The Morning Of Your Surgery
Instructions for drinking before your surgery
You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.
Take your medications as instructed
If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.
Shower with a 4% CHG solution antiseptic skin cleanser
Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.
Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.
Things to remember
- Wear something comfortable and loose-fitting.
- If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
- Dont wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
- Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
- Leave valuable items at home.
What to bring
Once youre in the hospital
Get dressed for surgery
When its time to change for surgery, youll get a hospital gown, robe, and nonskid socks to wear.
Meet with a nurse
Less Time Under Anesthesia With Open Prostatectomy
An open prostatectomy, however, is a much shorter surgery than the robotic procedure, which means patients spend less time under anesthesia. Length of anesthesia for an open prostatectomy is 2 to 3 hours, compared to 4 to 7 hours for a robotic prostatectomy.
In several measures, there is no demonstrated difference between open and robotic prostatectomy. The risk of blood transfusion for an open prostatectomy is less than 1 percent, and fewer than 1 percent of patients have wound complications. Post-operative pain on the morning following surgery is typically 2 on a 10-point scale. The patients length of stay in the hospital is 1½ to 2 days. Approximately 85 percent of patients regain excellent urinary control, and three-quarters retain sexual potency.
While all precautions are taken to reduce the likelihood of complications, no surgical treatment is completely without risk. Potential complications of open and robotic prostatectomies include infection, bleeding requiring blood transfusion, urinary incontinence, erectile dysfunction and injury to adjacent organs.
What Are The Advantages Of Laparoscopy
As is the case with other minimally invasive procedures, laparoscopic prostate removal has significant advantages over traditional surgery:
- Laparoscopy can shorten your hospital stay to 1 or 2 days. About 50% of men are discharged one day after surgery.
- There is much less bleeding during the operation.
- You are less likely to need prescription painkillers after you leave the hospital. Patients often need nothing more than Tylenol.
- At your follow-up appointment 1 week after surgery, the tube, or catheter, draining your bladder will be removed if there are no signs of other problems. Occasionally, the catheter remains in place for another week, as with conventional surgery.
- About 90% of patients can return to work or resume full activity in only 2 to 3 weeks.
Read Also: What Is Perineural Invasion In Prostate Cancer
Talking Counselling And Sex Therapy
Talking to your partner about your erection difficulties can help. Or it may help to talk to a close friend if you are not in a relationship.
Not talking to those close to you could be one of the main barriers to coping with this side effect. You might then find it easier to consider ways that could help.
Counsellors or therapists can help if youre worrying about anything to do with your sex life and sexuality. You can be referred by your GP to a counsellor or therapist within the NHS. You might need to go on a waiting list to see them.
Talk to your GP to find out what is available in your area. Your local hospital or your local Erectile Dysfunction Clinic might have this service.
The drugs used to treat erection problems include:
- tadalafil
- vardenafil
- avanafil
These belong to a group of drugs called phosphodiesterase type 5 inhibitors. They work by increasing blood flow to the penis. For the drugs to work, men need to be aroused and have some sort of sexual stimulation. In other words, the drugs wont cause an immediate erection, some foreplay is usually needed.
As drugs work best in men who have sexual desire, they might not help some men who are having hormone therapy. There is limited evidence to say these drugs work when having hormone therapy. But some specialists believe that they are still worth a try if you would like to give them a go.
Possible side effects of PDE 5 inhibitors include:
- headaches
- temporary problems with vision
What Concerns Could Arise
Some men experience a loss of desire for sex, an inability to achieve or maintain an erection, inability to reach orgasm or have a change in orgasm , experience pain during sex, or just do not find sex pleasurable. Sexuality is an important factor in their quality of life for many men. Know that these concerns are common and your healthcare team can provide guidance. Write down your questions and concerns so you dont forget to ask about them. If your provider cannot help, ask them to recommend someone who can.
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What Is A Robotic Or Laparoscopic Radical Prostatectomy
Now routine procedures at Cleveland Clinic, laparoscopic or robotic prostatectomy are minimally invasive surgery procedures used to remove the prostate. Both forms of surgery are now routinely offered at the Cleveland Clinic to patients with prostate cancer. Our single-institution experience now exceeds 1000 cases of laparoscopic and robotic prostate surgery performed.
How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
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Newly Diagnosed With Prostate Cancer Why Choose Robotic Prostatectomy
When first diagnosed with prostate cancer, its common for men to wonder what the future will hold. Certainly, a prostate cancer cure is a top priority, but then what?
Dr. David Samadi understands that men want to know:
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Will I have sex after prostate cancer?
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How will sex after prostate cancer be different?
For many men, prostate cancer treatment choice determines these answers.
If you select robotic prostate surgery your chances of enjoying sex after prostate surgery are very high. Robotic prostatectomy is a minimally invasive prostate removal. It is considered one of the best treatment options for prostate cancer due to its success rate and fast recovery rate.
The da Vinci robotic prostate cancer surgery system enables the surgeon to make precise movements. This ensures cancer-removal efficiency and sparing of the nerves and muscles that are responsible for the sexual function.
However, it is absolutely critical to choose a robotic surgeon with a high case volume and extensive prostate surgery experience. The robot does not perform the surgery and technology is no guarantee of success.
Dr. Samadi explains how the preservation of sexual function is possible:
If my only responsibility was to remove the cancerous prostate, my job would be much easier, he acknowledges, But patients deserve much more than that. It was paramount that I find a way to remove the prostate gland without damaging functions critical to a comfortable and enjoyable life after recovery.
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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What Is The Importance Of Preserved Erectile Function
In considering the impact of the various treatment approaches for prostate cancer on their quality of life, many patients place paramount importance on the possibility of retaining natural erectile function. This matter is frequently important to young men who by age status are more likely to have intact erectile function than older men however, for all men having normal preoperative erectile function irrespective of age, preservation of this function is understandably important postoperatively.
