Life After Prostate Removal: What To Expect
The prostate gland is prone to inflammation and developing cancer.
Almost half of the men above the age of 60 have benign prostate hyperplasia or prostate enlargement.
However, BPH does not cause removing the prostate, but the presence of cancer or its early sign is the reason for prostate removal.
Prostate cancer has become a significant concern in recent years. Its incidence is increasing, and now its diagnosis is becoming more common even among middle-aged men.
Prostate cancer is now among the most common cancers in older men.
Aging indeed has lots to do with the increased prostate cancer rate, but it is not the only cause. It seems that this disproportionate increase in the annual incidence of prostate cancer also has to do with other lifestyle issues like a high-fat diet, greater prevalence of metabolic disorders, environmental toxins, hormonal changes, and more.
The prostate plays an important role in male fertility and sex life. Although men can survive without a prostate, unfortunately, for many men, prostate removal results in poor quality of life, issues like erectile dysfunction, and more.
Some men can expect to recover well from proctectomy. However, for others the journey to recovery is prolonged and distressing. Keep reading to find out more about life after prostate removal and what you can expect.
Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, its no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.
Treatment options include:
- hormone treatment
If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.
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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.
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How Can A Prostatectomy Impact Your Quality Of Life
Prostatectomy is not life-threatening, but prostate removal significantly affects the quality of life, and it may cause problems like urinary symptoms, bladder issues, erectile dysfunction, and more. T
These issues may last for several months and even years, something patients should be ready for if they decide to have the surgery.
However, a lot depends on the patients age and the kind of surgery done. Studies show that about 60% of patients would make an almost complete recovery within 3 months with no long-term complications. By 12-months, almost 90% of patients can expect to feel much better and nearly normal.
Unfortunately, improvement is slow for some people, and they need 2-3 years to revive their sexual function and get rid of urinary issues. Regretfully, these issues may continue to haunt some for a while.
Here it is vital to understand that the above data is for radical proctectomy . The outlook is better after partial proctectomy.
Overall Outlook Following Prostate Cancer Surgery
Surgery for prostate cancer has been refined over the years, and is now associated with fewer complications and a good long-term success rate. Nonetheless, complications such as incontinence and erectile dysfunction do still occur and can be very distressing.
It is important to ask your surgeon for information about all the things that are important to you before the operation. However, they can only give you statistics and probabilities and will not be able to tell you exactly what will happen to you every man has a different story to tell.
References
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What Are The Long
As per the American Cancer Society, there are two common long-term effects when the prostate is removed urinary inconsistency and erectile dysfuction.
Both these issues are quite common and will last at least three months in all the cases. Most will see improvement in about 12 months.
Nevertheless, some urinary issues and erectile dysfunction may be chronic and last for a few years, requiring continuous care and treatment.
What Changes Do I Need To Make To My Diet
Discuss your post-surgery diet with your doctor as you will probably want to avoid or at least minimize issues such as constipation. The lack of exercise, the medication, even the stress, might affect your bowel functions. Your diet will be focused on eating more vegetables, fruits, grains and avoiding meat, especially the red one, pasta, alcohol, fast-food, sugar and processed desserts.
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How Does The Doctor Know I Have Prostate Cancer
Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.
Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.
If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:
PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.
Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.
Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.
Was The Surgery Successful
The prostate gland will be examined under a microscope in the laboratory after it has been removed. The doctor will check the grade of the cancer cells again. and check that the edges of the prostate are clear of cancer, called ‘checking the margins’.
Negative margins: No cancer cells.Positive margins: Cancer cells found at the edge of the prostate.
These tests are used to predict your response to the treatment along with PSA checks. Your PSA level should drop within weeks of surgery.
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Prostate Removal Surgery: Recovery Time And Its Side Effects
Prostate removal surgery, also called prostatectomy is a procedure to remove prostate gland present in man. During the surgery, prostate can be removed in parts or as a whole prostate gland. Following are the indications for prostate operation
- Prostatism: Benign prostatic enlargement causes increased difficulty while passing urine with considerable frequency day and night, delay in starting and poor stream of urine are some of the symptoms for which prostate removal surgery is advised.
- Acute retention which is not relieved by passing a catheter.
- Chronic retention of urine: When the residual urine in the bladder is 200 ml or more. Raised blood urea, enlarged ureter or enlarged kidney due to urine retention demonstrated on X-ray and sonogram.
- Complications such as stone, diverticulum formation, etc.
