Tuesday, July 5, 2011

The Decision

Well I have essentially made my decision as to which procedure I will have performed on me to remove my cancer.  I have decided to go with the robotic surgery that will remove my cancer.  In this blog I will go into some detail as to what the procedure involves, the risks and the recovery phase.  If you are a bit queasy about learning about the gory details you may not want to read this blog but if you are a male over the age of thirty these are things you should probably know about.  As for you Caron, you will probably be shocked to learn that your mother was not a virgin when you were born and yes we have actually had sex during our marriage.

The Surgery Itself:

During the surgery I will be totally sedated and will have no idea as to what is going on.  There will be five holes about the size of your small finger about six inches below my waist.  These holes will be used to insert cameras and surgical knives into my pelvic area.  The camera will have about 12 X magnification so the surgeon will have an excellent view as to what he is cutting.  The computer will guide the movement of the camera and knives but the surgeon will always have ultimate control over the procedure.

The entire prostate will be removed as well as some lymph nodes in the area next to the prostate.  The lymph nodes will all be analyzed to determine if the cancer cells have migrated beyond the prostate.  Hopefully these results will come back clean.  Since the entire prostate is being removed that means that a section of my urethra will also be removed since it runs through the middle of the prostate. 

 The urethra is a tube that transports urine from the bladder to exit the body.
In males, sperm also exit the body via the urethra but not at the same time!  The urethra is vitally important if you want to be able to pee normally and have sex.  Once the urethra is removed (about 2 inches) it will have to be sewed back together.  The entire procedure should take less than three hours.  I will hopefully only have to spend one night in the hospital and will be home in my own bed the following night. 


Sine the urethra has been severed and sewn back together I will have a catheter in my penis for about two weeks to allow the urethra to heal.  I will probably not have total control of my bladder for a while and will have to wear a diaper for a while.  Hopefully this inconvenience will last for weeks and not months.  During this time you cannot tell any jokes about your father peeing in his pants.  When its time to remove the catheter I will have it done in my urologists office.

As you girls know from both your mother’s and your experiences with a C-section I will not be able to do any strenuous work for about two months but will be able to do light activities within a few days.  After two months I will hopefully be able to return to my normal physical activities, tennis, running, pickleball etc.  I will also not be able to have any sexual activity for about two months.  If things really go well, all will return to normal in about three months.  If things don’t go too will I will probably have a year or two before things get back to normal.   If things go terrible, well, I’ll be wearing a diaper the rest of my life and I can forget about sex.

The Risks:

The biggest risk is that the knife cuts into the colon or bladder and results in internal bleeding.  This would not be good and a serious infection would probably result.  If the urethra does not heal properly I will have problems peeing and likely have to wear a diaper the rest of my life.  The biggest risk is the possibility that the surgery does not remove all of the cancer and I will have to deal with it through radiation or hormone surgery.  I will have to have PSA tests done every six months for the rest of my life to make sure that the cancer was totally removed.  All of the above risks are really pretty small but they are a possibility.

What Am I Hoping For?

The prostate has two important functions: one is to help control urination and the other is to help sexual activity.

The prostate has a so-called passive role in the process of urination. It helps to control the rate at which urine flows out of the bladder and into the urethra. It does this by the effect of muscle fibers in the prostate that surround the urethra.

The prostate also has an active role in sexual activity. The prostate gland makes a whitish glandular secretion, which collects within the prostate and is fed into the urethra during ejaculation. This glandular secretion helps the mobility of the sperm in the urethra and makes up about a third of the seminal fluid, thus giving seminal fluid its whitish appearance.

Since I will be losing some of the muscles that help control urination I will have to go through therapy to effectively control my urine.  This therapy is called penal rehabilitation.  Think of it as a penal colony for prostate cancer survivors.  I hope to gain full control of this function within six months. 

Since I will be losing the gland that produces the fluid that helps carry the sperm through the urethra I will no longer have an ejaculation during sex.  I am told that I will have a climax but that’s it, nothing else.  I am hopeful that I will have a somewhat normal sex life (whatever that means for a 66 year old man) within six months.  There is a possibility that I will need the help of Viagra to put lead in my pencil.

Overall, the odds of things returning to normal are better than I thought.  We’ll see!


  1. I still have one more decision to make. Whether to have the surgery done in Lancaster or in Philadelphia. My meeting with the Phila surgeon is on August 12, which I am trying to get moved up. If I have it done in Lancaster it will probably be in the middle of August. If I have it done in Phila I don't know when it will be done.