S To Recover Orgasm And Potency After Prostatectomy
The key to enjoying sex after prostate surgery is to start when youre ready. Dr. Samadi and his knowledgeable team are available to support you and your partner as you work to resume sexual activity.
Sex After Prostate Surgery Getting Started
- Masturbate:This helps you learn how your body will respond to stimulation after surgery and builds your sexual confidence.
- Kegel exercises:Try out pelvic floor exercises to improve orgasm and urinary control.
- Involve your partner:
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Life Expectancy And Localized Prostate Cancer
So how do these treatments affect life expectancy? In one study, researchers in Switzerland examined the treatment and outcomes of 844 men diagnosed with localized prostate cancer. They compared men who had been treated with prostatectomy, radiotherapy and watchful waiting and found that at five years from diagnosis, the type of treatment made little difference to survival. When the researchers went to 10 years from diagnosis, they did find a difference in survival based on treatment, but it was fairly small.
After 10 years, 83 percent of the men who had gotten a prostatectomy were still living, compared to 75 percent who had undergone radiotherapy and 72 percent who took a watchful waiting approach.
What Is The Most Common Approach
A technique called transurethral resection of the prostate is considered to be the standard surgical approach. This procedure involves inserting a thin tube called a resectoscope into the urethra and guiding it through to the prostate. The resectoscope is equipped with a tiny camera and an electrical loop that is used to mechanically remove prostate tissue. The loop produces heat at the same time, which quickly seals off the blood vessels. The resectoscope also has valves that regulate the release of fluid to flush the removed tissue out. TURP takes about 90 minutes and is done under local or general anesthetic. Men who have had this procedure usually need to have a urinary for a few days after, and generally stay in the hospital for two to seven days. They then have to rest and take it easy for a few weeks.
Some variations of TURP are also considered to be standard treatments and have similar outcomes and consequences to conventional TURP. These include transurethral electrovaporization , transurethral vaporesection and plasmakinetic enucleation of the prostate .
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Erectile Dysfunction Or Impotence Post
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Impotence is simply described as the inability to achieve or maintain an erection suitable for sexual intercourse. Impotence affects 20 million American men or about 10% of the entire male population and 35% of the men over the age of 60. An erection is created when the penis fills with blood much like a tire fills with air. Blood is pumped into the penis and not allowed out, and the more blood that is pumped in, the firmer the erection. The reasons for lack of erections are either the lack of appropriate filling of the penis or inappropriate emptying.
For men who have had radical prostatectomy for prostate cancer, the nerves that control the flow of blood into and out of the penis may be cut or removed. These nerves do not control the sensation to the penis, nor are they responsible for the orgasm that occurs with sexual intercourse. Only the firmness of the penis is affected.
If nerve sparing was attempted during your procedure, the return of erections could take as long as 6 to 18 months. Partial erections may return earlier and may be a sign of subsequent complete return of function, although not a guarantee. Partial recovery is actually quite common and lends itself to some other options for treatment.
Medical Treatment
Injection Therapy
Urethral Suppositories
MUSE was released in early 1997 and more experience will be gained over the first few years that it is available to the public through their physicians.
Vacuum Devices
What Is New?
What Have I Learned By Reading This
You learned about:
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.
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Treatment Options For Localized Prostate Cancer
If you are diagnosed with low-risk prostate cancer, you may be presented with a number of different treatment options. The most common include:
- Active Surveillance: Your doctor may want to monitor your disease to see if treatment is necessary. With active surveillance, you will have regular check-ups with your doctors, and he or she may perform biopsies regularly. If your test results change, your doctor will discuss your options for starting treatment.
- Watchful Waiting: While some doctors use the terms active surveillance and watchful waiting interchangeably, watchful waiting usually means that fewer tests are done. You will still visit your doctor regularly, but your doctor will discuss changes in your health as they relate to managing your symptoms, not curing your disease.
- Prostatectomy: Removal of the prostate, called prostatectomy, is an option that has a strong likelihood of removing your cancer since you are removing the gland where it is located. However, this is an invasive procedure that can lead to other issues, which will be covered later.
- Radiation: Your doctor may suggest radiation as a means of therapy that targets tumors with radiation, usually through daily treatments in a hospital or clinic over multiple weeks.
Risks Of Radical Prostatectomy
Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.
Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:
- Urinary incontinence: More than 95% of men younger than age 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
- Erectile dysfunction : Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED , an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.
Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.
Other complications of radical prostatectomy include:
- Bleeding after the operation
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Life After Prostate Removal: Postoperative Care And Recovery
The duration of time people stay in hospital after their prostatectomy varies, though it will usually be between two and three days. However, if open surgery is performed this timeframe may rise to seven or more days in hospital, depending on which hospital and country the surgery is performed in.
After this, it will be necessary to spend some recovery time at home while the surgery site heals the length of this may vary depending on the type of operation. It is possible, particularly if the procedure was a laparoscopic prostatectomy, to recover sufficiently to return to work after a period of two to three weeks. Nearly everybody who undergoes a prostatectomy recovers sufficiently to return to work after six weeks.
As soon as the operation is complete, and while the person undergoing the procedure is still in the operating room, a temporary suprapubic catheter will be inserted to assist them in urinating during the immediate recovery process. A suprapubic catheter is a hollow, flexible tube which is inserted into the bladder through an incision in the stomach above the navel . The catheter is left in place for one or two weeks and helps drain the urine from the bladder whilst the area, which has undergone surgery, is healing. In some cases, instead of the suprapubic catheter, a transurethral catheter leading from the exit of the urethra at the tip of the penis to the bladder may be inserted.