Prostatectomy: What To Expect
Many prostate cancer patients dont need surgery. But for young patients with prostate cancer that hasnt spread, a surgery called a prostatectomy can help them become cancer-free and put prostate cancer treatment behind them. John Davis, M.D., a urologist who performs hundreds of prostatectomies each year, explains what patients undergoing this procedure can expect, including prostatectomy side effects and risks.
What is a prostatectomy?
A prostatectomy is the surgical removal of all or part of the prostate gland. Prostate cancer surgery types include:
- Robotic prostate cancer surgery: In this procedure, called robotic radical prostatectomy, a surgeon makes several small incisions in the lower abdomen and uses a robotic device to remove the prostate.
- Open radical prostatectomy: The surgeon makes one large incision in the lower abdomen to remove the prostate.
Robotic radical prostatectomies have become increasingly common over the years, and most surgeons prefer to conduct the procedure this way because its a little easier on them. But its important to know that both methods are safe.
Who needs a prostatectomy?
For some patients, prostatectomies will be the only treatment they undergo. Others who may have a difficult time recovering from surgery or have more advanced cancer may also have chemotherapy or hormone therapy treatment as well.
How long does it take to recover from a prostatectomy?
What side effects do patients experience following prostate removal?
Day Of Surgery Medications
You may take all your normal medications with a sip of water, except oral diabetic medication, ACE inhibitors and diuretics such as hydrochlorothiazide . Call our office if you have any questions about your medications. Due to COVID-19 restrictions we encourage you to contact our hospital concierge for the latest visitor guidelines by calling .
On the day of your surgery, you may use valet parking or park in one of the lots in front of the building. Your procedure will take place at AdventHealth Celebration, located at 400 Celebration Place, Celebration, Florida 34747. You will need to report to the hospital main entrance. Our concierge will meet you in the front lobby of the hospital to escort you to the surgery area and walk you through the process.
After your surgery is completed, Dr. Patel will call your family and give them an update on your status.
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How Do I Prepare For This Procedure
You will be provided with surgery instructions from the front desk during scheduling. The day before the surgery you must begin a liquid diet. This includes smoothies, milk, tea with lemon and sugar, fat free broth, clear carbonated beverages such as 7- UP, Sprite, gelatin, clear apple juice, strained fruit juices and water. You will be required to drink 3 glasses of water. No eating or drinking past midnight except for high blood pressure medication.
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Diabetes And Flu: Understanding How They Are Connected
Dear Dr. G,
I have been diagnosed with prostate cancer this comes after I went for a routine PSA blood test at the age of 55 years old and ended up with a biopsy, which detected prostate cancer.
I was devastated after the diagnosis and was anxious with the subsequent MRI and Gleason grading and I guess I am lucky as the tests showed intermediate early-stage cancer.
As I am considered young, the urologist recommended surgery and explained that I may encounter erectile dysfunction and urinary incontinence after the intervention.
Although I am prepared to face the worst, I am still holding on to hope that I can preserve my urinary continence, erectile function and fertility.
I hear my hope lies with the helping hands of robotic surgery, and therefore would like to put Dr. G on the spot to shed some light.
Can you tell me why I have prostate cancer at such a young age, and why does the operation result in incontinence and impotence? Can it affect my fertility?
Also, how does robotic surgery help to minimize the complications?
Finally, is the incidence of prostate cancer on the rise?
Thank you in advance.
Prostate cancer is a common cancer with the number of men diagnosed with it rising in many countries it currently affects up to one in six men. Many attribute the rise in the diagnosis of prostate cancer due to the prevalence of diagnostic tests with PSA and an overall increase in lifespans.
What The Study Found
According to the results, both methods were equally effective at removing cancer from the body, and post-surgical complications between them occurred relatively infrequently. However, there were some short-term differences between the two approaches. For instance, the robotically-treated men had shorter lengths of hospital stay , and they also reported lower pain scores after surgery. Men who underwent robotically-assisted surgery also reported fewer complications such as blood clots , urinary tract infections , and bladder neck contracture, which is a treatable condition that occurs when scarring in the bladder outflow makes it hard to urinate. In all, 45 men experienced a bladder neck contracture after open surgery, compared to nine men treated with the robotic method.
“With regard to urinary and sexual health, there were no appreciable average long-term differences between the two approaches,” said Dr. Peter Chang, a urologist at Harvard-affiliated Beth Israel Deaconess Medical Center in Boston, and the study’s lead author, in an email. “This suggests that with high-volume providers in academic centers, quality-of-life outcomes between open and robotic prostatectomy are similar.”
