Which Is The Best Laser For Prostate Removal
Revolix laser. Transurethral resection of the prostate has historically been the treatment of choice in treating BPH. Now, however, removal of the prostate using lasers to vaporize or resect the prostate have replaced TURP as the treatment of choice. RevoLix is the ideal laser for soft tissue removal from the urinary tract.
Side Effects Of Prostate Surgery
The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.
Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:
- Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
- Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
- Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
- Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.
After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
There are several options for treating erectile dysfunction:
Day Before Your Surgery
Follow a light diet
Follow a light diet, such as a small sandwich, eggs, toast, crackers, or soup. Limit the amount of dairy products you eat and drink, and avoid fried foods and foods with a lot of seasoning.
Note the time of your surgery
A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, theyll call you on the Friday before. If you dont get a call by 7:00 pm, call .
The staff member will tell you what time to arrive at the hospital for your surgery. Theyll also remind you where to go.
Do your bowel preparation
The night before your surgery, use a saline enema as instructed on the box.
Shower with a 4% CHG solution antiseptic skin cleanser
The night before your surgery, shower using a 4% CHG solution antiseptic skin cleanser.
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Where To Get Greenlight Pvp Prostate Laser Surgery In Nyc
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
How Long Will Recovery Take
You will likely spend one night in the hospital after the operation and then be discharged home with a urinary catheter in place for seven to 10 days. The catheter is not painful, but may feel uncomfortable, says Dr. Mohler. Many men can barely tell theyve had an operation except for the catheter. Restrictions are similar to other pelvic surgery: no lifting more than five pounds for six weeks. No straining to lift for six months. Men can resume sex and activities such as walking or swimming immediately. More strenuous exercise should wait at least six weeks.
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After Prostatectomy: What To Expect
At the hospital : You should expect to be in the hospital for one night. At Johns Hopkins, all rooms on the urology floor are private. Here, nurses help patients get moving shortly after surgery to prevent blood clots and other postoperative risks.
First few days at home : After youre sent home, you might find that regular ibuprofen or acetaminophen will be sufficient pain management for the first few days. If over-the-counter medications arent enough, your doctor can help you with alternatives.
One week after surgery : After your surgery site heals, your catheter will be removed. This is usually seven to 10 days after surgery. This can easily be done at your doctors office. Some people decide to take out their catheter at home. If thats the case, ask your doctor for instructions first.
This is also about the time your surgeon will call you with the final pathology results. He or she will discuss what you should know and whether further treatment is necessary.
One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery. Most people take off work for three to four weeks. If you work from home, you could return to work sooner.
- Urinary incontinence
- Erectile dysfunction
Recovery from surgery takes time. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help.
Does Incontinence Happen If I Treat Prostate Cancer With Radiation
Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.
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Types Of Prostate Surgery
There are several ways of removing the prostate keyhole surgery either by hand or robot-assisted, and open surgery.
Although robot-assisted keyhole surgery is the newest technique, the most recent research suggests all three techniques are as good as each other for treating prostate cancer, as long as the surgeon is experienced. They also have similar rates of side effects.
The advantages of keyhole surgery, both by hand and robot-assisted, are that you are likely to lose less blood, have less pain, spend less time in hospital, and heal more quickly than with open surgery.
Keyhole surgery .
- Robot-assisted keyhole surgery Your surgeon makes five or six small cuts in your lower abdomen and a slightly bigger cut near your belly button, and removes the prostate using special surgical tools. These include a thin, lighted tube with a small camera on the tip. The image will appear on a screen so the surgeon can see what theyre doing. Your surgeon controls the tools from a console in the operating room via four or five robotic arms. Although its called robot-assisted, its still a surgeon who does the operation. You may hear the equipment called the da Vinci® Robot.
- Keyhole surgery by hand As with robot-assisted keyhole surgery, the surgeon will make four or five small cuts in your abdomen. But they will hold the surgical tools in their hands, rather than using robotic arms.
Tips For A Smoother Recovery
Your doctor will probably recommend that you rest as much as possible for a few weeks after your surgery. Take your time getting back to your routine and keep these tips in mind:
- Dont exercise strenuously or lift anything heavy until you get your doctors permission. You can do gentle or low-impact exercises once you feel up to it.
- Drink at least 8 cups of water per day to flush out your bladder.
- Eat foods that are high in fiber to prevent constipation.
- Wait four to six weeks to start having sex.
