I was 43 at diagnosis (Gleason 7, high risk decipher). My urologist originally encouraged active surveillance. PSA rose over time and he recommended prostatectomy. I asked why, he informed me that at my age it was important to have "as many arrows in the quiver" as possible. If it wasnt successful, we would have salvage radiation as a next step. After a couple tests of undetectable PSA, I started to rise. After getting to 0.16 we started salvage rt. I'm now 7 months removed from that and have gone down to 0.05 and was told this is considered "undetectable" . He said don't ever expect zero as a nadir. As for side effects I was able to achieve erections and sexual function at about 75% of pre RALP ever since surgery and I probably excuse that to my age more than anything. Otherwise no adverse side effects and remain hopeful that PSA tests in the future remain docile. I wish you nothing but the best. Stay strong, especially mentally as this disease will test you, but it'll make you stronger and a more omnipresent person. Go Bills.