Will I Have Erectile Dysfunction
Whether or not you experience erectile dysfunction after radical prostatectomy will depend largely on your age, your health and what your erections were like before the operation. This side effect may occur if nerves were injured during the operation.
There are two main nerves running through the pelvis that branch into many nerves covering the prostate. Urologists call them neurovascular bundles because they really are bundles of many nerves. Urologists always aim for nerve-sparing surgery, and we rarely need to remove the neurovascular bundles. But sometimes the bundles are stretched and some of the thousands of nerve fibers within an individual nerve can be damaged, says Mohler. In most men, both neurovascular bundles can usually be spared. If the cancer is advanced, sometimes one or both cannot be.
Benefits of Robotic Radical Prostatectomy
Have more questions about radical prostatectomy? Our experts give you the answers.
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How Soon Can I Return To Work After Rezum Procedure
Most men are able to return to usual activities the next day after the procedure if they do office-type work. Men who are physically active may need to take a few days off if the catheter is interfering with the usual activities until the catheter is removed. However, most men are able to function without significant discomfort with the catheter in place.
We advise our patients to avoid driving for the first few days to see how you deal with the catheter. Usually, its best to wait until the catheter has been removed until you start driving. Urge to void or discomfort from the catheter can distract you from driving.
How Does The Robotic
It is similar to the conventional, minimally invasive laparoscopic prostatectomy. However, working from a special console in the operating room, the surgeon operates four precision-guided robotic arms to cut and remove the prostate. The procedure uses a small video camera, inserted through a keyhole-sized incision to provide surgeons with magnified, 3-D images of the prostate site. This expansive view allows doctors to see the nerve bundles and muscles surrounding the prostate. The robotic arms, with full 360-degree rotation capabilities, are placed through several other keyhole incisions allowing surgical instruments to move with greater precision, flexibility and range of motion than in a standard laparoscopy.
The procedure usually takes 2 to 3 hours under general anesthesia. Most patients experience only a small blood loss and blood transfusions are needed in less than one percent of patients. Prostatectomy patients typically spend one night in the hospital and are usually discharged as soon as their laboratory tests are acceptable, pain is controlled and they are able to retain liquids. Patients are discharged with special catheter, which is removed during an outpatient visit 5-7 days after the operation.
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Cancer After Prostatectomy: When Surgery Is Not Enough
Three months later, I was back at work, delivering a three day workshop at Warwick University, when I got the call I had been dreading: my first PSA test results. I got a phone call to say
I am sorry Martin, your PSA is still high. We havent caught the cancer. It has spread within your body.
That for me was more devastating than my initial diagnosis.
Id just climbed the mountain of prostate cancer and radical open surgery, and recovered from that only to find there was another even higher mountain to climb. And it is a journey of uncertainty.
I was then passed on from the surgery department to oncology. And I wasnt asked about my wants they simply said, this is what needs to happen and heres who you need to see. I didnt like it then, it felt very impersonal. Now I realise that they were working on the bigger statistical picture. Generally, people whose cancer is not cured by surgery need further treatment from oncologists. They were very matter of fact and technical.
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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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Recovery From Robotic Prostate Surgery
The recovery from robotic prostate surgery takes lesser time as compared to the other types of surgeries. Many people manage to walk even after a few hours after the surgery, while doing the regular daily activities is possible in a few days. The reason for this is, that the incisions which are made are very small and gas under pressure is used to restrict the bleeding to occur. You can get a discharge from the hospital in just one day after this procedure.
The number of people opting for the prostate surgery for enlarged prostate and prostate diseases is increasing rapidly. Apart from the surgery, cleanliness, and personal hygiene play an important role in maintaining the prostate health.
Urinary Problems Are Treatable In Nearly Every Man And Woman
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of urinary problems caused by enlarged prostate and BPH in men. We understand the challenges that urinary problems such as a slow stream, waking up at night, pain in the penis and perineum create for our patients, their relationships, and their self-esteem. We help you find a treatment for your urinary problems that fit your needs, lifestyle, and your preferences.
Urologists are doctors specializing in the treatment of men with symptoms caused by prostate enlargement, including frequent urination, poor urine flow, frequent UTI, blood in urine, urinary incontinence, urinary problems caused by an enlarged prostate, prior surgery, neuropathy, chemotherapy, and radiation. By virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man and woman who desire an effective treatment for their urinary problems. We offer medical and surgical treatment for mens prostate problems.
