Talking With Your Doctor
Different kinds of doctors and other health care professionals manage prostate health. They can help you find the best care, answer your questions, and address your concerns. These health care professionals include:
- Family doctors and internists
- Physician assistants and nurse practitioners
- Urologists, who are experts in diseases of the urinary tract system and the male reproductive system
- Urologic oncologists, who are experts in treating cancers of the urinary system and the male reproductive system
- Radiation oncologists, who use radiation therapy to treat cancer
- Medical oncologists, who treat cancer with medications such as hormone treatments and chemotherapy
- Pathologists, who identify diseases by studying cells and tissues under a microscope
View these professionals as your partnersâexpert advisors and helpers in your health care. Talking openly with your doctors can help you learn more about your prostate changes and the tests to expect.
Post Greenlight Laser Surgery Recovery
I had GL surgery four days ago and would appreciate feedback regarding the recovery process from those that have also undergone this procedure. I currently void every 30 to 60 minutes at night and every 30 to 60 minutes during the day. My flow is a stream for a few seconds then dribbles for maybe 30 seconds. Is this pretty typical? After the surgery I was drinking 1 1/2 liters of water per day but I may reduce this because I am not convinced my bladder is emptying fully. What do you think about this? When I void, it really burns at first and often I will get bladder spasms as well. Do you think the pain is radiated pain from where the prostate was vaporized? Do you think I will see improvement with these symptoms on a daily basis or weekly basis over the next month or so?
3 likes, 163 replies
Posted 7 years ago
I had a similar problem. it was caused by blood clots forming in the uretha and thus the inconsistant flow of urine.I went to A& E because i was unable to pass urine at all at one stage. They flushed out the bladder and it was unbelievable how many clots there were. They are unlikely to disove them selves. BVut this is some thing yiu need to check out.
Posted 4 years ago
I have had the surgery 2010 and since been having problems with bladder not emptying it sounds like Im going to have it redone again
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How Much Pain Might I Have
Some men have no pain at all. Men who do have pain experience different levels of pain. Some men only feel mild discomfort and are able to carry out their daily activities as normal, but other men find that the pain affects their daily lives.
Only you can describe how your pain feels. Another man with advanced prostate cancer may not feel pain in the same way. So predicting how much pain you might have is difficult, as it varies from man to man.
How much pain you have will depend on several things, including:
- where the pain is
- whats causing the pain
- how soon your doctor or nurse can help you manage the pain
- finding the right pain relief for you
- taking the right amount of pain-relieving drugs at the right times
- how tired you feel
- how well you feel in general
- if you feel anxious
- if you feel depressed.
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Adverse Reactions To The Anesthesia
If a person has a history of swelling of the face or generalized itching, it is important to inform the anesthetist before the procedure because, although allergic reactions to anesthesia can be mild, involving only wheezing or some skin irritation, it is also possible to experience an anaphylactic response which can be life-threatening.
Somebody suffering from an allergic reaction to an anesthetic may display signs like breathing difficulties, low blood pressure, rashes, hives and swollen skin around the eyes or mouth and throat. It is possible to perform tests prior to the surgery to identify which chemicals trigger an allergic reaction and if necessary an appropriate alternative anesthetic solution can then be chosen.
Other adverse reactions, such a muscle soreness, a sore throat from the breathing tube or nausea and vomiting after the surgery are a lot more common than allergic reactions. Around 10 percent of people will experience some kind of adverse reaction to anesthetic drugs, and anesthetists are trained to recognise and treat reactions as and when they occur during or after surgery.
Symptoms Of Metastatic Prostate Cancer
Metastatic prostate cancer means that a cancer that began in the prostate gland has spread to another part of the body. It is also called advanced prostate cancer.
If your prostate cancer has spread you might:
- have bone pain
- feel generally unwell
- have weight loss for no known reason
You might have specific symptoms depending on where the cancer has spread to. These symptoms can also be caused by other medical conditions so might not be a sign that the cancer has spread.
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Drugs To Strengthen The Bones
Treatment for bone pain is usually reserved for men with advanced prostate cancer. IF you have advanced prostate cancer, its likely youre already receiving cancer drugs to treat the cancer directly. For bone pain specifically, Filson says bisphosphonates are the usual course of treatment. Cancer drugs that lower testosterone can weaken bones, and doctors prescribe bisphosphonates to help reverse the process.
What Is A Prostatectomy
A common surgical approach to prostatectomy includes making a surgicalincision and removing the prostate gland . This may beaccomplished with either of two methods, the retropubic or suprapubicincision , or a perineum incision .
