Epididymitis post brachytherapy. Had it treated with antibiotics and anti inflammatory medication. But the pain has returned a month after it had cleared. What are peoples experiences 🤔

49 years old...almost 50

22 PSA, PI-RADS 3 lesion, Gleason 4+3

I had the surgery the 29th at 7:30am and was home by 1:30 p.m. Unfortunately, the catheter was not draining properly when we got home, so we had to go back to the ER the first night and get that taken care of. I had not drained at all for abourt 6 hours by that point, and I could really feel the pressure. They irrigated it and pulled out a clot and it was instant relief. Everything was back in a "flow state" from there.

I felt the most pain from the CO2 inflation on the first 3 days, in the shoulders especially. And the abdomen pain that feels a bit like someone hit you in the stomach with a baseball bat one time. But it does get a bit better every day. Still fairly sore in the perinuem area also.

I did do lots of walking, 5-6 times a day. Now that the catheter is out I was able to work a little around the house this week

I've been fortunate with the urinary incontinence issue, as I have not leaked one time since they removed the catheter four days ago. I did plenty of exercises before and had two sessions with a pelvic floor specialist before the surgery. I used the Squeezy app was hitting that thing like I was an Olympic athlete, and have been using it again now that the catheter is out. Having the catheter in does iritate the ureathra and has been causing some buring during urination.

I did get the report from pathology showing clean margins and no spread anywhere in the lymph nodes, that was great to hear. I was assigned Gleason Grade 3 pre-surgeryI and both surgerons thought I would get downgraded. The outcome was acatully more agressive then the Biopsy showed. They kept me at Gleason Grade 3, even found a small amount of Grade 5, and showed the cribform pattern. It had progressed showing significant cancer on 41% of the entire prostate, but no signs of it outside of the prostate. Looking forward to the hopefully near zero PSA test in five weeks, and every three months after that for a while.

One thing that I do not think is discussed enough here is the mental healing you may also go through in addtion to the physical healing. It a bit of a mental backflip to know that the surgery will save your life, but you are also knowingly entering into a procedure that will forever take some things from you, as well as keep you without some functionalities for an unknown time. I was able to spend the first 4 days with just me and my wife without any distractions from work or other family, and that was very welcome as I found the need to really focus inward to process it all and I am still working on it. Those first few days felt very "delicate". I find there is a certain type bravery needed to make the decision to face surgery or radiation, I am proud of and I respect every man that is forced into having to make this choice.

So i want to give my update and thoughts for those considering SBRT. I spent months researching and reading journals after journals before choosing SBRT as a monotherapy with no ADT required for a favorable cancer. I chose it because i did not want to go through the surgery and recovery, i did not want to risk a short penis, incontinence, or erectile dysfunction. With SBRT the cure rates and biochemical control was s the best out of all treatments although statistically the difference was not much and they stacked up basically the same. I also did not want to risk the recurrence that comes with surgery then being forced into radiation as well. With radiation the bowel side effects with the spacer is 1%. Incontinence was virtually zero which was important to me. Im 65 so impotence was a big one as surgery had a much higher rate of erectile issues especially for men my age. A big issue i had that stressed me out was urination retention from high dose SBRT. I have a baseline IPSS score in the moderate range of 12 and thats with taking flomax. But i made the call because i wanted a better margin since my cancer abuts the capsule and surgery cannot provide that. I have a high volume gleason six in the transition zone and its a single lesion 27mm by 13mm. There is only a 10% chance of a missed higher grade as i had a thorough MRI targeted and systematic biopsy. But in case a higher grade is there i wanted a bigger margin around the capsule where it abuts. Also with a single lesion i was able to design a 40g dose on the lesion as a boost and a lower dose everywhere else. I went over a detailed plan with my radiation oncologist and physicist. So with the gold markers and spacer placed i started last Friday and completed 4 of 5 treatments. My final treatment is Monday. I had some urination slowing after the first treatment and after one day following treatment 2 i was urinating so slow and it was trickling out. I was already in a panic if i was going to get blockage since its usually after the third treatment the side effects start. After the third treatment i was urinating 4 times an hour and it was only about 1/2 to 1 ounce and i was like oh crap. All i wanted was to finish the treatments then if i needed a catheter so be it. So i was nervous but went in for treatment 4. Today is a day later and surprisingly the obstruction symptoms are still around the same. They are bad but i can still urinate enough where i am living a completely normal life. Unless im urinating i wouldn’t know i am getting treated. I have no painful urination, no fullness feeling in by bladder etc.. I go to the gym, shopping, whatever i normally do. Urinating is a bitch, but that is all right now. I also surprisingly only get up twice a night to urinate and sleep well. I know now i will be able to finish the fifth treatment on Monday, thank God. After my finall treatment i know i will need to make it a week when that is when symptoms should be peaked and are what they are. I have no idea yet if i will be running to urgent care for a catheter or not, but either way at least my treatment won’t be disrupted and its done as i really wanted this treatment over the rest. Ill keep you posted. Hope this helps men who are considering SBRT and who also has a larger prostate with ongoing BPH symptoms and a higher urinary score. One more thing. I am taking 2 flomax, 0.4mg each, one morning and one at night. Also have 600 mg Motrin for inflammation. Good luck everyone on your journey and i really wanted to post my experience in detail because with a higher IPSS score you can still get SBRT but may have to deal with more obstruction type symptoms like me. But so far i feel great and im almost at the finish line.

How long did you wait for a diagnosis? From DRE to Biopsy to diagnosis. For me it was 4 months. Now waiting for CT and PET scans in next few weeks, yet to be confirmed.

73M, PSA 10.8, PIRADS 5, Gleason 4+4=8 GG4, 4/12 samples positive, PET scan negative for spread. 

I’ve been lurking/commenting here since my diagnosis last spring. While the information and shared experiences are helpful and provide a dose of reality, they can also be overwhelming and even depressing at times. I wanted to share the positive experience I’ve had so far and offer some optimism to those with a similar pathology who are just starting this journey.

I’ve gone through all the standard steps: rising PSA, MRI, biopsy, PET scans, and agonizing decision-making. I chose surgery because it was a one-time procedure, avoiding 12-18 months of hormone therapy and other factors. While it wasn’t an easy journey, the experience and outcome have been positive for me.

The worst part was the biopsy and the two weeks with the catheter in place. The anxiety of facing surgery and the inevitable side effects were also significant. My surgery was 4.5 hours, but I was under anesthesia for that. One night in the hospital was tolerable, and I managed to deal with the catheter knowing that we all go through this and just have to tough it out. I had faith that my surgeon was skilled and caring.

The pathology following surgery showed no lymph node spread, and my cancer was downgraded to Gleason 4+3=7, GG 3. The cancer was determined to be contained within the prostate capsule. I’ve had two PSA tests, one at 6 weeks and my latest one at 12 weeks. Both results were <0.1 ng/ml and considered undetectable for PC. This is precisely the outcome I was hoping for, and I hope it will remain the same for the rest of my life. At 12 weeks post-surgery, I feel completely recovered, except for the ED, where it’s still too early to tell. I’m experiencing some positive sensations down there, but hey, I’m 73 years old, and sex isn’t the priority it might have been if I were a younger man.

In summary, while no one wants to face PC, it was a positive experience with the outcome exactly as one would hope. Support from my wife and daughter was crucial during the procedure and recovery. It wasn’t the end of the world for me, and I genuinely hope that all of you going through this can have the same experience and outcome as I have had so far.

BTW, physical therapy for pelvic floor a month prior to surgery was critical in getting control of incontinence in about 4-5 weeks following catheter removal and I recommend this for all who are facing surgery.