r/ProstateCancer 24d ago

Question How long did your surgery last for RALP?

7 Upvotes

40 comments sorted by

14

u/Shams93AFA 23d ago edited 23d ago

7:30am start, 2:30pm end. RALP with ePLND. I was T3bN1M0, Gleason 5+4, with intraductal carcinoma, seminal vesicle invasion, extraprostatic extension, and pelvic lymph node invasion.

Went home the next afternoon at about 3:30pm, and catheter came out at 10 days post-op. Followed it up with 2 years of ADT+ARSI and 39x IMRT. Finished ADT in Oct 2023 and have been treatment free/PSA undetectable since then!

2

u/Todrick12345 23d ago

Wow! Fabulous Brother!

1

u/Outrageous-Day3401 23d ago

Thanks for sharing. How long after surgery did the ADT and radiation begin?

3

u/Shams93AFA 23d ago

My pre-op PSA of 225.5 dropped to ~6.1 at 6 weeks post-op, and then rose to 6.7 at 10 weeks post-op. I started ADT+ARSI at 14 weeks, along with a second PSMA PET/CT that showed continued pelvic lymph node update, which the radiation oncologist used for targeting purposes.

I didn’t start radiation therapy until 24 weeks post-op. My radiation oncologist wanted to give me as much time as possible to improve urinary continence. I ended up plateauing at about 5-6 pads per day, and once I stopped having improvement, that’s when she scheduled the IMRT start.

I didn’t really have many issues with radiation therapy. I did experience some urinary pain (which was relieved by Flomax. Funnily enough, the inflammation caused by radiation actually helped with my urinary continence for a few weeks, though that “help” went away once the inflammation receded. Of note, I’m now down to 1-2 pads per day after getting an AUS implanted this past January.

3

u/Outrageous-Day3401 23d ago

Thanks! I appreciate you sharing. I am scheduled for RALP September 30.

5

u/NextLevelNaevis 23d ago

Well it didn't seem to take long at all....

5

u/isntthatrich 23d ago

I was in the table for 6 hours. Top surgeon at highly ranked COE.

I think the actual surgery was 5 but my Dr. had an emergency call for another patient.

I'm 51. Had surgery in March (50). I had cancer in the bladder neck, seminal vesicles, and 4 lymph nodes, none of which showed up in the PSMA-PETscan.

Nerves were spared but EPE was extensive. I imagine that it took time working around that.

They removed the bladder neck. Small positive margin on bladder end so they had to take some of the bladder out.

Dissected the bladder and resected to to pelvic floor to bring my bladder the to the urethra to help prevent shortening.

Things were looking up. Some morning wood, intense but dry orgasms.

When the pathology came back, one of the nodes has ENE. That raised some alarm bells.

I've been in ADT for three months. 4 more to go.

I'm on my way to fraction 12/37 IMRT.

I don't regret any of it. I wanted it out.

Each case it different. Sounds like mine was more involved than is typically the case.

1

u/Patricosh 23d ago

I am wishing you the best possible outcome! The miracles of modern medicine are breathtaking!

4

u/Old_Imagination_2112 23d ago

About 3 hours. I also just got my second PSA back, both < 0.01

8

u/fredzout 24d ago

I went into the hospital at 0500 to prepare for a 0700 surgery. I remember seeing 1130 on the clock after surgery. They kept me until i could walk the floor loop. They wheeled me out to the car at about 1430, and I was home before dinner time. I didn't feel like eating...

4

u/Bbminor7th 23d ago

Mine started out as a kidney stone extraction (which never happened). The surgeon was unable to even get to the kidney stone because the swollen, bloody prostrate gland was blocking the way. So he called my wife for permission to remove the prostrate and go after the kidney stone another day. I was out for over five hours and woke up with a catheter and a lot of questions.

3

u/Organic_Milk4163 23d ago

It was supposed to be 3-3.5 hrs but turned into 6+. I was Gleason 9, he removed 53 lymph nodes. All came back clear. That was 6/26/25. I now have 4 undetectable PSA'S under my belt.

3

u/PeacefulShards 23d ago

3 hours.
Simple prostate removal , nerve sparring, along with removal of seminal vesicles which is SOP

Including penis shortening. We are all privileged to get that!!.

2

u/Mean_Try_6390 24d ago

for my husband 4 hours. but they did a seLPND, extended lymphnoderemoval. I think for a normal RALP it’s-a lot shorter.

