russ

Do prostate nerve bundles rejuvenate themselves after a PC operation?
In December 1993 I had my first PC operation using iodine uranium
seeds. I had no erection problems at all. Eleven years later, at the
age of 77, I had my second PC operation in January 2005. This time I
had cryosurgery (where they freeze the prostate with probes), the
doctor told me that he thought he could save one third of the prostate
including some of the nerve bundles.


Now for the question: Do prostate nerve bundles rejuvenate themselves
after a PC operation such as mine or not?


Thank you, Russ.

steve jordan

IIRC, no. If they have been destroyed, that's the end of the story.

It appears that this was a "focal cryotherapy" procedure, if Russ describes
it properly. Well, did it work?

Since Russ is inquiring, I would have to conclude that it did not. What's
the PSA?

Duke Bahn et al. published a study of men aged at least 71 whom they had
treated with cryoablation. Ninety-five percent sustained impotence. What
proportion was simply due to age I dunno.

See, http://www.prostate-cancer.org/education/localdis/bahn_cryoablation.html

About the only accurate/truthful thing I was told by my damned uro prior to
his botched attempt at cryoablative surgery in November 2003 was that it
was certain to make me impotent. At the time, I was 67.

It never ceases to amaze -- and disappoint -- me that men come to support
sites to ask questions that a competent and caring medic should have
answered for them. Perhaps it has something to do with the report that
medics typically spend no more than twelve minutes with a patient during an
office visit.

That's why we must each of us study, learn, and *take charge*.

Regards,

Steve J

"'MD' does not mean 'Medical Deity.'"
-- Stephen B. Strum, MD

dan dubosky

I would think that once the nerves are destroyed, that's the end of the
story as Steve has stated. On the other hand, Katz from Columbia
Presbyterian in the FAQ of his web site,
http://www.nycryotherapy.com/faqs.html, states the following:

" Even if cryosurgical ablation is required and complete ablation is
performed, there has been regrowth of nerves in this area and a subset of
our patients have had return of their ***ual function, especially when using
oral agents such as Viagra, Levitra, or Cialis. "

I certainly wouldn't want to rely on my being one the select group of
patients. Maybe they happen to be the ones for which cryoablation was not
entirely successful.

But I am confused by Russ's comments since it would appear that his uro was
going to do a focal cryotherapy, and for this type of procedure the Duke
Bahn et al article seems to indicate that he and Onik were between 80 and
87% successful in "Potency Preservation". See Table 3. Am I reading this
table wrong?

Dan

russ

Thanks Steve and Dan, you both help a lot.

In July 2004 my PSA was 4.7. In December my PSA was 6.4. My biopsy: 3
out of 18 was cancerus; Gleason Index: 2+2, I guess that is why the
doctor said he is going to do a two thirds freeze and thaw of the
prostate. I hope he was right.

Is that what they call a focus cryosurgery?

Thank you gentlemen, Russ

dan dubosky

Russ,

Focal cryotherapy is generally used to describe cryotherapy that focuses on
the cancerous portion of the prostate in contrast to cryoablation which is
generally used to mean freezing of the entire prostate. On the Katz web
site which I cited previously, he says the following:

"The concept of focal cryosurgery is to freeze that area of the involved
prostate gland and leave the other side unfrozen. This has the potential
advantages of causing no urinary or ***ual dysfunction, but may leave
unfrozen prostate cancer on the other side. Even if the biopsy did not
reveal cancer, there can still be areas of small cancer that were not
detected on biopsy."

I assume that all 3 of the samples that had cancer were in one lobe of the
prostate. If so, you have a very low Gleason score and a relatively small
number of the 18 samples were involved, so you could be a good candidate for
focal cryotherapy as long as you recognize that there is a risk that not all
of the cancerous tissue will be removed.

Best of luck to you. Let us know how well it turns out.

Dan

russ

Thanx Dan, shall-do. russ