other patient is likely to be a perfect model for any other.

In the case under discussion, and as outlined in his video, there are many relevant differences from other patients. For example, contrast his profile with that of another patient.

[Steven F]

Hi Drs. Muff & Krongrad -

Just checking in to let the forum know that I had an LRP last July.  I'm very thankful for your guidance - I don't know if I would have pursued this course of treatment without knowing that it existed as option - as all the doctors I'd spoken to prior always looked at me with a sort of bemusement when I wanted to discuss it. 

6 months out now and I'm much happier.  The pain is 95% gone - all that seems to remain is some minor residual pain.  Gone are the tiredness, chills,etc. 

Strangely, even though my PSA scores were always <1.0, the post-surgical pathology report indicated a gleason 6 tumor that had reached the capsule, but not breached it.  So, I dodged a bullet with the surgery, it appears.

Incontinence is improving - I'm down to 1 pad a day, and really only use it for peace of mind.  The biggest risk is when I'm in the gym - certain exercises can create a problem. 

Erections are coming back, though sex isn't my main focus right now, to be honest.

I'm so glad I had the surgery.  I feel like I have my life back.  Thanks!

[Arnon Krongrad, MD]

Good news. And yes, we see prostate cancer in many of these prostates.

Thank you for the update.

[Arnon Krongrad, MD]

A hematologist suffering from chronic prostatitis characterized by perineal pain and post-ejaculatory pain has unearthed this 20-year old article about perineal pain and prostatectomy. 

[Sam]

Hi Steve, where was the surgery done.

Steven F said:

Hi Drs. Muff & Krongrad -

Just checking in to let the forum know that I had an LRP last July.  I'm very thankful for your guidance - I don't know if I would have pursued this course of treatment without knowing that it existed as option - as all the doctors I'd spoken to prior always looked at me with a sort of bemusement when I wanted to discuss it. 

6 months out now and I'm much happier.  The pain is 95% gone - all that seems to remain is some minor residual pain.  Gone are the tiredness, chills,etc. 

Strangely, even though my PSA scores were always <1.0, the post-surgical pathology report indicated a gleason 6 tumor that had reached the capsule, but not breached it.  So, I dodged a bullet with the surgery, it appears.

Incontinence is improving - I'm down to 1 pad a day, and really only use it for peace of mind.  The biggest risk is when I'm in the gym - certain exercises can create a problem. 

Erections are coming back, though sex isn't my main focus right now, to be honest.

I'm so glad I had the surgery.  I feel like I have my life back.  Thanks!

[Greg Donay]

Are they still performing LRP's. ?

[John haynes]

Hi Steven , really pleased you are doing well buddy.
Do you make no telling me what age you are?

[Greg Donay]

Steven F said:

Hi Drs. Muff & Krongrad -

Just checking in to let the forum know that I had an LRP last July.  I'm very thankful for your guidance - I don't know if I would have pursued this course of treatment without knowing that it existed as option - as all the doctors I'd spoken to prior always looked at me with a sort of bemusement when I wanted to discuss it. 

6 months out now and I'm much happier.  The pain is 95% gone - all that seems to remain is some minor residual pain.  Gone are the tiredness, chills,etc. 

Strangely, even though my PSA scores were always <1.0, the post-surgical pathology report indicated a gleason 6 tumor that had reached the capsule, but not breached it.  So, I dodged a bullet with the surgery, it appears.

Incontinence is improving - I'm down to 1 pad a day, and really only use it for peace of mind.  The biggest risk is when I'm in the gym - certain exercises can create a problem. 

Erections are coming back, though sex isn't my main focus right now, to be honest.

I'm so glad I had the surgery.  I feel like I have my life back.  Thanks!