Prior to having a prostatectomy, it’s often necessary to have aprostate biopsy. Please see this procedure for additional information.
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Glute Stretch: 3 X 15 Sec Holds
This stretch hits the tightness that youre sure to have around your hips by targeting the glute muscles. Despite what will most likely feel really good, it is still important to be sure that youre not aggravating the surgical site if its still early in recovery. If you arent feeling it in your glutes remember to draw your knee towards your opposite shoulder.
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Infections At The Surgery Site
The parts of the body which are most likely to be infected after surgery are located in the abdomen . Infections after prostate surgery, if they occur, are usually due to the intestine being injured during surgery, which is more common in cases where the operation has been carried out by keyhole surgery than when an open approach has been used.
Other Symptoms Of Prostate Cancer
Prostate cancer usually has no early warning signs. Because of this, many doctors and health authorities recommend screening men at risk.
When prostate cancer does cause symptoms, they may include:
- a frequent, urgent need to urinate
- nocturia, or needing to urinate frequently during the night
- reduced urine flow
- trouble starting or stopping the flow of urine
- pain with urination or ejaculation
- blood in the urine or semen
However, these can also be symptoms of other conditions, including:
- benign prostatic hyperplasia, which is enlargement of the prostate and very common in older men
- prostatitis, which is inflammation of the prostate
Neither of these conditions involves cancer, but it is still important to see a doctor for evaluation and treatment.
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Can Back Pain Be A Symptom Of Prostate Cancer
Prostate cancer cells may spread to a persons bones.
There can be a connection between back pain and prostate cancer, but back pain alone is not necessarily a sign of the disease.
In advanced prostate cancer, cancer cells spread beyond the prostate to other parts of the body. These cells usually spread to the bones first, and doctors refer to this as bone metastasis.
If prostate cancer spreads to the bones, it most often reaches the spine, ribs, and hips. This occurs in stage 4 prostate cancer, and it can cause pain. According to ZERO, an advocacy group, bone metastases will affect more than 60 percent of men with advanced prostate cancer.
Individuals with chronic back pain that has no obvious cause should see a physician for an evaluation.
Living With Prostate Cancer
Receiving a diagnosis of prostate cancer can be alarming studies show that the risk of suicide and cardiovascular disease goes up in the week after someone is told they have prostate cancer.
If you feel anxious, frustrated or upset about how prostate cancer may be affecting your life, talk with your doctor, partner or friend and get support.
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Additional Treatment After Surgery
Additional treatment can come with one of two approaches: treatment given as adjuvant therapy , or as salvage therapy . In the modern era, most additional treatment is given as salvage therapy because firstly this spares unnecessary treatment for men who would never experience recurrence, and secondly because the success rates of the two approaches appear to be the same.
Regardless of whether an adjuvant or salvage therapy approach is taken, the main treatment options following biochemical recurrence are:
- Radiotherapy this is the commonest approach. Because scans dont show metastatic deposits until the PSA is more than 0.5 ng/ml and because radiotherapy is more effective when given before this level is reached, the radiotherapy energy is delivered to the prostate bed. This is because we know that this is the commonest site of recurrence in most men, and that 80% of men treated in this way will be cured.
- Active surveillance this is appropriate for a very slowly-rising PSA in an elderly patient who has no symptoms.
- Hormonal therapy in many ways this is the least appealing option as it causes symptoms but does not cure anyone, although it does control the recurrence and lower the PSA.
Prostate Cancer Recurrence After Prostatectomy: Why Does It Happen And How Do We Treat It
Filed in Life After Treatment
The concept of prostate cancer recurrence after prostatectomy puzzles many patients. A frequently asked question is how can the cancer come back if the prostate has been removed? The explanation is that, as with any cancer, if cancerous cells migrate out of the organ in which they arose before the organ is removed , they can settle and grow elsewhere. These migrating cells are called metastases, secondary deposits or secondaries.
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Do All Men With Advanced Prostate Cancer Have Pain
No, not all men with advanced prostate cancer have pain. Men who do have pain experience different levels of pain. Pain is more common in men whose cancer has spread to their bones. If the cancer has spread to several places in your body, you might not get pain in all of these places.
With the right treatment and management, pain can usually be relieved or reduced. Tell your doctor or nurse if youre in pain or your pain relief isnt working well.
Who Is It Suitable For
GreenLight Laser surgery is suitable for any patient that TURP is indicated, with the exception of men who need laboratory analysis of the prostate tissue that is removed. The latter will be relatively few with the use of the prostate-specific antigen tests and other prostate diagnostics that are available.