- Ask your doctor when its safe for you to drive.
Some side effects, like pain and blood during urination, are normal. You should see your doctor if you notice any of the following:
- signs of infection, including fever or chills
- pain or burning during urination that lasts for more than a few days
- blood clots in your urine
- very red blood in your urine
- trouble urinating
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Things You Should Expect After Prostate Surgery
Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.
In the immediate hours after surgery:
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Erectile Dysfunction Following Radical Prostatectomy
Assuming the management of erectile dysfunction requires expert diagnosis and treatment.
Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.
Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.
Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins noted Sexual Behaviors Consultation Unit.
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What Treatments Are Available To Me If My Incontinence Doesnt Go Away After A Year
While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.
Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.
With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.
An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.
As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor.
What Is A Radical Prostatectomy
Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.
The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.
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After A Radical Prostatectomy: What To Expect
Answers to your questions about sex, incontinence, fertility and more
If your medical team determines that your prostate cancer has become aggressive and needs to be treated, an operation called radical prostatectomy removal of the prostate is typically the first-line treatment. This surgery removes the prostate gland and surrounding tissues such as the seminal vesicles and sometimes nearby lymph nodes.
Minimally invasive techniques and most commonly, robot-assisted surgery help speed recovery after radical prostatectomy, since they cause less blood loss, less pain and shorter hospital stays. At Roswell Park, 100% of radical prostatectomies are performed with robot assistance. Regardless of how the operation is performed, the potential for lingering side effects urinary incontinence and erectile dysfunction must be considered as you decide on your treatment.
The good news is that not all men experience these, says Roswell Park urologist James Mohler, MD, Associate Director and Senior Vice President, Translational Research. And for most of the men who do, these effects are temporary. Here are answers to some of the most common questions men have about recovering from radical prostatectomy.
Getting Ready For Your Surgery
You and your care team will work together to get ready for your surgery.
Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you arent sure.
- I take a blood thinner, such as:
About drinking alcohol
The amount of alcohol you drink can affect you during and after your surgery. Its important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
- If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know youre at risk for these complications, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
Here are things you can do before your surgery to keep from having problems:
If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling .
About sleep apnea
Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device for sleep apnea, bring it with you the day of your surgery.
Ask about medications
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How Does The Procedure Work
After anesthesia, a surgeon will insert a tool called a resectoscope into the urethra. In some cases, a separate device will be used to flush sterile fluid through the surgical site.
Once the surgeon has positioned the resectoscope, they will use it to cut away abnormal prostate tissues and seal broken blood vessels.
Finally, the surgeon will insert a long plastic tube called a catheter into the urethra and flush destroyed prostate tissues into the bladder where they are excreted through urine.
The First Few Days After Surgery
After the successful completion a robotic prostatectomy you will stay in hospital for one to two nights. You will be mobilised early. Most patients wake up with a catheter tube and a small drain. You will be prescribed painkillers as well.
You can expect to have this catheter in place for a week, however, some patients will require it for longer, depending on the specifics of the surgery. Your urology specialist will detail how to care for your catheter and will assist in its removal when ready.
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When To See A Doctor
Most people begin to feel better and have an improved urine flow within 4 to 6 weeks after TURP surgery.
Overall, the risk of serious complications after TURP surgery is quite low. But as with all surgeries, there are some potential health risks associated with the procedure that require medical attention and intervention.
Reasons to seek medical attention after TURP surgery include:
- bleeding from the urethra, outer prostate, or penis
- inflammation and pain in the urethra, prostate, or penis lasting longer than 2 weeks or worsening
- reduced urine flow or urinary symptoms, such as incontinence or urinary urgency 6 weeks post-surgery
- blood in the urine that is severe or lasts longer than 4 to 6 weeks
- severe clots of blood in urine or urine that is entirely red
- weakness and fatigue that does not improve after 4 weeks
- impotence or erectile dysfunction
What Happens Right After Prostate Surgery
After surgery, youll stay in the hospital for a day or two. You may feel sore, but nurses will encourage you to get up as soon as possible. Walking helps your body start to recover from the surgery and function normally again.
Because you cant urinate on your own right away, youll have a catheter in your penis. The thin, flexible tube empties urine into a bag.
Your doctor may prescribe pain medicine for a few days immediately following surgery. After that, youll switch to over-the-counter pain meds.
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What Are The Side Effects
The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .
Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.