Tuesday, January 31, 2023

Surgical Removal Of Prostate Gland

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Minimally Invasive Surgical Options

Robotic surgery for prostate cancer

In minimally invasive surgical procedures, we make several small incisions in your abdomen. We then insert a tiny, lighted telescopic camera called a laparoscope, along with specially designed surgical instruments that a surgeon uses to perform the operation.

When you have minimally invasive surgery, youre likely to have less discomfort after the procedure and more likely to recover faster than with a traditional open surgery, in which incisions are larger and more extensive. Many men who have their prostates removed in a minimally invasive operation are able to return home the following day.

We offer two types of minimally invasive surgery.

Many of our surgeons perform robot-assisted laparoscopic prostatectomy. This sophisticated tool offers much finer precision than any other surgical technique.

Using a device called the da Vinci® Surgical System, a surgeon performs the operation while seated at a console that has a viewing screen as well as hand, finger, and foot controls. The screen projects a three-dimensional image, magnified tenfold, of the prostate and the surrounding area. This allows the surgeon to view the surgical site in great detail. The robot then translates the surgeons hand, wrist, and finger movements into real-time movements of the instruments inside the patient.

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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.

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.

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How Is Prostate Surgery Performed

Surgeons perform prostate resections to remove only part of the prostate gland when it is enlarged. These are minimally invasive procedures with no incisions in your skin. They are often done with local anesthetic or regional anesthesia, although you may require general anesthesia. If you have a local anesthetic or regional block, you will also receive a sedative to relax you during the procedure.

Here are the different prostate resection procedures:

Surgeons perform prostate removal surgeries while you are under general anesthesia in a hospital operating room. There are several approaches your surgeon may choose from, depending on your diagnosis and overall health:

Open Radical Prostatectomy Vs Minimally Invasive Radical Prostatectomy

Prostate surgery

In 2003, only 9.2% of radical prostatectomies were done using a minimally invasive procedure. By 2007, that number had jumped to 43.2%. In 2009, researchers in Boston reported on a study that compared outcomes, benefits, and complications of open surgery vs. minimally invasive surgery:

  • No difference was found in deaths or in the need for additional cancer therapy between the two approaches.
  • The median hospital stay was two days for minimally invasive surgery and three days for open surgery.
  • 2.7% of men having laparoscopic surgery required a blood transfusion compared with 20.8% of men having open surgery.
  • There was more anastomotic stricture narrowing of the suture where internal body parts are rejoined for open surgery than for minimally invasive surgery .
  • There were fewer respiratory complications with minimally invasive surgery than with open surgery .
  • There were lower rates of incontinence and erectile dysfunction with open surgery. The overall rate was 4.7% for laparoscopic surgery and 2.1% for open surgery.

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Surgery To Remove Prostate Cancer

Surgery is one of the main treatments for prostate cancer. You usually have surgery to remove your prostate gland. This is a radical prostatectomy.

A radical prostatectomy is a major operation with some possible side effects. You may not need this type of surgery if you’re an older man with a slow growing prostate cancer. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.

What Are The Risks Of Prostate Cancer Surgery

If your prostate cancer treatment plan includes surgery, you might be wondering about the risks associated with your procedure. The oncologists in the Urologic Oncology Program at Moffitt Cancer Center can provide some general information for you to consider. We encourage you to review this information prior to having an in-depth discussion about your individual risk profile with your treatment team, which is always your best source of advice and support.

The most commonly recommended type of surgery for prostate cancer is a radical prostatectomy. This procedure involves the removal of the entire prostate gland and some surrounding tissues, including the seminal vesicles. Like all forms of surgery, a radical prostatectomy has some inherent risks, which can vary widely from patient to patient.

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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.

Urgent Signs And Symptoms

Surgery versus radiation

For emergencies that can’t wait, call 911.

  • You have a persistent or recurring temperature greater than 101 F or repeated chills.
  • Your catheter stops draining urine despite adequate hydration and no kinks in the tubing.
  • Your urine in your Foley catheter is cloudy, foul smelling or persistently bloody .
  • You have no bowel movement by day five after surgery.
  • You have an unexplained severe pain that you didn’t experience while in the hospital.
  • You are nauseated or vomiting.
  • You have asymmetrical leg swelling .
  • You have worsening redness, swelling or drainage from your incisions.

