Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
Help Managing Cancer Treatment Side Effects
The team at Compass Oncology is experienced in helping patients treat prostate cancer and manage the side effects of treatment. If you live in the Portland-Vancouver area, have more questions about the side effects of prostate cancer treatment, or need help managing your side effects, request an appointment at one of our locations that’s convenient for you. We’re here with you every step of the way.
What Are The Risks Or Complications Of Radical Prostatectomy
Radical prostatectomy is generally very safe. Surgeons try to protect the nerves that run from the prostate to the penis. But problems due to nerve damage can occur. There is a risk that you may experience:
- Urinary incontinence: Some people experience urinary incontinence, although most people recover continence. Your provider can help you manage loss of bladder control and urine leakage.
- Erectile dysfunction: Many people have problems maintaining erections after this surgery. The likelihood of recovery of erectile function depends on your erections before surgery and your surgeons ability to spare the nerves that control erection at the time of surgery. You may need to use erectile dysfunction medications or other treatments. The older you are, the more likely problems may occur.
There is also a small risk that you may experience:
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How To Manage Incontinence
There are multiple ways to manage incontinence:
- Pelvic floor muscle strengthening: Pelvic floor muscle exercises can help muscle strength and bladder control get better by doing exercises that tighten and relax muscles that control the flow of urine.
- Bladder training: This can help manage how often you need to urinate throughout the day by assigning certain time intervals to empty your bladder.
- Medicines: Some medications can help the muscles of the bladder and the muscles that control urine flow. Most of these drugs affect either the muscles or the nerves that control them. They work best for urge incontinence.
- Surgery: This may be used to correct long-term incontinence. It can remove blockage. Material such as collagen might be recommended and injected to tighten the muscle that controls urine flow. A small device called a urethral sling can also be implanted to press the urethra against the pubic bone. An artificial muscle controlled by a scrotal pump may be an option for men, and it’s implanted to squeeze the urethra.
- Incontinence products: They can help keep you active and comfortable. Adult briefs and undergarments are bulkier than pads worn under your clothing, but provide more protection. Bed pads or absorbent mattress covers can also be used to protect the bed linens and mattress.
Questions To Ask Your Doctor Or Nurse
You may find it helpful to keep a note of any questions you have to take to your next appointment.
- What type of surgery do you recommend for me and why?
- What type of surgery do you recommend for me? Will you try to do nerve-sparing surgery?
- How many of these operations have you done and how many do you do each year?
- Can I see the results of radical prostatectomies youve carried out?
- What pain relief will I get after the operation?
- How and when will we know whether the operation has removed all of the cancer?
- How often will my PSA level be checked?
- What is the chance of needing further treatment after surgery?
- What is the risk of having urinary problems or erection problems and what support can you offer me?
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Am I A Good Candidate For A Radical Prostatectomy
Other treatment options may be better for you if:
- your health is poor and youre unable to undergo anesthesia or surgery
- your cancer is growing slowly
- your cancer has spread beyond your prostate gland
Your doctor will do a thorough check of your health. Some health conditions in particular need to be under control before the surgery. These include:
- lung problems
- high blood pressure
Your doctor will order many tests and scans before your surgery to learn as much as possible about your condition. These will likely include:
- blood tests
- an ultrasound of the prostate and nearby organs
- a biopsy of the prostate
- a CT or MRI scan of the abdomen and pelvis
Make sure that you tell all of your doctors and nurses what drugs and vitamins you take, especially any medicines that may thin your blood. These may cause complications and excessive bleeding during surgery. Problems may occur with drugs or supplements such as:
- vitamin E
Make sure not to eat before the surgery to avoid complications from the anesthesia. You may need to drink only clear liquids and take a special laxative the day before the surgery to clear your digestive system.
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Why Is This Important
An enlarged prostate can cause two main symptoms of the lower urinary tract: voiding and urinary retention. Prior to this research, some experts believed surgery did not help men with urinary retention. However, the trial found both prostate procedures are effective for treating both voiding symptoms and urinary retention.
Although previous research suggested that the laser procedure would lead to fewer complications and a reduced hospital stay compared to TURP, this was not seen in the study. The new findings from Bristol suggest hospitals who already perform TURP do not necessarily need to invest in equipment and training for the ThuVARP laser procedure. Patients can be reassured that either surgical option is safe and effective. The researchers say new treatment approaches should continue to be compared with TURP, as NICE guidelines recommend.
What Necessitates Prostate Removal
Prostate cancer and sometimes benign prostatic hyperplasia can necessitate the removal of prostate gland. However, the most common cause is prostatic cancer as BPH can nowadays be managed with other treatment options. The prostate gland removal surgery is known as prostatectomy. The risks, benefits and side-effects of prostatectomy should be discussed with the patient, before making the decision to get prostate gland removed.
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How Fast Will I Become Totally Continent After Prostate Surgery
During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.
The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.
It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.
Can Prostate Cancer Be Completely Cured
Prostate cancer is the second most common cancer in men. The average age of diagnosis is 66 year olds, although it may affect younger men as well. By age 80, more than half of all men have some cancerous growth in their prostate.