- Hemorrhage caused due to ruptured vein overlying the prostate, which does not stop on catheterization, needs emergency prostate removal surgery.
- Lastly, cancer of prostate.
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
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.
Open surgery
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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.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
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Facts About Prostate Removal Surgery
Prostate cancer surgery can be extremely concerning for many patients. You may be wondering how your surgery will be performed because of your prostate glands location. Youll probably have questions about pain and the side effects including questions about your sexual life afterward and your ability to control urine.
The good news is that todays technology offers minimally-invasive prostate removal surgery. The method is known as Robotically Assisted Laparoscopic Radical Prostatectomy . RALP is the most often used surgical method for prostate cancer. The da Vinci robotic system allows surgeons to use one or more small incisions for your surgery. Surgeons use a high-magnification 3D camera system to help them operate with accuracy.
Side Effects Of Removing The Prostate
While it is great to be cancer-free, a prostatectomy is not without risks or side effects. The prostate gland surrounds the urethra and sits close to the muscles responsible for starting and stopping urination. Nerves in the area that control erections are also susceptible to damage.
The most common side effects of removing the prostate are:
- Urinary incontinence
- Altered bowel function
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Immediately After A Prostatectomy
- You will stay in hospital for two to five days.
- Nurses will monitor your vital signs.
- Your pain will be managed with medication.
- You may be given antibiotics to reduce the risk of infection.
- You may have a drip inserted into your arm or hand for a few days.
- You will most likely have a drain tube out of your abdomen that will be removed in the first day or two after the surgery.
- In most cases, you will have to go home still wearing the catheter. You will be taught how to care for it.
Should You Worry About An Elevated Psa After Prostate Removal
PSA stands for prostate-specific antigen and is often a very good indicator of how effective treatment has been, in case of prostate removal or other prostate surgeries.
After prostate surgery, the PSA level gets very low, but this result isnt always reliable. Thats why the patient should discuss the expected PSA levels after prostatectomy with their doctor.
A lower PSA level following the removal of the prostate gland is only a part of the overall picture. There are many factors to monitor closely after prostate surgery.
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Treatment Options For Urinary Incontinence Can Include:
- Pelvic floor physical therapy. These specialized physical therapists are trained to help men strengthen their pelvic floor muscles. These muscles help you control the flow of urine. The exercises are called Kegel exercises just as you might do bicep curls to strengthen your arm muscles Kegel exercises help you learn to tighten and relax the muscles that control your flow.
- Bladder training. The bladder is a muscular organ that can be trained. A pelvic floor physical therapist or your urologist will provide simple behavioral changes to help retrain your bladder.
- Medication. Prescription medicines help the muscles in your bladder and sphincter . These medications work well for men with urge incontinence.
- Surgery. Surgery may be scheduled if you have a blockage. Other surgical procedures include injecting collagen to strengthen the urinary sphincter that controls urine release or implanting an artificial urinary sphincter.
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.
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
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Staging Of Prostate Cancer
Doctors will use the results of your prostate examination, biopsy and scans to identify the âstageâ of your prostate cancer .
The stage of the cancer will determine which types of treatments will be necessary.
If prostate cancer is diagnosed at an early stage, the chances of survival are generally good.
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Prostate Removal Side Effects
Urinary incontinence
It is a common but temporary effect of prostate surgery. Usually, the symptoms improve within a year after the prostate removal.
Sexual dysfunctions
Erectile dysfunction is one of the most common prostate removal side effects. About 40% of men lose some erectile function after radical prostatectomy, but they see gradual improvements within 2-3 years.
Infertility
Other side effects of prostate removal
In rare cases, bowel function is affected and dry orgasms appear.
Robotic Or Laparoscopic Prostatectomy
Robotic prostate surgery removes the entire prostate gland and is done by laparoscopic or robotic techniques. This type of surgery is less invasive than radical prostatectomy, in which a camera and instruments are inserted through key-hole incisions into the pelvic region. This allows a better view of the pelvic area without a large abdominal incision. The surgeon then controls the robotic instrument for the operation of prostate removal.
Robotic prostatectomy causes less bleeding and less pain and may shorten recovery time. The sexual and urinary side effects are similar to those of radical prostatectomy.
Why is da Vinci® prostatectomy a good option for prostate removal?
Robotic prostate surgery is accomplished using the da Vinci® Surgical System, which allows surgeons to operate with improved vision, dexterity, and control.
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While In The Hospital
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.