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Coping : Stories : Richard

Richard, 53 - Radical Prostatectomy

My name is Richard and I am 53 years old. My general health is good and I run regularly.

In June 2003 my PSA was found to be 2.6 during a BUPA health check. By June 2004 it had risen to 4.3. I was referred to a urologist, who felt a nodule in my prostate and recommended a biopsy. The biopsy was virtually painless. Very fine needles are fired into the selected area guided by an ultrasound scan. A local anaesthetic is used. Three of the biopsy cores showed cancer identified as Gleason 6. I was of course shocked, although for some reason it was not completely unexpected. An MRI scan was clear. Based on this result and my previous data I was graded as stage T2a and suitable for radical prostatectomy.

A member on the Prostate Cancer Charity web site posted the web site of Mr Chris Eden who is the most experienced laparoscopic RP surgeon in the UK. He has performed around 400 such operations in the last 4 years, nearly 150 this year alone.

Operation Day

Arrived at Hampshire Clinic at 10 am. The surgeon, Mr Eden and the anaesthetist discussed the procedure with me. At 2:15 I changed into gown and walked to the operating theatre complex. All the prep was done here which was not at all stressful and halfway through a sentence I was no longer aware of anything.

I became aware of coming around and being in a bit of pain as the painkillers were adjusted to make me comfortable. Mr Eden came to see me but I cannot recall what was said I was just aware of him offering some encouragement. I was then aware of my wife being present which was comforting. I was back in my room at about 9PM and a nurse made me comfortable. I was attached to various pieces of monitoring equipment and managed to sleep fitfully. The nurse frequently came into check the vital signs and equipment but I was quite comfortable as long as I did not move suddenly. The surgeon visited again but again I did not remember much. He also spoke with my wife to say the operation went well and he was hopeful of a good pathology report.

Post-op day 1

Various drips were removed fairly quickly and I was given a bed bath. My stomach was sensitive to the touch as you would expect but not painful at all. I was encouraged to get out of bed before 12 noon (just 16 -17 hours after the end of the operation) and I cleaned my teeth and shaved. I had some soup and tea for lunch and a scrambled egg for tea. I was given a sleeping tablet and slept very well until about 6 am. Pain was managed by paracetamol from this time onwards, which kept me comfortable.

Post-op day 2

The drain was removed. The catheter was also not as uncomfortable as I was expecting. I managed to walk a couple of lengths of the corridor.

Post-op day 3: discharge from hospital

The dressings were removed, which was not painful, and I had a shower. Mr Eden agreed I could be discharged. My wife drove me home which was a little uncomfortable as it was a one and a half hours drive. The night bag was a little awkward and at first and you worry that you may pull on the catheter by turning over but I never experienced this problem.

2 weeks post-op.: catheter removal

I was dry immediately after they removed the catheter if I did not move but leaked a little urine when I stood, which is quite normal. I was given a pouch type pad to wear inside my underwear and was put on a course of antibiotics for 6 days to prevent any infection.I stayed the night in hospital due to the distance away from home. I wore padded pants for the night but found I did not leak when laying in bed, only when I stood up to go to the toilet. I went 3 times during the night. It was stressed to me that I must practice the pelvic floor exercises 4 to 5 times a day to help control the bladder and sphincter. I found there were various methods of performing the exercise suggested but they are all variations on the same theme.

2-4 weeks post-op

Recovery continued at home. My appetite is good and I am regularly passing about 300ml of urine about 8 times a day. I am drinking between 2 and 3 litres of liquid daily. I am also drinking a glass or two of wine and I have had a few beers some evenings. No erections yet but a few twinges. Sensations are normal in the penis and orgasm mechanism checked out OK even with no erection!

4 weeks post-op : pathology results

The good news is that the cancer appears to have been confined within the prostate with negative margins. Seminal vesicles appear free of tumour. Overall probability of non-recurrence within 7 years was calculated at 96%, which is a good prognosis. Cialis will be prescribed to assist in recovering erections.

Back to work at 4 weeks. I have been very happy with laparoscopic RP. Compared with experiences of men that have undergone the traditional open RP I am sure I made the right decision. I have also been very happy with the treatment, consideration and information given to me by the surgeon and the nursing staff.

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