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.
How To Return To An Active Sex Life After Prostate Cancer Treatment
No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them. Surgery, radiation therapy and other treatments may impact a patients sex life, causing challenges like low sex drive, loss of penis length, dry orgasm or low sperm counts. Despite the angst these issues may cause, experts say most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment.
Unfortunately, sexual dysfunction is a possibility for nearly all treatment options for prostate cancer, including surgery, says Scott Shelfo, MD, FACS, Medical Director of Urology at our hospital near Atlanta. The degree of dysfunction depends on many factors, including the patients overall health, co-existing medical problems, as well as the patients level of sexual function and ability before treatment.
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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:
Will I have sex after prostate cancer?
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.
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What Are Some Major Surgeries
There are many different surgeries that fall into this category. They include:
- Cesarean section
- Heart surgeries
- Bariatric surgeries, including the gastric bypass
While some of these procedures may be able to be performed in less invasive ways, they still involve major trauma to the body and can have long-lasting complications.
What You Need To Know About Prostate Surgery
What is prostate surgery for?
The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm.
Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia .
Pretreatment education is the first step to making a decisions about your treatment. All types of prostate surgery can be done with general anesthesia, which puts you to sleep, or spinal anesthesia, which numbs the lower half of your body.
Your doctor will recommend a type of anesthesia based on your situation.
The goal of your surgery is to:
- cure your condition
- maintain the ability to have erections
- minimize side effects
- minimize pain before, during, and after surgery
Read on to learn more about the types of surgery, risks, and recovery.
The goal of prostate surgery also depends on your condition. For example, the goal of prostate cancer surgery is to remove cancerous tissue. The goal of BPH surgery is to remove prostate tissue and restore the normal flow of urine.
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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?
Uk Guidelines For Keyhole Surgery
The National Institute for Health and Care Excellence has guidelines for keyhole surgery. These state that surgeons can use it to remove cancer of the prostate but they must:
- tell people having the surgery about the risks and benefits
- monitor people closely
- collect information about any problems people have and report on them
Researchers are looking into whether keyhole surgery is as good as open surgery.
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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
Preparing For A Prostatectomy
The time between a prostate condition being diagnosed and a prostatectomy being scheduled varies depending on the particular person and the advancement of their specific condition. In cases where a prostatectomy is being carried out because of prostate cancer, there is often an interval of six or more weeks between the diagnosis â which involves taking a biopsy â and the scheduling of the operation. This is to allow any inflammation, that has occurred as a result of the biopsy, to heal.
These actions and forward-planning measures are helpful in preparing to undergo a prostatectomy:
Kegel exercises: Schedule an appointment to learn Kegel exercises before the operation. These strengthen the muscles around the bladder and will assist the process of regaining normal urinary function after the catheter, which is regularly administered after surgery, is removed. They should be practiced before and after prostate surgery.
Hospital stay: A prostatectomy is an inpatient procedure that will require a hospital stay of two to three days, in general, after which it is possible to return home. Preparing for this, logistically and emotionally, will make this period run as smoothly as possible.
These medicines and dietary modifications are helpful preparations for the day before the surgery is due to take place:
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Figure 2 Practice Makes Perfect
The likelihood that a surgeon performing laparoscopic prostatectomy will have to switch to open abdominal surgery in order to complete the operation goes down significantly with practice, measured in the number of operations performed.
Source: Journal of Urology, July 2005.
Did he mention anything about the visualization of the neurovascular bundles?
Yes, he felt pretty confident that with the increased magnification, he would be able to move them aside, and remove the prostate with no problem. He said, If the cancer has spread into the seminal vesicles, then obviously we have to deal with that. And we wont know until the operation. But he seemed pretty confident that after the operation Id be in good shape.
Did you consider having robotic surgery closer to home?
You know, I did look into it. But I did some research, and it looked like there werent many people doing this at the time in the city where I live, and they didnt have a lot of experience. One surgeon had done 50 of these operations. The doctor I met with had done about 400. So Im thinking, Okay, 50 versus 400. I think Ill go with the guy whos done 400.
What kind of logistics were necessary, with you being in one city and the operation being done in another?
There were some logistical challenges. I ended up doing the preoperative testing at a hospital near my home, and then had it sent to the surgeon in the other city. He was willing to accept their medical tests.
How long did you have it in place?
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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Where Can I Find Prostate Cancer Support Groups
Even though once you complete the surgery you most likely will find yourself cancer-free, the anxiety and stress may never totally go away. The support of your friends and family is essential in these moments, but the most relief you will find is among people that have gone through the same experience.
We advise you to search locally for prostate cancer or cancer survivors support groups and discuss your journey in beating this. You will find there plenty of people that lived through the same emotions and painful experiences and you will gather your strength to overcome this and not let it define the rest of your life.
