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How Do They Surgically Remove The Prostate

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What Happens If Prostate Cancer Comes Back

What is a robotic prostatectomy?

The prostate is a small gland about the size of a walnut that helps make seminal fluid. Its intertwined with your urinary tract system, resting below your bladder and surrounding the urethra. As you age, this gland continues to grow, sometimes resulting in benign prostatic hyperplasia. While this growth is normal, cancerous growth is not. Cancer occurs when the cells in your prostate gland begin to grow out of control.

While prostate cancer is common, especially among older men, its got a fairly positive outcome. When caught early and treated, most men survive and continue on with remission after five years. Unfortunately, for a small percentage of men, the cancer returns. To give you some clarity on this situation, heres what happens if prostate cancer comes back.

Good Prostate Cancer Care

Your MDT will be able to recommend what they feel are the best treatment options, but ultimately the decision is yours.

You should be able to talk with a named specialist nurse about treatment options and possible side effects to help you make a decision.

You should also be told about any clinical trials you may be eligible for.

If you have side effects from treatment, you should be referred to specialist services to help stop or ease these side effects.

Caring For The Catheter

You will be discharged with a Foley catheter, a tube that continuously drains urine from your bladder into a bag and that you will use for seven to 10 days. Before you leave the hospital, your nurse will teach you how to empty and care for your catheter and drainage bag. The catheter works with gravity and should be draining urine at all times, so you have to keep the drainage bag below your bladder at all times, even when you shower. If your urine is not draining, lower the bag and check the connection for kinks or loops. Loops can cause an air lock that prevents drainage. You can also try emptying the bag. Then try briefly disconnecting the catheter from the clear plastic tubing to allow a little air into the system. Your nurse will show you how to do this before your discharge.

To prevent infection, you must keep your catheter clean. This section explains how to clean the catheter, the area around the catheter and the drainage bag. It also explains how to apply your leg bag and secure the catheter to your leg.

We will provide most of the supplies you need to care for your catheter. They include:

  • StatLock Foley catheter securement device
  • Shaving supplies

You should empty the catheter bag when it’s half full. This helps prevent air locks from developing in the tubing.

To apply the leg bag:

  • Wash your hands with soap and water.
  • Remove the tape at the joint of the catheter tube and bag.
  • Swab all connecting areas with alcohol pads.
  • Drain, then remove the big drainage bag.
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    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.

    How Long Has Cleveland Clinic Been Performing Laparoscopic Prostatectomies

    Dr Swati Shah

    Cleveland Clinic was the first in the United States to establish laparoscopic prostatectomy program in 1997 and routinely offer this procedure to patients. Our specialists have been performing robotic prostate surgery for the past 5-6 years.

    Robotic and Laparoscopic Surgery Offer Advantages in Treatment of Prostate Cancer

    Cleveland Clinic was the nation’s first medical center to routinely perform laparoscopic prostate surgery and amongst the first to perform robotic radical prostatectomy. Now laparoscopic and robotic surgery is enabling surgeons to perform this complex minimally invasive surgery with more precision, offering patients improved outcomes. Cleveland Clinic uses the state-of-the-art robotic surgical system that has been approved by the FDA for use in performing many surgical procedures, including radical prostatectomies, general laparoscopic surgery, thoracoscopic surgery, and thoracoscopically-assisted heart procedures.

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    During Surgery For Bph

    The vast majority of BPH surgeries are performed using a transurethral technique, of which there are several types. With each, a tube-like instrument called a cystoscope or resectoscope reaches the prostate gland via the urethra.

    Some transurethral techniques include:

    • Transurethral resection of the prostate : An electrified wire loop is used to remove prostate tissue. This is the most common surgery used to treat BPH.
    • Transurethral electrovaporization of the prostate : Electrical energy applied through an electrode is used to heat and vaporize an area of enlarged prostate tissue.
    • Transurethral incision of the prostate : No prostate tissue is removed, but two deep cuts are made starting in the bladder neck . The purpose of these cuts is to widen the urethra in order to improve urine flow.
    • Laser energy is used to vaporize prostate tissue.
    • Laser enucleation of the prostate: A holium or thulium laser is used to remove large chunks of excess prostate tissue that is blocking urine flow.
    • Prostate urethral lift: Implants are placed in the prostate to lift the prostate and keep the urethra open.
    • Prostate water vapor therapy: Targeted, controlled doses of stored thermal energy in water vapor are used to decrease prostate tissue.