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What Should I Expect Following Prostate Cancer Surgery

If you undergo a radical prostatectomy, you can expect to be hospital-bound for one to three days after the procedure. Youll likely have a catheter to assist you in urinating. This catheter might need to stay in place for some time, even after youve returned home. Typically, most men will keep the catheter in for up to two weeks following surgery. Your doctor and healthcare team will help to determine how long you need to continue using the catheter.

It is common to experience some pain following prostate surgery. This pain is typically controlled with prescription medication or over the counter medications, such as ibuprofen or acetaminophen. Depending on whether youve had robotic surgery or open surgery, the duration of pain can vary. Generally speaking, recovery time after prostate cancer surgery is 4-6 weeks. Consult with your doctor to determine the best pain management plan for you.

Youll need to schedule follow-up visits with your physician. Though prostate surgery is often successful, there is always a chance that the cancer might return.

What Is The Outlook For Men Who Have Benign Prostatic Hyperplasia Surgery

Benign prostatic hyperplasia surgery has a very high success rate. However, for the best results from treatment, you should seek medical help at the earliest signs of a problem. Also, talk with a doctor if you are experiencing symptoms of BPH after surgery.

There is no evidence that BPH increases the risk of developing prostate cancer. However, the symptoms of BPH and prostate cancer are similar. The American Urological Association and the American Cancer Society recommend annual prostate screenings for men ages 55 to 69. Men at high risk such as African-American men and men with a family history of prostate cancer should begin screening at age 40.

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What Are The Benefits Of Prostatectomy

Prostatectomy is most commonly performed to treat prostate cancer, in conjunction with other therapies such as radiation therapy, chemotherapy, hormone therapy, etc. It is also performed for BPH patients to provide permanent relief from urinary symptoms caused due to an enlarged prostate gland.

Benefits of prostatectomy inlcude:

  • Permanently removes cancer cells from the body by removing all the prostate tissue and its surrounding structures
  • Long-term relief from urinary symptoms of BPH, such as:
  • Frequent urinary urge
  • Difficulty in starting and maintaining urinary stream
  • Increased urinary urge at night
  • Feeling of bladder fullness even after urinating
  • Frequent urinary tract infections, etc.

Changes In Your Sex Life

Prostate surgery

Most men experience some decline in erectile function after their prostate is removed, but this can be managed. It can take six months or even up to a year for the affected nerves to recover from surgery. But with proper therapy and treatment, most patients can have good erectile function again, says Dr. Fam.

Treatment options include:

Work with your doctor to find a treatment that is right for you.

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What To Expect After Radical Prostatectomy

Most men stay in the hospital for 1 to 3 days after radical prostatectomy. Your care team inserts a urinary catheter during the surgery, and some men may need to wear the catheter home for a few days to a few weeks. Another catheter inserted through the skin also may need to stay in place for a few days after returning home.

Pain after radical prostatectomy can generally be controlled with prescription pain medicines. It can take weeks or months for urinary and sexual function to return to their maximum levels.

After radical prostatectomy, itâs important to see your doctor for all your regular follow-up appointments to make sure your prostate cancer doesnât return.

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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.

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Are There Differences Between Orp Lrp And Ralrp

According to a 2010 of different surgery types for prostate cancer, the outcomes for open radical prostatectomy , laparoscopic , and robotic-assisted prostatectomy are not significantly different.

But people who choose LRP and RALRP may experience:

  • less blood loss
  • shorter hospital stay
  • faster recovery time

Also, people who choose RALRP report faster recovery in continence and decreased hospital stay, in comparison to LRP. But the overall outcomes still depend on the surgeons experience and skill.

What Is A Prostatectomy

How Radiation Affects The Prostate | Mark Scholz, MD

A prostatectomy is a surgical procedure for the partial or complete removalof the prostate. It may be performed to treatprostate cancerorbenign prostatic hyperplasia.

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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Who Should Get A Radical Prostatectomy

Men younger than 75 years old with limited prostate cancer and who are expected to live at least 10 more years tend to get the most benefit from radical prostatectomy.

Before doing a radical prostatectomy, doctors first try to confirm that the prostate cancer has not spread beyond the prostate. They can figure out the statistical risk of spread by looking at tables comparing the results of a biopsy and PSA levels.