About the Author
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
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Top Prostate Cancer Surgeon
Dr. Razdan is considered by many as one of the Most Experienced Robotic Prostate Cancer Surgeons in the Worldwith over 8,500 procedures performed to date. He is considered a Pioneering Researcher and Surgeon on Prostate Cancer and has some of the best Robotic Surgery Outcomes in the world. Patients travel from all around the world to Miami to have Prostate Cancer Surgery with Dr. Razdan. From CEOâs of large corporations, celebrities, government officials and even other surgeons entrust Dr. Razdan and his unique set of skills and incredible outcomes. He was the First Surgeon in the World to USE HUMAN AMNIOTIC MEMBRANE for EARLY RETURN of ERECTILE FUNCTION after robotic prostate surgery. He founded and pioneered the technique of MAXIMAL URETHRAL LENGTH PRESERVATION for EARLY RETURN OF URINARY CONTINENCE after robotic prostate surgery which was also published Patients travel to Dr. Razdan for his leading outcomes in terms of Cancer Control, Urinary Continence and Erectile FunctionMost patients have full urinary control often within days of surgery and almost 98% are continent by 6 monthsMajority of patients have erections sufficient for sexual activity by 6 months
Why Robotic Prostate Surgery
During open radical prostatectomy for prostate cancer, the prostate is removed using a large midline incision from the umbilicus to the pubic bone. The major drawback of this approach is not only the size of the incision but also the stretching of the abdominal muscles and skin that is necessary to place a retractor to gain the appropriate visualization in order to perform an open prostatectomy. This large incision can take longer to heal and results in increased post-operative pain and impaired mobility.
Da Vinci Robotic Surgical System
The robot itself consists of two units. The Patient-side cart has four robotic arms for carrying out the surgery one arm holds a camera and the other three hold instruments. The surgeon sits at a console with a stereoscopic 3D view of the operating field. Unlike a conventional screen, this allows the perception of depth which makes accurate surgery much easier. Beneath the display are the master controls which translate the surgeon’s hand movements in real-time to the movement of the robotic arms and instruments. The system is designed to remove tremors and allow very precise movement.
What Are Laparoscopic And Robotic Surgery
Laparoscopic and robotic prostate surgery are minimally invasive techniques for performing surgery. Both these procedures allow surgeons to operate through small ports rather than large incisions, resulting in shorter recovery times, fewer complications and reduced hospital stays. Surgical robotics combines minimally invasive surgery with advanced robotic technology.
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Featured Patient Testimonial: Dr David Mantik
As a physician speaking to a patient, I have on a number of occasions disclosed to them that I myself had prostate cancer and actually had this procedure and I highly recommend it for the appropriate candidates.
Dr. David Mantik is a radiation oncologist. For more than 40 years, hes specialized in the use of radiation therapy to treat patients with prostate cancer.
However, at the age of 79 when he noticed his PSA score was rising, Dr. Mantik went to see Dr. John Feller. Now in remission, Dr. Mantik shared why he chose laser focal therapy over radiation treatment for his prostate cancer.
What Is A Biopsy And How Effective Is It
A needle biopsy is the only way to diagnose prostate cancer when it is suspected. But there are problems with the method most commonly used, called transrectal ultrasound guided biopsy. These problems often lead to inaccurate diagnosis.
For the last two decades, TRUS biopsy has been used to diagnose prostate malignancy. It is actually a blind and random procedure. Specific prostate tumors, especially very small ones, cannot be identified because ultrasound cannot visually detect specific cancer sites. Therefore, it is blind to tumors. In addition, TRUS biopsies tend to target the peripheral aspects of the gland and are likely to miss 30-40% of prostate cancer located in the anterior, midline transition zone, or apex. This is called sampling error. To attempt to overcome it, TRUS biopsies typically average 12-14 needles saturation biopsies use as many as 24 needles. The more needles used, the greater the risk of discomfort, infection, and urinary or sexual side effects while tumors continued to be missed. No other type of tumor cancer is biopsied this way!
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Why Choose Dr David Robbins
Miami urologist Dr. David Robbins trained at New York University and learned how to perform robotic surgery from world leaders in the field of prostate cancer surgery and da Vinci robotic surgery. This specialized training in robotic prostate cancer surgery along with Dr. Robbins’ intense drive toward improvement has helped him to develop the skills necessary to provide patients with the highest quality robotic surgery outcomes especially with regard to prostate cancer cure, urinary continence, and maintenance of erectile function.
In addition to patient satisfaction with the functional aspects of robotic prostate cancer surgery, Dr. Robbins is highly appreciated by his patients for the personal care that he delivers and his genuine compassion. For these reasons, Dr. David Robbins is considered by many to be the best urologist specializing in robotic prostatectomy surgery and prostate cancer treatment in Miami, Florida.
Challenges Of Randomized Studies For Prostate Surgery
The three forms of surgery studied are “open radical” in which the prostate is removed via an abdominal incision in the belly button or pubic bone laparoscopic prostatectomy that requires several small minimally invasive “keyhole” incisions in the abdomen, and robotic surgery, which is a form of laparoscopic surgery. RALP is done through keyholes with the aid of robotic arms that eliminate hand tremor as well as advanced optics that magnify the prostate and surrounding nerves in three-dimensions.