    What Are The Side Effects

    Medical research shows that symptoms of incontinence and impotence are similar for both minimally invasive surgery and traditional surgery. Men usually return to normal urinary function within 3 months.

    Because this technique is nerve-sparing, a mans postoperative ability to have an erection should be comparable to that of traditional surgery. Recent studies have shown no difference between laparoscopic surgery and open surgery called open radical prostatecomy .

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    Transurethral Resection Of The Prostate

    In most cases, doctors use this procedure to help people with something called benign prostatic hyperplasia , an enlargement of the prostate that isn’t cancer.

    People with prostate cancer have TURP done to ease symptoms like trouble peeing. Doctors don’t use this surgery to try to cure the cancer.

    A surgeon removes the inner portion of your prostate gland that surrounds something called the urethra. That’s the tube where the urine leaves your bladder. Then they’ll pass a tool called a resectoscope past the tip of your into the urethra. From there, they’ll either send electricity through a wire to heat the area up or use a laser to vaporize or cut tissue.

    Advantages Of Ralp Over Traditional Surgery Include:

    Prostate Gland Surgery: Radical Prostatectomy
    • Small incisions
    • Less blood loss than in traditional surgeries
    • Less pain than an open incision surgery
    • Less risk of infection over other kinds of surgery
    • Shorter stay in the hospital
    • Faster recovery at home

    The magnification system provides your surgeon with a clear view of the tiny blood vessels, nerves, and muscles surrounding your prostate to help minimize side effects after your surgery.

    Not every man who needs prostate removal surgery will be a candidate for robotic surgery. Each prostate cancer patients situation is unique, with some patients requiring a different surgical method either traditional open surgery or, less frequently, radical perineal prostatectomy.

    If you have recently been diagnosed with prostate cancer and are looking for a second opinion on treatment options before undergoing surgery, consult with one of the prostate cancer specialists at Compass Oncology located throughout the Portland-Vancouver area.

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    How Is The Prostate Removed

    Different procedures can be used to remove or resect a portion of the prostate. One procedure is called transurethral resection of the prostate . In this procedure, tissue from the central portion of the prostate is removed to enlarge the size of the urethra in this region. The prostate gland surrounds the urethra just below the bladder, and as it enlarges with age, can cause difficulty with urination. The procedure is safe, but can result in bleeding for several days following the surgery. The bleeding will gradually subside.

    When the patient has prostate cancer, a radical prostatectomy is done to remove the entire prostate, the surrounding tissue and lymph nodes. There is significant bleeding associated with this procedure. Again, the bleeding will decrease in a few days following the procedure.

    A computer enhanced robotic laparoscopic radical prostatectomy is an advanced procedure that is becoming the treatment of choice for prostate cancer. This procedure involves very precise resection of the gland under microscopic guidance, avoiding nerves and blood vessels. This results in significantly less bleeding than traditional radical prostatectomy.

    What Should People Know About The Potential Complications Or Side Effects From A Radical Prostatectomy

    A radical prostatectomy is very complex and requires a high level of technical precision. The prostate is surrounded by nerves and structures that are important to normal urinary and sexual function. Men who have this procedure are understandably concerned about the possibility of complications that affect longer-term quality-of-life issues. These can include urinary control, also called urinary continence, and changes in sexual function.

    Over the past few decades, technical refinements have dramatically reduced the number of complications with this surgery. At MSK, weve found ways to use the results of imaging tests when planning a surgery. Then we can avoid injuring important structures, which minimizes the risk of incontinence and maximizes the chance of maintaining sexual function. We continue to look for ways to further minimize the risk of side effects.

    Studies have shown that patients of surgeons who regularly perform radical prostatectomies have fewer complications on average than those who do these surgeries less often. I myself have performed more than 3,000 radical prostatectomies. The other MSK surgeons also have vast experience in this procedure.

    Its always a balance between removing the cancer and trying to preserve function. The balance is different for each person because each cancer is different. People need to ask questions and be clear about their expectations.

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    Caring For The Incision

    You will be able to take a shower the second day after your surgery. You may continue to have some discharge at the drain site for three to five days. Once you leave the hospital, the key words on caring for the drain site and incisions are clean and dry. Showering once a day and gently patting the area with a clean towel should be sufficient.

