You go through a paper from a journal club level to clear facts for the general public. Excellent summary on the Retzius approach; great video, as always.
Dear Doctor Ahdoot you are simply amazing. I appreciate your videos very much and only wish I could be your patient because you are so dedicated to the.cause of PC. Since being diagnosed, I have watched a lot of videos and tried to gather all the information I can and you are truly one of the best out there. Thank you very much. And the incontinence is one of my biggest concerns because I am about to have the surgery very soon Jeff Noel
I greatly appreciate Dr Ahdoot's efforts in explaining complicated issues. I would like to point out that the ongoing PACE-A trial(surgery vs SBRT) at 2 years shows a 47% incontinence rate with surgery. Numbers are low and the definition of incontinence is different.
Love that people are reading clinical trials. I have not reviewed the interim results of this study to validate this finding but I love that you are looking to source information
Thanks Dr. Great video and information. I am 53 and was diagnosed with prostate cancer in August. Gleason 10. Did the PMSA Pet scan (saw your video on it as well) as recommended by my urologist - found it has metastasized at least into 1 lymph node and seminal vesicles. I decided to do the prostatectomy and have a robotic surgery scheduled in Austin, TX at the end of December. Can the RS-RARP be done if cancer is present outside of the prostate? Thank you
Yes it can but it’s more difficult so not too many people are doing it yet. If cancer is growing into the urinary sphincters getting the cancer out can affect continence outcomes. Finally people with cancer in the nodes are likely to get radiation in addition to surgery in hopes of eliminating the cancer.
Everyone has a different perception of risk which is why I want people to know the data so they can make informed decisions. Great example is hearing your opinion. Thank you for sharing
Yes you can still do retzius sparing when there is growth of the cancer into the nerves. It’s a bit more challenging so some doctors will not be comfortable with this but I have done it many times as have colleagues I know who do retzius sparing.
I’m very sorry to hear that. Just so you are aware there is an implantable device called an artificial urinary sphincter which can give you back full continence. Have you considered that to be pad free.
I had a RALP in 02/2021 and RT in 11-12/2021 w/adt. I had not recovered continence when I started RT so I was locked in 4-5pads/day until this year. I had a REEMEX Adjustable Sling installed in 01/2024 and my first adjustment in 08/2024. My leaking is contained with one light pad /day and is very manageable. I had my surgery at UCM in Chicago. I recommend the REEMEX Sling! Good luck!
Yes, there is a way to not have incontinence with prostate cancer treatments today. Have EBRT treatments with a brachytherapy boost. No incontinence for me! Modern radiation is as effective if not more effective than Prostatectomy today.
Awesome to hear you are doing well!!! I’ll make some more videos about radiation in the future to try to convey more about the modern outcomes with radiation therapy. Brachy boost is a particularly interesting topic as the cancer control rates are improved but the urethral stricture risk also rises. Nonetheless, the majority of people who get surgery or radiation have a mostly positive outcome
Thanks!Dr Ahdoot is amazing and as a prostate cancer patient I appreciate him very very much and hope he continues to work. Thank you Dr.
So very kind of you. Thank you
You go through a paper from a journal club level to clear facts for the general public. Excellent summary on the Retzius approach; great video, as always.
Thank you! I’m happy I can help people by sharing
Dear Doctor Ahdoot you are simply amazing. I appreciate your videos very much and only wish I could be your patient because you are so dedicated to the.cause of PC. Since being diagnosed, I have watched a lot of videos and tried to gather all the information I can and you are truly one of the best out there. Thank you very much. And the incontinence is one of my biggest concerns because I am about to have the surgery very soon Jeff Noel
I wish you a speedy recovery!
Thanks
Extremely kind of you!
I greatly appreciate Dr Ahdoot's efforts in explaining complicated issues. I would like to point out that the ongoing PACE-A trial(surgery vs SBRT) at 2 years shows a 47% incontinence rate with surgery. Numbers are low and the definition of incontinence is different.
Love that people are reading clinical trials. I have not reviewed the interim results of this study to validate this finding but I love that you are looking to source information
I had a prostatectomy in 2015 and am still incontinence free after the first 4 weeks with maybe a dribble every now and then.
Awesome!
Thanks Dr. Great video and information. I am 53 and was diagnosed with prostate cancer in August. Gleason 10. Did the PMSA Pet scan (saw your video on it as well) as recommended by my urologist - found it has metastasized at least into 1 lymph node and seminal vesicles. I decided to do the prostatectomy and have a robotic surgery scheduled in Austin, TX at the end of December. Can the RS-RARP be done if cancer is present outside of the prostate? Thank you
Yes it can but it’s more difficult so not too many people are doing it yet. If cancer is growing into the urinary sphincters getting the cancer out can affect continence outcomes. Finally people with cancer in the nodes are likely to get radiation in addition to surgery in hopes of eliminating the cancer.
Like your videos, 10 percent worth the chance your more normal
Everyone has a different perception of risk which is why I want people to know the data so they can make informed decisions. Great example is hearing your opinion. Thank you for sharing
reduces incontinence after RALP downhill running?
Never saw any studies on downhill running and incontinence
Where do you make incision and if there is nerve invasion would this work on him?
Yes you can still do retzius sparing when there is growth of the cancer into the nerves. It’s a bit more challenging so some doctors will not be comfortable with this but I have done it many times as have colleagues I know who do retzius sparing.
I had I had surgery 4 years ago and I still use 6 pads a day
I’m very sorry to hear that. Just so you are aware there is an implantable device called an artificial urinary sphincter which can give you back full continence. Have you considered that to be pad free.
That's awful :(
I had a RALP in 02/2021 and RT in 11-12/2021 w/adt. I had not recovered continence when I started RT so I was locked in 4-5pads/day until this year. I had a REEMEX Adjustable Sling installed in 01/2024 and my first adjustment in 08/2024. My leaking is contained with one light pad /day and is very manageable. I had my surgery at UCM in Chicago. I recommend the REEMEX Sling! Good luck!
Thank you for your in put , enjoy the holidays
@@thomashall9641 I am glad you found a solution. Your comment brings attention to the numerous options that are available for treating incontinence.
Yes, there is a way to not have incontinence with prostate cancer treatments today. Have EBRT treatments with a brachytherapy boost. No incontinence for me! Modern radiation is as effective if not more effective than Prostatectomy today.
Awesome to hear you are doing well!!! I’ll make some more videos about radiation in the future to try to convey more about the modern outcomes with radiation therapy. Brachy boost is a particularly interesting topic as the cancer control rates are improved but the urethral stricture risk also rises. Nonetheless, the majority of people who get surgery or radiation have a mostly positive outcome
Stanford Med School brain, on display for the masses
Hoping thats a complement!
Indeed!!