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Patients speak about prostate cancer and laparoscopic radical prostatectomy

Charles Cox, Valrico, Florida

A biopsy in May of 2007 confirmed that I had prostate cancer. Eight weeks later, on July 11th, Dr. Arnon Krongrad performed a laparoscopic radical prostatectomy. I am writing my story on August 8, 2007, just 28 days after that prostate cancer surgery.

Learning that I had prostate cancer was not a surprise given the family history of prostate cancer, with both my father and an older brother having been diagnosed. With this family history, I stayed up to date on prostate cancer treatment options, and had already concluded that surgery, preferably laparoscopic radical prostatectomy, would be my prostate cancer treatment of choice - if my pathology and physical condition made this a viable option.

I was convinced that the laparoscopic radical prostatectomy, when performed with excellence, would give the best potential for a permanent prostate cure while minimizing the normal pain, extended recovery time and inconvenience of open surgery. Thankfully, laparoscopic radical prostatectomy proved to be an excellent option for me and both my diagnosing urologist and my primary care physician recommended this procedure.

My research on laparoscopic radical prostatectomy had not only revealed the significant advantages of laparoscopic surgery, but also made very clear that the results of this very challenging procedure have varied significantly, depending on the skill and experience of the surgeon selected, from remarkably good to remarkably poor! It did not take long to focus in on just the few surgeons who had the greatest experience and best track records doing laparoscopic radical prostatectomy. 

Dr. Krongrad was quickly at the top of my list. Having been the laparoscopic radical prostatectomy pioneer in the United States, he had chosen to specialize in this procedure, with more than 1200 completed since 1999. Many of his patients had shared the story of their surgery experience on this web site, as I am now doing. These extremely positive stories were very helpful and indicated that something very special was going on with this practice that I needed to explore carefully.

The next week I had my consultation with Dr. Krongrad. After a physical examination and reviewing all my pathology reports, he confirmed that I was a good candidate for this procedure. He was very pleasant yet professional, to the point, precise in his communication, and very self confident - in the positive way you would like your surgeon to be! I left with no question in my mind that he was the right surgeon for me. Within a few days I called Hope, (who was a delight to work with!) and scheduled a date for surgery.

My wife and I drove down to Aventura two days before the surgery to both complete my pre-surgery physical and the pre-registration. Everything went smoothly, and every one of the hospital staff we met was friendly, helpful and punctual. The hospital itself was only a few years old, and much like a fine hotel, with all facilities and equipment very modern and first class.

On the day of surgery we arrived at 6:00 AM for surgery at 7:30. There was no waiting, with everyone efficiently doing their part of the preparation. Everyone was professional and pleasant, with even a little humor! At 6:50, one of the nurses told us that "Dr Krongrad usually arrives at 6:55." At 6:55 a voice over the intercom announced: "Dr Krongrad has arrived", and a minute later he came in to visit with us.

All in all, I wasn’t apprehensive, just pleased to be getting on with the surgery. It was clear that Dr. Krongrad was now in charge and that he and every member of his very experienced team knew exactly what to do. I had no question I was in the best of hands!

Shortly after 10:00, Dr. Krongrad visited with my wife to let her know the surgery had gone well, with no surprises and that she could join me in the recovery area at 10:30.

I woke up feeling sleepy but comfortable. As I began taking inventory of all my bits and pieces, I had a very positive realization that everything felt remarkably right, with no numbness or strange sensations - and no pain. I had an immediate sense that Dr. Krongrad had done a fine job of, as he later described it, "taking out your prostate and putting you back together again."

The first afternoon I was alert, sat up on the side of the bed and had a liquid dinner. My wife stayed in the private room with me, and we both slept well - between the nurses mandatory vital sign checks. The next morning, I walked for an hour up and down the halls and was discharged from the hospital around noon, after Dr. Krongrad removed the abdominal drain, (hardly felt this!) checked everything out, and gave us a few important medical instructions.  From the time we walked into the hospital till the time we left, we received "VIP treatment" in every way!

We stayed at a local hotel for the second night, and after visiting the Doctor that next afternoon to get the results of the Pathology report, (which were great!) he gave me a final check-up, then travel clearance to head home. With my wife driving, the three hour trip was quite pleasant and not at all difficult. My friend for twelve days, the Foley catheter, was never painful nor a significant inconvenience, and proved to be a positive in allowing me to sleep soundly all night those first two weeks!

The only "pain" ever experienced was in the first few days, when I was silly enough to use my abdominal muscles to sit up without help, but by the third or forth day, even this effort caused very little discomfort. I took a few Tylenol during those early days, but nothing was really needed. It also took a few days after surgery to get the digestive system functioning again, but I carefully followed the Doctor’s instructions on diet and this proved relatively easy to accomplish. Starting in the second week, there has been some periodic discomfort when sitting, which is easily relieved with Ibuprofen or a soft cushion.

The next significant event was the removal of the catheter on the 12th day after surgery, by my local Urologist. It took about 5 minutes, and was not uncomfortable. Doctor Krongrad had told me to expect temporary incontinence, so I was quite pleased when this turned out to be a very minimal issue for me. The body seemed to adjust quite quickly to the slight differences in the new plumbing system! Within two weeks of catheter removal, this was fully resolved. Through this 28th day after surgery, the healing has continued steadily with nothing else significant to report.

I had set aside a month to primarily focus on recovery, but found that this procedure really only requires a week or two of reasonably serious commitment to rest and recovery. It was nice, however, to have more time to relax and be spoiled a bit by my wife! 

If it had been necessary, I could have accommodated any reasonably light business or personal duties after the first three days, as long as it was not for extended periods of time. After two weeks or so, I have been able to do pretty much anything that I feel like doing, including exercise like swimming and walking.

Unlike much of my prior experience, Dr. Krongrad has personally remained easily accessible and in communication each step of the way, answering even the little questions, or giving a bit of advice or re-assurance, either by e-mail or telephone - and always promptly! He seems to remember every one of his patients and genuinely shows both personal and professional interest and concern for their welfare.

In summary, it should be obvious to anyone reading this that I have found the procedure very easy to tolerate! After going through this entire experience, I would now be much more comfortable making the same treatment selection again - even with my very fresh and precise knowledge of exactly what to expect!

This laparoscopic radical prostatectomy procedure has enabled me to achieve the benefits of prostate removal surgery, my very best treatment option, done excellently and with extremely minimal discomfort, side effects, recovery time or inconvenience, all in a very positive, personal and pleasant setting.

My sincere thanks to Dr. K and his entire team for their remarkable care!
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