“It is hard to accrue patients for randomized studies. We have an ongoing study open at our institution, investigating the quality of life differences between robotic and open radical prostatectomy. This is designed as a randomized controlled study,” he says. “But no one has enrolled because they did not want to be randomized to a treatment they don’t prefer. Patients often come, especially to prostate cancer specialists, self-selecting for a particular treatment modality.”
So Dr. Tewari and Peter Wiklund, M.D., of Sweden’s Karolinska University Hospital, developed a study that examined all of the peer-reviewed studies published on any of the three techniques.
This ambitious effort was aimed at understanding the short-term outcomes of the three surgical techniques. Given the short time frame, the meta analysis did not compare outcomes for urinary continence or sexual potency.
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Is Taking The Help Of Hospital Which Uses Robotic Surgeons For Prostate Cancer Safe
Yes, it is safe to have your surgery from a hospital that uses robotic prostate cancer surgeons. The reason is that robots or robotic surgeons are controlled by specialized doctors who know how to use it.
And also, it could be beneficial for you if you visit the type of advanced hospital because if prostate cancer surgeries are done with the help of technologies, there will be no chance of mistake. Also, the surgery will take less time, and you can also go home soon.
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Featured Patient Testimonial: Toms Story
I just felt like the technology and the skill level of HALO Dx was light years ahead of what was here available to me locally and thats why I made the choice to go down there. It just seems like a rational, logical alternative that you dont have to be a doctor to be able to appreciate.
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Da Vinci Robotic Prostatectomy Procedure
One of the many advantages to da Vinci robotic prostatectomy for prostate cancer is that it can be performed through five tiny incisions and the prostate removed through the umbilicus at the end of the procedure. This leads to less post-operative pain and scarring and a quicker return to regular activities. Additionally, the view of the surgical field afforded by the 3D stereoscopic display means that the surgeon has a much clearer view of the nerves and blood vessels surrounding the prostate which helps to minimize blood loss and reduces the risk of damaging the nerves responsible for continence and erectile function.
During da Vinci robotic prostatectomy for prostate cancer, the prostate gland and seminal vesicles are separated from the bladder and urethra and then these two structures are reconnected over a foley catheter to maintain a contained urinary channel. For advanced disease, the pelvic lymph nodes can be sampled to verify that the disease has not spread beyond the prostate.
Know About The Best Robotic Prostate Surgeons
Sharing is caring!
Our body is designed quite systematically. Each part of the body is linked with another to ensure that all the organs, muscles, and fluids work together while synchronizing to support life today and every day. However, there can also be times when the body might not work properly because of some constraint or blockage.
This could result from maladaptive lifestyle practices or even an internal problem that might lead to serious diseases.
Find The Best Surgeon You Can Get It Done Right
Radical prostatectomy is a very difficult operation. It takes not only skill, but the kind of expertise you get only after being involved in a lot of procedures, first from the sidelines as a doctor in training, and then learning how to do it meticulously with the guidance of an expert surgeon.
The very best prostate surgeons specialize in the prostate. Thats often all they do, and they do a lot of these procedures every year.
You dont want to be part of the learning curve.
Another point: Because there are so many bad surgeons out there, you cant trust everything you read on the internet or from hospitals propaganda.
Our goal is to weed out the bad surgeons, so they stop doing procedures they arent skilled enough to do.
As for you, well, this is your one shot at this. Do your due diligence. How can you find the right surgeon? We have developed this checklist with the help of three experts. Please. Take the following things into consideration before you go under the knife:
What Is Robotic Prostate Surgery
A surgical treatment for prostate cancer, the radical prostatectomy procedure removes the entire prostate gland. Radical prostatectomy can now be done by laparoscopic or robotic techniques. In open prostate surgery, the prostate gland is removed through a larger incision in the lower abdomen. Laparoscopic prostate surgery involves key-hole incisions which used for inserting a lighted viewing instrument into the pelvic region and allows examination and removal of the prostate without a large abdominal incision.
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Tell Me About The Robotic Prostatectomy Surgery
Instead of a step-by-step process of the surgery, you just need to understand what happens during the surgery. Through those tiny keyhole incisions, Dr. Bevan-Thomas will inflate carbon dioxide into the abdomen to create space to work. Think of it as inflating a balloon so you can see inside.
Dr. B-T will place those tiny instruments through the incisions to get down to the prostate. He will gently remove the prostate from the surrounding tissue like the muscles in the pelvis and the erection nerves.
After he removes the prostate, he will place it in a small sac and remove it through one of the keyholes. He usually has to open the incision a little bit more to create enough room to remove the prostate in the bag. He may also remove some lymph nodes in the pelvis as well.
The prostate sits between the bladder and the urethra, so next he will reattach these areas with sutures.
At the end of your surgery, the prostate and lymph nodes go to a pathologist .
Your sutures will take five to seven days to heal. At that time, you will plug the tube and try to urinate on your own. If you can urinate, you will come to the office so the nurse can remove the tube.
When the pathology results come back — also in five to seven days — Dr. B-T will go over them with you at a postop appointment in his office.