John Z
John's problematic urination led to a PSA test and DRE. A trans-rectal biopsy detected cancer and he decided to have brachytherapy but a later trans-perineal biopsy indicated more advanced cancer and he then had a robotic laparoscopic prostatectomy. He later had a 'male sling' to treat his incontinence.
John is a married writer with one adult child and his ethnic background is White British.
More about me...
In 2008 John was experiencing embarrassing urination problems for some time and while he suspected he may have a prostate problem, as his dad had prostate cancer for twenty years, he didn’t do anything about it. He eventually went to the doctor in August 2008 with a very bad stomach upset and when the GP had dealt with that issue he then asked about his general health. On telling him about his problems urinating the GP said there were some simple tests to discover the problem and he gave him a digital rectal examination and a PSA test. The PSA test result came back a few weeks later at 19 and he was referred to hospital for further tests. This included a rectal biopsy which took 12 samples and, while not very conclusive, did detect some cancer. After consulting with specialists he decided that brachytherpay was his best treatment. Around the time of John’s diagnosis towards the end of 2008 he was moving house some 150 miles away and was given, and took, the choice to have his treatment in a hospital near his new home. Unfortunately, rather than beginning treatment he was “right back at the bottom rung of the ladder” going through the process of tests all over again with a DRE and PSA test by his new GP and referral to the hospital. This time however he had a trans-perineal biopsy which takes 24 samples and which, unlike the rectal biopsy, revealed that the cancer was fairly advanced. This meant that brachytherapy was no longer recommended and that the only treatment choice open to him was a prostatectomy. The hospital he was now attending offered a robotic laparoscopic prostatectomy and he had this surgery in April 2009. Since then his PSA has been undetectable and he feels the operation was a great success. While a side effect of the surgery, incontinence, improved over six months, two years after his prostatectomy in April 2011, John decided to have a ‘male sling’ to support his bladder and reduce the incontinence. This was very uncomfortable and while somewhat helpful has not reduced his incontinence as much as he had hoped.
Interview conducted in 2011 by Anne Montgomery.
John recalls what it was like to have a trans-perineal biopsy and why he decided to have a robot-assisted laparoscopic radical prostatectomy.
John recalls what it was like to have a trans-perineal biopsy and why he decided to have a robot-assisted laparoscopic radical prostatectomy.
At the new hospital, the biopsy was a trans-perineal, I think it’s called, biopsy, which takes twenty four samples instead of twelve, and it was quite a painful experience, and there was a lot of blood and the outcome of it was that it revealed what the first biopsy hadn’t revealed, which was that the cancer was right in the centre of the prostate and it was fairly advanced, so as a result I was told that brachytherapy would have been the very worst possible treatment for me because it wouldn’t have been possible to have surgery after the brachytherapy, because of the amount of scar tissue created by the brachytherapy, so there was only one option which was a prostatectomy. The hospital I was at now, it was able to offer robotic laparoscopic prostatectomy, so I was, referred for an operation and so it had been quite a long process from seeing the GP at the, where I was originally living in August 2008 to being operated on in April 2009.
The operation went well but John thought that the hospital environment and organisation was 'chaotic'.
The operation went well but John thought that the hospital environment and organisation was 'chaotic'.
The operation was a great success, it was, I thought the surgeon was fantastic, everything was really great, my PSA since then has been, undetectable, the hospital treatment wasn’t great, the ward was, chaotic, it was very difficult to tell who was what, the cleaners wore the same uniform as the surgeons, but you know, you’re there to be treated and you go through it and it was just great to know that it was out of my system, it was a really good feeling,
John had a catheter for about 10 days after his surgery. Once that was removed he progressed fairly quickly .
John had a catheter for about 10 days after his surgery. Once that was removed he progressed fairly quickly .
Post operation I had a catheter for about ten days, again that was a little bit chaotically organised, I know other people who’ve been through the same experience and they’ve come home with pads, and catheters and a stand to put the catheter on at night, and I had none of that, and nobody really seemed that bothered about helping out, so I had to kind of sort it out for myself, the catheter I hated, it was very uncomfortable, very difficult walking around, I was able to walk, reasonably, the day after I got home, I went out for a short walk, walking very very slowly, quite unsteady, but things improved fairly rapidly and once the catheter was removed then I progressed fairly quickly.
After surgery John experienced some incontinence. Two years later he still had problems so had a minor operation, the insertion of a 'male sling', which seemed to improve matters.
After surgery John experienced some incontinence. Two years later he still had problems so had a minor operation, the insertion of a 'male sling', which seemed to improve matters.
The two principal side effects were firstly, incontinence I had to wear incontinence pads, I was wearing quite large pads, and getting through a couple a day, two or three a day to begin with, things improved over the course of the first six months I suppose, I was doing pelvic floor exercise, perhaps not as consistently as I might have done but they helped, but then it’s, it reached a plateau, I was, after that point I was going back to the hospital every six months, for a check up which consisted of a PSA test and a chat about my condition generally, and after the first two or three perhaps of those assessments I had... the guy I saw had been trained and was operating on male slings which reduce incontinence and he thought that I was an ideal candidate for that, so I had a test for that, which was basically to see the capacity of my bladder and the amount of leakage, and they decided that because I wasn’t too severely incontinent that I was a good candidate for that so I was put forward for that second operation, which took place just about two years after my prostatectomy. I had the operation under, I had the choice of local anaesthetic or a general anaesthetic, and I chose a local because I don’t like anaesthetics very much, the operation was quite straightforward, quite quick, I went home the following day. It was incredibly uncomfortable, the operation is basically you’re, you’re cut open, right underneath, right underneath the bit you sit on, which made it very difficult, when I got home, very difficult to get comfortable, difficult at night, difficult when you are sitting down, and difficult walking, the first couple of weeks were pretty uncomfortable, it was, I would say it was, that the operation was worth doing because the incontinence was reduced, but I had rather hoped that I’d be completely free and in control of, that aspect and free of having to wear pads, but it wasn’t, things were a lot better, I wear one smaller pad now, and I don’t have to worry so much about it, I don’t have to worry about making sure that I’m within reach of a loo so I can change my pad when I go out in the evening or anything like that, so from that point of view it’s been very beneficial, not as good as I would have hoped.
John explains that his incontinence may still improve as his 'male sling' gets stronger. He finds that pelvic floor exercises help.
John explains that his incontinence may still improve as his 'male sling' gets stronger. He finds that pelvic floor exercises help.
After his robot-assisted laparoscopic prostatectomy John was impotent. He tried Cialis, and a vacuum pump to increase blood flow to the penis, but these measures did not improve his erectile dysfunction.
After his robot-assisted laparoscopic prostatectomy John was impotent. He tried Cialis, and a vacuum pump to increase blood flow to the penis, but these measures did not improve his erectile dysfunction.
The other side effect of my prostatectomy was loss of sexual function, and I think that, seemed to be more, more a problem for the people at the hospital than it was for me, I mean I’ve been married a long time, my wife and I have a very loving relationship, but I mean physically, we’re kind of not all that bothered, so neither of us felt it was a major problem, but the hospital tried me out with Cialis which is to try to increase the sexual function, and with a vacuum pump to encourage blood flow into the penis, and I was, to be honest, rather half-hearted about the whole thing and I’ve given up with all of that, now, and I think, that probably gets us up to pretty much where I am right now.