Due to routine screening of prostate-specific antigen levels in the United States, nearly 90% of prostate cancers get detected in early stages. In most cases, the cancer is confined only to the prostate and does not spread to other organs. With the widespread use of screening tests in the United States, early diagnosis of prostate cancer has become much easier.
When found early, there are several treatment options available and prostate cancer has a high chance of getting cured. Moreover, prostate cancer is a slow-growing cancer that takes many years to become big enough to cause symptoms. It also takes quite long to spread to other organs. This gives sufficient time for the doctors to treat it.
Oncologists recommend patients to not rush and take some time to understand the various treatment options available after consulting with more than one doctor. Patients can discuss various modes of treatment with the doctor and select the most appropriate option for their prostate cancer.
The 5-year survival rate for most men with local or regional prostate cancer is nearly 100%. There are more than three million survivors of prostate cancer in the United States today.
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Advantages And Disadvantages Of Prostate Surgery
- Surgery will completely remove the cancer if it is only in the prostate gland.
- The prostate can be removed and be fully analysed and staged in the laboratory.
- The success of the treatment can be easily assessed by PSA testing.
- If the PSA were to rise after surgery you would still be able to get other treatments like radiotherapy or hormone treatment.
It involves a general anaesthetic and the usual risks you would expect with surgery, like the risk of bleeding, infection and blood clots.
- You will have to stay in hospital for a few days.
- You may get side-effects afterwards like problems with erections and urinary incontinence.
- You will not be able to father children after the surgery, as the prostate, which normally makes some of the fluid needed for semen to be made, has been removed.
- Recovery takes around 6 weeks.
Open Or Laparoscopic Radical Prostatectomy
In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.
In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.
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How Is A Radical Prostatectomy Performed
The prostate is inside the pelvis and is surrounded by many other organs, including the rectum, the bladder, and the sphincter. Many important nerves and blood vessels also surround the prostate.
There are several methods for performing a radical prostatectomy. The one you undergo will depend on the location of your tumor or tumors, the extent of your cancer, and your general health and life stage.
All of these surgeries are done in the hospital and require anesthesia to prevent you from feeling pain. General anesthesia is usually used, so youll be asleep during the surgery. Epidural or spinal anesthesia can also be used. With this type of anesthesia, you cant feel anything below your waist. Sometimes, both types of anesthesia are used to control potential bleeding and to provide the best pain management.
The three main types of radical prostatectomy surgery are:
Can I Have An Orgasm Without An Erection
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.
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The Purpose Of Prostate Surgery
Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.
It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.
Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:
Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.
The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.
Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.
Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment
If your prostate-specific antigen blood level shows that your prostate cancer has not been cured or has come back after the initial treatment, further treatment can often still be helpful. Follow-up treatment will depend on where the cancer is thought to be and what treatment youve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.
Why The Procedure Is Performed
An enlarged prostate can make it hard for you to urinate. You may also get urinary tract infections. Removing all, or part, of the prostate gland can make these symptoms better. Before you have surgery, your doctor may tell you changes you can make in how you eat or drink. You may also try some medicines.
Prostate removal may be recommended if you:
- Cannot completely empty your bladder
- Have repeat urinary tract infections
- Have bleeding from your prostate
- Have bladder stones with your enlarged prostate
- Urinate very slowly
- Took medicines, and they did not help your symptoms or you no longer want to take them
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What The Research Shows About Radiation Vs Surgery
The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.
The results, published in 2016, showed that the rate of disease progression among men assigned to radiotherapy or radical prostatectomy was less than half the rate among men assigned to active monitoring. However, there was no significant difference in survival at the median 10-year mark for radiation therapy, surgery or active surveillance.
If youre interested in directly comparing treatment outcomes by treatment method and risk group , the Prostate Cancer Free Foundation provides an interactive graph on its website with information from data obtained from over 100,000 prostate cancer patients over a 15-year period.
As discussed earlier in the sections on the side effects of radiation therapy and surgery, the researchers conducting the ProtecT trial also looked at side effects and quality-of-life issues and found that the three major side effects of these two treatment options that affect quality of life after prostate cancer treatment are urinary incontinence, sexual dysfunction and bowel health.
The trial found that urinary leakage and erectile dysfunction were more common after surgery than after radiation therapy. Gastrointestinal bowel problems were more common after radiation therapy.
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Penile Rehabilitation After Prostate Removal May Include:
- Prescription medications. Medications, called phosphodiesterase-5 inhibitors, work for many men unless their nerve bundles were damaged or removed. These medications include Viagra and Cialis.
- An injection. Your body makes prostaglandin E1, a substance that helps your body have an erection. A made-made version is now available. Your doctor can teach you to inject this at the base of your penis about 5-to-10 minutes before intercourse. The injection is virtually painless this medication is also available as a suppository placed into the tip of your penis.
- Vacuum devices. These devices draw the air from around your penis. The vacuum created brings blood into your penis, creating an erection.
- Penile implants. A device is surgically implanted into your penis. Penile implants provide a lasting solution for ED, lasting 10 or 15 years. There are risks, but if none of the other penile rehabilitation methods work, many men agree that a penile implant is a cosmetically-acceptable solution for their prostate cancer-related erectile dysfunction.