Other tests to check for signs of spread, if needed, can include CT scans, bone scans, MRI scans, ultrasound, PET scans, and bone scans.

If it appears that the prostate cancer hasnât spread, your surgeon may first offer you other options besides surgery. These can include radiation therapy, hormone therapy, or simply watching the prostate cancer over time, since many prostate cancers grow slowly.

Depending on how high your risk of the cancer spreading is, your surgeon may also consider doing an operation called pelvic lymph node dissection.

Transurethral Resection Of The Prostate

Transurethral resection of the prostate is a urological operation that involves cutting away a section of the prostate. It is most often used to relieve symptoms of urinary blockage, not necessarily to treat prostate cancer.

An instrument called a resectoscope is inserted through the opening of the urethra and the surgeon removes the inner part of the prostate gland .

The intervention lasts about an hour and it is most often used for non-cancerous blockage, but may also be used in cases of prostate cancer. The doctor doesnt need to make any incisions on the body. While most people can go home the same day, it is also likely that patients spend one or two days in the hospital. After the surgery, a urinary catheter will be placed because of the swelling that blocks urine flow.

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What Are The Risks And Potential Complications Of Prostate Surgery

All surgical procedures have a risk of complications. The general risks of surgery include:

  • Anesthetic reaction

  • Bleeding, which can be extensive with some open procedures

  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs causing a pulmonary embolism.

  • Confusion or delirium from the anesthesia, particularly among older men

  • Damage to nearby organs

What Are The Types Of Prostate Surgery For Benign Prostatic Hyperplasia

How Is Prostate Surgery Performed

Several minimally invasive surgeries may be used for benign prostatic hyperplasia. These include:

GreenLight laser: Photoselective vaporization of the prostate is a treatment that vaporizes prostate tissue to create a channel in the urethra for free urination. This is surgical treatment performed in the operating room under general anesthesia.

Plasma button electrovaporization: Prostate tissue is removed using low temperature plasma energy. Tissue is vaporized. This is an operating room-based therapy and requires an anesthetic.

Water vapor therapy : Water vapor is directly delivered to the prostate tissue. Over a 3-month period the tissue is destroyed and reabsorbed by the body. This is an office-based therapy and is performed under a local nerve block.

UroLift®: A mechanical approach that places implants to pin the lateral prostate lobes out of the way to reduce obstruction. This is an office-based procedure performed under a local nerve block.

Prostatic artery embolization: This approach uses catheters to deliver agents that block blood flow to the prostatic artery to reduce symptoms of BPH by shrinking tissue. This prostate procedure uses local anesthesia and doesnt require a hospital stay.

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What You Need To Know About The Prostate Surgical Removal Of The Prostate Gland

A enlarged prostate can also cause blockages in the urethra. A blocked urethra can also damage the kidneys. A patient suffering from an enlargement of the prostate may have pain in his lower abdomen and genitals. If pain is present, a digital rectal examination will reveal hard areas. A doctor may prescribe surgery or perform an endoscopic procedure. If the enlarged prostate is not completely removed, it will shrink.

While the size of an enlarged prostate will influence the extent of urinary symptoms, men may experience a range of urinary symptoms. Some men have minimal or no symptoms at all. Some men will have a very enlarged prostate, whereas others will have a mild enlargement. Generally, the symptoms can stabilize over time. Some men may have an enlarged prostate but not notice it. If they have an enlarged colon, their physician can perform a TURP procedure.

Benign Enlarged Prostate: What Are The Pros And Cons Of Surgery

Surgery can very effectively reduce the problems associated with a benign enlarged prostate. It is considered if other treatments don’t provide enough relief, or if the enlarged prostate keeps causing medical problems such as urinary tract infections. But surgery often has side effects.

Most men who have a benign enlarged prostate aren’t in urgent need of surgery. They can take their time to carefully consider the pros and cons. There are various possible reasons for deciding to have surgery. For instance:

  • The prostate-related problems may be very distressing, and other treatments may not have led to a big enough improvement.
  • The enlarged prostate may frequently cause other medical problems, such as recurring urinary tract infections or bladder stones.
  • Treatment with medication may not be possible for medical reasons.

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The Purpose Of Prostate Surgery

Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.

It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.

Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:

Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.

The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.

Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.

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