I talked w/ a urologist who has done a 1000 robotic prostate removals - he says there are big problems when the prostate has to be removed from person w/ a j pouch / has any one w/ a j pouch had there prostate removed? / do you perhaps lose the pouch and have to have an ostomy?
I'll reply to my post - I came across an article from The Journal of the American College of Surgeons (Fen 2010) in which addressed radical prostate removal from those w/ a pouch - they studied 16 patients w/ cancer confined in the prostate and in each patient the pouch was not compromised during biopsy or prostate removal
I would imagine any additional issues with prostate removal for you would be related to the degree of adhesions (scar tissue) that has formed because of your rectal dissection and j-pouch.
If your urologist thinks this is a big deal, you probably should seek a second opinion from someone with more experience. But, if he is confident in his skills and only being up front about possible pitfalls, that is different.
There are a few here who have had prostatectomy. Have you checked the Men’s Health Forum?
thanks for the reply - received J pouch at age 50 (I'm now 66) in 2 step procedure and also had my gall bladder removed in 2008 - have never had any problem w/ either (eat and do whatever I want - life no different than before either surgery) but I assume I have lots of scare tissue which could complicate further pelvic surgery - don't know if I will ever need prostate removed but would like to know if I do if my pouch will be compromised
66 years old. J-Pouch from 1989 (history of UC). BPH from 2008 (last measurement 127cc). My pouch has given me all sorts of issues since 2014, which is when the prostate exceeded boundaries and encroached upon the pouch. Accelerated bouts of pouchitis for the past 4 years. After multiple catheterizations during the years as a result of AUR, Oct 2018 I was unable to successfully withdraw use of the indwelling catheter and went immediately for the prostatectomy option. My urologist had never encountered a J-Pouch patient before, but after he researched, he decided that the best alternative for success, both prostatewise and J-Pouchwise was an SPP, simple suprapubic prostatectomy. (No laser, no laparoscopy, no robots, just 10 fingers). The relevant premise is that he approaches the prostate through the abdominal wall and an incision into the bladder. In essence, he doesn't need any approach to the J-Pouch (as long as he is super-careful).
I had the operation 18 Nov 2018. I am recovering at home, and feeling OK. My J-Pouch is back to performing the way it did 15 years ago. Early to draw conclusions, but no regrets.
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