radical prostectomy

[Keith Buller]

Hi my first pos,t does anyone know whether it is possible to have radical prostectomy after having had course of radiotherapy for prostate cancer

[Arnon Krongrad, MD]

Yes. That's called a "salvage" radical prostatectomy.

[Keith Buller]

thanks Dr Krongrad, how successful are these salvage operations or is it absolutely last resort Have you undertaken many and were outcomes successful. Is rejoining of tissue a problem if damaged by radiotherapy. 

[Arnon Krongrad, MD]

To be sure we're on the same page: Salvage prostatectomy are usually aimed at eradicating prostate cancer when a primary treatment, such as radiation, has failed. Depending upon clinical circumstances, they can accomplish this goal. So if other treatments have failed, then I supposed one could define this as a "last resort."

 

Yes, I have done salvage operations in all sorts of complex situations, including after radiation, infection, previous surgery, etc. Yes, they have worked nicely. The rejoining of urethra to bladder is generally not much of an issue. 

[Keith Buller]

Thanks very much for your reply Dr Krongrad. I should really explain my full history, Between 1995 and 1998 I had two TURP operations. After the first one I began to suffer pelvic pain,, I went back to the surgeon who dismissed it as just one of those things which would eventually go. I then had a second TURP during which a discovey of cancer was detected (gleason 3+2) following a biopsy. My wife and I were traumatised we even found it difficult to discuss. I was offerred prostectomy by open surgery or radiotherapy and with very little knowledge opted for the latter. Following the radiotherapy had severe rectal pain which over time subsided. Since then I have had regular periods of penis discomfor,t pelvic pain, and really bad rectal pain recent sigmoidoscopy didn't show anything. These pains have been getting more regular I am hardly free of them and they are getting more severe its just ruining my life. Ive had masses of antibiotics and painkillers following referrals to the pain clinic but nothing has really helped. I have found GPs somewhat dismissive and the whole thing is getting to me mentaly particularly as the radiotherapy has resulted in becoming totaly impotent. Sorry for all the rambling but ive reached the point of just not knowing where to turn