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Re: RP or DaVinci

David,

I compared open RRP and Laproscopic surgery before having my own open RRP a year ago Thursday. In truth, I dismissed DaVinci (and other laproscopic) fairly quickly. I wasn't concerned about recovery time - I prioritized in my mind that first was getting rid of the cancer (Gleason 3+3, 5% in 1 of 12 samples), second in not being incontinent, third in regaining potency. My research pointed to finding the best surgeon I could, and who I felt comfortable with. Although there seem to be plenty of top surgeons out there who use DaVinci, the arguments put forth by the open surgeons just resonated with me - I really do think it comes down to comfort and surgeon skill - results will probably be comparable in the right hands with either method. I have my one year PSA in a couple of weeks, I've been pad free since around 2 months after surgery (and was using just a thin Always pad as a security blanket within 2-3 weeks of surgery), potency is bouncing back - I wish it was better but I've been told by Dr Mulhall that I'm doing very well. So, except for stressing about the PSA test, I suppose I'm fairly pleased about the whole ordeal. It's up to the surgeon to do what he needs to do in order to get rid of the cancer, but I really think the other two are in your hands almost as much as his. Continence - lots of kegels, starting now. I was diagnosed in late October and had surgery in early February (took over a month to get an appt with the sugeon I ultimately chose) and did kegels continuously in between. Potency - I was started on viagra (25mg) nightly as soon as the catheter came out - the belief is that it helps stimulate blood flow during the night. Take it religiously - after a while I got used to the stuffy nose and occassional light sensitivity and they don't seem as bad. Potency is probably 70% mental - stay positive about it - I expected my appt with Dr Mulhall to do no good, and in truth, nothing changed in my regimen, but somehow, there was a huge mental improvement that translated into a physical one.

Feel free to e-mail me and best of luck.
Dan

Re: RP or DaVinci

Hi Dan-

Thanks for your input. The surgeon is the bottom line. Being comfortable with him/her is a definite plus. Yeah, I'll email you later and I'll express to you my concerns etc. I do agree with you whole heartedly: GET THE CANCER OUT PERIOD AMEN. Thanks for your input and responding.

Dave

Re: Re: RP or DaVinci

In December I had DaVinci assisted surgery in Washington , DC. I had discussed the options: open vs. robotic, with a friend who had open prostate surgery by the dean of Washington Urologists two years previously. Since my surgery, we have been comparing results.

The outcomes were identical in terms of removing the cancer, (3+4=7, T2c, N0 MX)no cancer in seminal vesicles or lymph nodes, PSA undetectable.

The only difference we had, is that my recovery & discomfort was 1/4 his. I was walking in the evening of the surgery and home without pain medications the next noon. After a month, my incontinence was minor, only a few drips when straining.

To echo the advice of the other respondents, get a surgeon (open, lap or robotic) who has done over 400 procedures. There are many out there.

Best wishes for whatever path you choose as it will be the right one "for you".

Richard Washington, DC USA

Re: RP or DaVinci

A cancellation in Dr. Kawachi's office. I just got the call to see if I would come in tomorrow morning (2/13). My appointment was to see him next week, 2/20. He's the doc I hoped for. Over 1,000 DaVinci surgeries and at one of the top cancer hospitals in the country. Things just have a way of working out. What I've read and learned: Big hospital, skilled surgeon. Dave

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