That walnut sized organ: the Prostate

Just found this thread, and I will add a few thoughts, which I hope will help other people here.

I am 15 years down the line from a radical prostatectomy that was carried out in Beaumont, so this was before the days of keyhole surgery or robotic assists

After a medical examination in Denver, (for private flying) picked up that my prostate was enlarged, I came home, and went through the loops and hoops of PSA (it was high) and related tests, biopsy and scans, as well as a lot of investigation and discussion about the right treatment.

I was just over 50 at the time, reasonably fit, and if I'd not had the medical, I would not have known there was a problem, as I had zero symptoms

The eventual decision was to remove it, the main decider being the very honest opinion of the radiology consultant at the Mater, who made it clear that if he did radiotherapy, there was no way that there would be a future surgical option due to scar tissue, but if I had surgery and there were then issues with a subsequent return of cancer, there was still then a radiotherapy option. He also suggested that as I was relatively young and reasonably fit, the recovery from surgery would be reasonably rapid, and unlikely to cause me too many problems, and in that respect, he was right.

Surgery happened in Mid December 2002, I was in the hospital for about 7 days, originally planned as 10, but by 7 days I was prowling the wards like a caged tiger, so there was no advantage staying there as long as I didn't do anything stupid. I came home catheterised, and that was a total pain both physically and emotionally, and the day of the removal was incredibly uncomfortable, the first pee after it was removed was total agony, but it was only the first.

The biopsy came back with clear margins, so my ongoing monitoring was pretty much as others have described, PSA checks on a regular basis, and I'm now down to having one check a year, and at this stage, they are still coming back undetectable, which is as good as it gets, especially after this length of time.

I was off work for 7 months, due to the very physical nature of the work I was doing (baggage handling), but in most other respects, there were no major hassles, if I'd been doing a less physical job I'd have been able to go back to work a lot sooner.

The surgeon managed to do a process called nerve sparing, which means that while erections are not as good as they were, they still happen. The absence of the prostate, and other things from around that area means however that while the erection is there, and things still work, it only fires blanks, but that didn't come as any surprise.

Incontinence, by the sound of it, I was lucky, in that from relatively soon after the catheter came out, I only use lightweight (ladies) pads during the day for insurance against stress incontinence, and I don't have any problems at night at all, and I don't have to be too careful about limiting fluid intake, I just have to make sure I don't do the trouser belt too tight, which is not unreasonable, and I can go for long periods both by day and night without problems, so long car journeys, or flights, are not an issue.

Psychologically, at the time, it was a roller coaster, with a whole gamut of good and bad emotions, but eventually, things settled down, and as time has gone on with no PSA issues to cause concerns, while I'm obviously aware of it every day, it's not a focus of thought or attention at this stage, it's now something that happened, and while I recognise that I was very lucky that it was caught early enough to have no longer term consequences, I'm also relieved that I didn't ignore the doctor in Denver.

I know how difficult prostate issues can be to talk about or face up to, so hopefully, my comments here will provide some encouragement to people who are facing the issues now, my surgery and treatment was a long time ago medically speaking, it seems that the procedures and techniques have improved significantly in the intervening time, which should help make the process easier to bear.

Hope that helps someone