If physical presence is not an option for you, there are plenty of forums and online communities that gather around this subject. You can find people that share their experiences and advice below:
Prostate cancer surgery is not as severe of a surgery as other ones. The recovery, especially after robotic surgery, usually lasts up to 2 to 3 weeks and patients can return to work and to living their normal lives.
How Long Is Recovery After Turp Surgery
TURP , or prostatectomy, is the surgical removal of all or part of the prostate. TURP is a major surgery with serious risks and potential complications. You may have less invasive treatment options.
One may also ask, how soon can I drive after a TURP operation? Ask your doctor when you can drive again. Many people are able to return to work within 1 to 3 weeks after surgery. It depends on the type of work you do and how you feel. Do not put anything in your rectum, such as an enema or suppository, for 4 to 6 weeks after the surgery.
One may also ask, what are the after effects of TURP surgery?
Common side effects of TURPCommon side effects after surgery include: bleeding after the operation this usually reduces over time and should stop after four weeks. retrograde ejaculation most men are able to have erections and orgasms after surgery to treat an enlarged prostate.
What is the success rate of TURP surgery?
The 5-year risk rate for a reoperation following TURP is approximately 5%. Overall mortality rates following TURP by a skilled surgeon are virtually 0%.
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Being Diagnosed With Prostate Cancer
One of the most devastating news for a man is a diagnosis of prostate cancer. On receiving such a diagnosis, many men follow the medical protocols by their doctor without doing their own independent research.
Most men scheduled to have their prostates removed are unaware that the surgery may have a little positive effect on their lifespan and a significant negative effect on both sexual ability and quality of life.
This is especially true for localized prostate cancer.
Every man for whom surgery is recommended should get opinions from several doctors or organizations that have no investment in the outcome.
An organization that provides expert professional advice to men with prostate cancer is the Prostate Cancer Research Institute .
They provide a free hotline for patients and caregivers to help them intelligently navigate the maze of options.
Surgical removal of the prostate is considered major surgery, and, as such, it has a significant risk of complications.
In addition, all prostate surgery carries with it the likelihood of severe long-term side effects. This is particularly true in the area of sexual performance and continence.
In many cases, especially with older men, the risks of surgery may be considerably greater than disease progression.
A 2012 study in the New England Journal of Medicine found that adverse events within thirty days after surgery occurred in 21.4 percent of men, including one death.
What Other Tests Do I Need
After prostatectomy, youll probably have a PSA test in about six weeks or so. Your doctor will recommend a follow-up schedule, usually every three months for two years. Depending on the results, you may need to test once or twice a year thereafter. Testing may be more frequent if it appears to be rising.
If your PSA levels are high and you have symptoms such as bone pain, imaging tests can be used to determine if cancer has spread. These may include bone scans and CT scans. If a mass is found, a biopsy can determine if its cancerous.
You might not need treatment right away. If youve had multiple PSA tests and it appears that your PSA level is rising, a number of other factors determine the next steps. These factors include:
- age and life expectancy
- if cancer has spread and where
- previous treatments
Radiation therapy after prostatectomy, also known as salvage radiotherapy, can be quite effective after a prostatectomy. External beam radiation can be delivered directly to the area around where the prostate was. The goal is to destroy prostate cells that may have been left behind after surgery. This lowers the risk of recurrence and metastasis, or of the cancer spreading.
Metastatic prostate cancer may not be curable, but there are treatments to slow progression and manage symptoms. Treatments may include:
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When To Call Your Doctor Or Nurse
Its important to tell your doctor or nurse if:
- your bladder feels full or your catheter isnt draining urine
- your catheter leaks or falls out
- your urine contains blood clots, turns cloudy, dark or red, or has a strong smell
- your wound area or the tip of your penis becomes red, swollen or painful
- you have a fever
- you feel sick or vomit
- you get cramps in your stomach area that will not go away
- you get pain or swelling in the muscles in your lower legs.
Your doctor or nurse will let you know if you should go to the hospital.
What Is The Prostate Gland And Why Is A Prostatectomy Performed
A prostatectomy is performed in order to treat a variety of conditions which can affect the prostate gland. This gland is the size of a walnut and is located inside the male body, beneath the bladder and between the bladder and the penis.
Women also have a gland which is equivalent to it, commonly referred to in medicine as the paraurethral gland or Skeneâs gland, but they are much less likely to be affected by problems in this area than men.
In healthy males, the prostate gland produces prostate fluid, one of the main components of semen. It also contains muscle fibres. During ejaculation, it functions to push the semen into the urethra, the duct which conveys both urine and semen out of the body.
Prostate problems most commonly develop in later life, predominantly affecting men over 50 years of age. Problems, which may be addressed by a prostatectomy, include prostate cancer, enlargement and inflammation . If you are concerned that you, or a loved one, may be experiencing problems related to the prostate, get a free symptom assessment by downloading the Ada app.
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