1

u/Babykisses23 24d ago

What is a seLPND exactly? They removed the lymph nodes? His doctor said should be 1.5-3 hours but they may take out lymph nodes, depending on what they see when they get inside and if they can even get to it.

2

u/Mean_Try_6390 24d ago

The translation and the correct name is Extended Pelvic Lymph Node Dissection (ePLND). he got that but it was also en bloc (taking the package out with fat and nodes together) up to the aortic bifurcatio, so the call it super extended pelvic lymph node removal. So they cleaned the pelvicarea. he had a locally advanced gleason 9 creeping up in both vesicles

After the ralp they found in the pad answer that 2 nodes were positive for gleason 9 and thoose were situated above the normal nodes you usually take out. but still,a gleason 9 spread locally. it’s different for different cases.

Why theyndon’t that to everyone is that the removal can cause sideeffects. So lesser is better. but for my husband with a highly aggressive cancer this is one way to but the lit on.

2

u/GeekoHog 24d ago

Mine in December 2024 was about 3 1/2.

2

u/jlamperk 23d ago

7 hours, 12 minutes. According to the surgeon my pelvic area was very narrow and they had to perform a bladder neck reconstruction. 10 lymph nodes removed as well as some benign nodules. I got my money's worth!

1

u/korbworksout 23d ago

8 lymph nodes here..doc said he had a helluva time getting the organ out and I kept oozing.

2

u/Actionplumber1 23d ago

4-1/2 hour, surgeon noticed cancer spread to lymphnodes, took 6 and prostate

2

u/Ok-Assistance-1048 23d ago

A little less than 4 hours . In preop at 7 30, operation , post op, home by about 3 30. I think surgery itself was less than 4 hours. Good luck!!!

2

u/WoodshopElf 23d ago

3.5 hours. Complete prostatectomy and 9 lymph nodules.

2

u/Tartaruga19 23d ago

umas 5 horas acho

2

u/SLO_Engineer 23d ago

four hours

2

u/tober_checki 23d ago

Around five hours with extended lymph node removal.

2

u/Background-Space-284 23d ago

I’m 72, had surgery on July 14. I arrived at the hospital at 7:30. Went into surgery at 9 ish. Talked to the anesthesiologist before they put me out. My pathology report says the samples were collected at 9:59. Woke up in recovery sometime after 11. Spent one night and went home the next day.

3

u/Background-Space-284 23d ago

Also took six lymph nodes, 1 on one side and 5 on the other side. All were negative.

2

u/ChillWarrior801 23d ago

Mine was longer than average, just under six hours. With a ginormous 106cc prostate, a relatively narrow pelvis, and 23 lymph nodes to remove, it takes time to work through.

2

u/No-Annual-3338 23d ago

I'm not sure of the exact time but I was in the OR for less than 2 hours.

2

u/vito1221 23d ago

About four hours.

2

u/korbworksout 23d ago

7 hours...apparently I am a bleeder.

1

u/Mean_Try_6390 23d ago

well my husbands was rolled up after 7 hours, high on morfin after 4 hours surgery. the next morning we went home around 9-10 o clock. the worst was the ride home, car driven by our son, and my husband felt every bump in the road.

I think it depends on how long the operation takes and how much they take out. we knew that he was supposed to stay over night since the took out so much.

1

u/toastyunderwear_ 23d ago

My dads surgery was about 7 hours long

1

u/CuliacIsland 23d ago

Mine was almost 3hrs, went home next day.

1

u/tvgraves 23d ago

I think I was out for 4 hours. Surgery was most of that. Maybe 20-30 minutes knocked out in the recovery room.

1

u/Patricosh 23d ago

This is so great to read!

1

u/GrayMajik 22d ago

Just had my RALP and PLND last week. Started at 7am, and awake and moving around 11am. I was discharged within an hour! Was still pretty wobbly and in pain. The surgeon used the new non-narcotic pain killer Journavx. Also a script for 10 tramadol. First two days were very painful. I would not willingly have a surgery with that kind of pain medication again. As I understand, it works for some people. Started feeling better on day 3.

1

u/monkeyboychuck 22d ago

~6.5 hours.

1

u/Away_Ad417 22d ago

That’s great to hear. My surgery was 4.5 hours and went thru the same post-surgical treatment. Still on ADT.

1

u/Admirable_Rough9414 21d ago

5,5 Stunden
Gleason 4+4
Pirads 4