    Going Home With A Catheter

    Prostate Problems in Dogs  Hypertrophy, Prostatitis, Cancer &  Cysts

    It is normal for your urine to look cloudy for a few weeks after surgery. Occasionally, bleeding may occur around the catheter or be noticed within the urine. This also is common. If you see large clots â more than an inch in length â or if the catheter becomes plugged, contact your doctor. No anesthesia is required for catheter removal, and most patients experience only a little discomfort.

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    Diet Fluids And Bowel Movements

    Constipation is a common side effect of pain medications and surgery. You should have received prescriptions for an oral stool softener and a laxative.

    You should start drinking fluids as soon as you are comfortable after surgery, and you can resume your normal diet the first day after surgery. But while waiting for normal bowel function to return, you should avoid large meals in favor of several small meals a day. To prevent constipation, we recommend drinking at least eight to 10 glasses of fluids each day and eating lots of fruits and vegetables. Avoid carbonated beverages and cruciferous vegetables such as broccoli, cauliflower, brussels sprouts and cabbage for approximately two weeks, as they frequently cause gassy discomfort and distention.

    Take your stool softener and laxative as prescribed. Normal trajectory for return of bowel function is one to two days to pass gas, three to five days for the first bowel movement.

    If you haven’t had a bowel movement by day three after your surgery, take oral Miralax , an over-the-counter laxative. You can combine Miralax with the prescribed stool softener and laxative. Follow the instructions on the box. Do not use any enemas or take stronger laxatives, such as magnesium citrate. Contact the clinic if you still haven’t had a bowel movement by day five.

    What You Need To Know About The Prostate Do They Remove The Prostate In Male To Female Surgery

    A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

    While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

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    Potential Risks And Side Effects

    Its important to be aware of potential side effects and risks associated with a radical prostatectomy.

    Immediately after the surgery, risks may include:

    • Reaction to the anesthesia
    • Infections at the surgery site
    • Damage to other organs near the prostate

    You should also ask your doctor about side effects. Some of the most commonly experienced side effects from the surgery include:

    • Impotence or temporary erectile dysfunction
    • Incontinence or urine leakage
    • Inguinal hernia

    Not all patients experience side effects, and side effects arent always permanent. However, if you experience long-term side effects, treatments are available for some of the main issues, such as erectile dysfunction and urinary incontinence.

    While In The Hospital

    Robotic surgery for prostate cancer

    It’s important to your recovery to start moving as soon as possible. Most men are out of bed and walking around the unit on the same day as their surgery. Your nurse will assist you until you can manage on your own. When you first get up, raise the head of your bed, take a couple of deep breaths, and allow your body to adjust to the change in position. Dangle your feet over the side of the bed for a few minutes, then slowly stand up. Be careful because getting up too quickly can make you light-headed.

    Get out of bed at least three times each day preferably more. This helps prevent lung infections and blood clots. You may be prescribed an injectable blood thinner to further reduce the risk of blood clots. The more time you spend out of bed, the faster you will recover and the faster your bowel function will return to normal. Your nurse will also give you an oral stool softener and mild laxative to prevent constipation.

    In addition to walking, you will be encouraged to do two other things that help prevent complications: Use an incentive spirometer , and wear compression stockings while in bed. Both will be provided and the nurses will instruct you on how to use them.

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    Why Erectile Dysfunction May Result From Prostate Disease

    In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. While these factors can cause erectile dysfunction, doctors now think that 70% of the time the problem can be traced to a physical condition that restricts blood flow, hampers nerve functioning, or both. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.

    However, some types of prostate disease and treatments may also be responsible.

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    Your Cancer Care Team

    People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.

    The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.

    Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.

    When deciding what treatment is best for you, your doctors will consider:

    • the type and size of the cancer
    • what grade it is
    • whether the cancer has spread to other parts of your body

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    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.

    Urgent Signs And Symptoms

    Transurethral Resection of the Prostate

    For emergencies that can’t wait, call 911.

    • You have a persistent or recurring temperature greater than 101 F or repeated chills.
    • Your catheter stops draining urine despite adequate hydration and no kinks in the tubing.
    • Your urine in your Foley catheter is cloudy, foul smelling or persistently bloody .
    • You have no bowel movement by day five after surgery.
    • You have an unexplained severe pain that you didn’t experience while in the hospital.
    • You are nauseated or vomiting.
    • You have asymmetrical leg swelling .
    • You have worsening redness, swelling or drainage from your incisions.

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