The younger the patient, the more years he has to live. Cure rates are extremely important and long term side effects are equally important.
9 days ago I operated on my youngest prostate patient. He was diagnosed last month at the age of 39. He just turned 40 prior to surgery.
The main reason why I saw him in the first place is that he had prostate cancer and was scheduled for an open prostate operation by another surgeon. He then heard about robotic surgery and found me.
I was confident that I could cure his cancer (90% chance) and give him total incontinence (95% chance), but our main variable was the quality of his erections. Fortunately his anatomy allowed a very nice nerve sparing and after the operation I commented to my partner, “I give him a 90% chance of having normal erections in 3 months”.
At his 1 week visit today (9 days), X-Rays confirmed his catheter could be safely removed and when I started talking about erections, he commented that he had already had an erection with the catheter in place although he tried not to.
My next comment was then “NO INTERCOURSE FOR 2 MORE WEEKS”.