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Reasons For The Procedure
The goal of radical prostatectomy is to remove all prostate cancer. RP isused when the cancer is believed to be confined to the prostate gland.During the procedure, the prostate gland and some tissue around the gland,including the seminal vesicles, are removed. The seminal vesicles are thetwo sacs that connect to the vas deferens , and secrete semen.Other less common reasons for radical prostatectomy include:
Inability to completely empty the bladder
Recurrent bleeding from the prostate
Bladder stones with prostate enlargement
Very slow urination
Increased pressure on the ureters and kidneys from urinary retention
There may be other reasons for your doctor to recommend a prostatectomy.
Treating Prostate Cancer That Doesnt Go Away Or Comes Back After Treatment
If your prostate-specific antigen blood level or another test 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 you’ve already had. Imaging tests such as CT, MRI, or bone scans may be done to get a better idea about where the cancer is.
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How Will Prostate Surgery Affect My Sex Life
Experienced robotic surgeons like Dr. David Samadi dont open the endopelvic fascia during surgery, which spares the rick of damage to nerve bundles that control sexual function. The recovery of the function, however, is not immediate and you should not feel discouraged if weeks or even a few months after surgery you experience erectile dysfunction. It is not an indication of long-term damage.
One major change that you will notice in your sex life is the absence of sperm. Having no prostate, the body will not produce semen during the orgasm. The sperm cells will be simply reabsorbed by the body them. This is not harmful and you shouldnt be worried about it. Plenty of men deal with the problem with the help of medication that improves erectile dysfunction.
What Are The Symptoms Of Prostate Cancer
Even if you have prostate cancer, you may not notice any symptoms unless the cancer grows large enough to cause problems.
Some symptoms of advanced prostate cancer include:
- needing to urinate frequently or suddenly
- finding it difficult to urinate
- discomfort when urinating
- finding blood in urine or semen
- pain in the lower back, upper thighs or hips
While these symptoms might not mean prostate cancer, if you notice any of them, check with your doctor.
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Radical Prostatectomy Perineal Approach
You’ll be placed in a supine position in which the hips and knees will be fully bent with the legs spread apart and elevated with the feet resting on straps. Stirrups will be placed under your legs for support.
An upside-down, U-shaped incision will be made in the perineal area .
The doctor will try to minimize any trauma to the nerve bundles in the prostate area.
The prostate gland and any abnormal-looking tissue in the surrounding area will be removed.
The seminal vesicles may be removed if there’s concern about abnormal tissue in the vesicles.
Details Of The Procedure
In the majority of cases men will be treated with a single overnight stay in hospital or be allowed to return home on the same day as their operation. A general anaesthetic most commonly is used for this prostate laser surgery. A telescopic camera is then inserted into the penis and the internal surface of the prostate visualized. The GreenLight laser beam is then directed onto the prostate surface and tissue vaporized in an almost bloodless fashion. GreenLight Laser vaporization is continued until all obstructing prostate tissue has been removed.
A small urethral catheter is inserted at the end of the procedure. This is left in place overnight only. After removal of the catheter, men go home once they have successfully passed urine and emptied their bladder.
Follow-up takes place 12 weeks after the prostate laser surgery to confirm symptomatic improvement.
The Prostate Clinic
The Prostate Clinic, located in Australias Gold Coast, specialise in minimally invasive surgery and treatments, for the prostate and prostate cancer.
Dr. Charles Chabert carries out medical therapy and procedures such as robotic prostate surgery and UroLift, to GreenLight laser prostate surgery or laser prostate surgery. These treatments are aimed at patients with prostate cancer, those seeking enlarged prostate treatment, erectile dysfunction and/or urinary incontinence.
Contact The Prostate Clinic to arrange an appointment to discuss your diagnoses and plan your way forward.
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What Factors Increase The Chance Of Cancer Recurrence
The likelihood of metastasis occurring increases with higher grade and stage of the cancer as the more aggressive and developed the cancer is, the higher the chance of it breaking out of the prostate. More specifically:
- High Gleason grades
- High clinical stages
- Positive surgical margins .
However, most prostate cancers are cured with surgery. As an example, using my results from operations performed on over 2,300 men with a variety of stages and grades, 96.3% of operations resulted in full cancer cure. Some combinations of minor prostate cancer had a 100% cancer cure rate, but the higher you go, the lower the full cancer cure rate.
The commonest sites of recurrence of prostate cancer following surgery are:
- the prostate bed 80% of recurrence cases
- lymph nodes 15% of cases
- bones 5% of cases.