We specialize in minimally invasive, highly effective treatment for symptoms of bladder pain, urethral burning, pelvic discomfort, incomplete bladder emptying, urinary frequency, and urgency.
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Who Can Have This Treatment
All patients with an enlarged prostate, known as Benign Prostatic Hyperplasia are suitable, including those on anticoagulants. Because we use powerful, third generation laser technology and proven techniques, we can treat men with large prostates, including those who have gone into retention and are dependent upon a catheter.
Life After Treatment: Alan Weiners Story
When Alan Weiner found out he had prostate cancer, it was a huge and frightening emotional bomb blast.
The New York native was diagnosed in February 2014 at age 69. After seeking out opinions from various doctors, Weiner underwent robotic prostatectomy in April at Mount Sinai Hospital in New York.
Because of the emotional toll his diagnosis took, Weiner says he found a support group that helped him through that uncertain time in his life. I joined Gildas Club after surgery, but if I had known about it, I would have attended sessions prior to deciding treatment, he says. I found a friend who went through the process and was understanding of my anxieties, fears, and projections.
I never thought that the emotional aspects of this would be so difficult to deal with, Weiner adds. I never believed that the mortality rate of prostate cancer was very low, and I believed that I would be the one who would not make it. I now know that my fears and negative thinking were things most men go through, however.
Today, Weiner goes for routine checkups, and two years after his initial diagnosis, his PSA level is undetectable. He deals with persistent sexual dysfunction, but the bladder control issues he first experienced after his surgery have resolved.
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Why Is There Less Blood Loss With Robotic
The use of the robotic equipment in surgery means a more precise and less disruptive dissection, which helps control potential sources of bleeding. Blood loss is also reduced because of the pressure generated by the gas used in inflate the abdomen during surgery, which provides surgeons with a better and more expansive view of the operating area around the prostate.
Urinary Problems After Surgery
Most men cant control their bladder properly when their catheter is first removed. This is because surgery can damage the muscles and nerves that control when you urinate.You might just leak a few drops if you exercise, cough or sneeze . Or you might leak more and need to wear absorbent pads, especially in the weeks after your surgery.Leaking urine usually improves with time. Most men start to see an improvement one to six months after surgery. Some men leak urine for a year or more and others never fully recover, but there are things that can help and ways you can manage it.
A few men may find it difficult to urinate after surgery . This can be caused by scarring around the opening of the bladder or the urethra .Some men find they suddenly and painfully cant urinate. This is called acute urine retention and it needs treating quickly to prevent further problems. If this happens, call your doctor or nurse, or go to your nearest accident and emergency department.
Watch Paul’s story for one man’s experience of managing urinary problems after surgery below.
Sexual problems after surgery
Change in penis size and shape
Changes to orgasm
The seminal vesicles, which make some of the fluid in semen, are removed during surgery. This means you wont ejaculate any more. You may have a dry orgasm instead where you feel the sensation of orgasm but dont ejaculate. This may feel different to the orgasms youre used to.
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What Happens Before Radical Prostatectomy
Before radical prostatectomy, your provider will ask you about your health history. Youll also need to tell your provider what drugs and vitamins you take. You may need to stop taking some of your medications a few days before your surgery, especially drugs that cause blood thinning.
Your hospital will give you specific instructions, including how long before your surgery to stop eating and drinking.
To check your health before your procedure, you also may need:
- Blood tests.
- Prostate ultrasound and biopsy.
What Type Of Patients Are Candidates For Robotic Prostatectomy
Robotic laparoscopic prostatectomy is used to treat patients who have clinically localized prostate cancer. Most patients who are candidates for open radical prostatectomy are also excellent candidates for the robotic approach. In many centers including the University of Florida, the robotic approached is the treatment of choice for the surgical management of clinically localized prostate cancer.
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Prostate Cancer Treatment Begins With Your Primary Physician
In most cases once youve been diagnosed with prostate cancer, your primary care physician and/or urologist will assist you with the necessary tests required before prostate surgery. This should be done approximately four weeks before surgery. If you have any questions regarding pre-operative tests please email us or call at .
Harvard Experts Discuss Surgical Options For Benign Prostatic Hyperplasia
Benign prostatic hyperplasia is one of the most common disorders affecting men as they grow older. Yet there is much confusion about the best way to treat this disorder surgically, in part because it seems that every year, a new surgical option is introduced.
Harvard editors invited three experts to participate in a roundtable discussion to share their thoughts about the relative benefits and risks of current surgical treatments for BPH.
|Note: Men who decide to undergo surgery to relieve BPH symptoms have multiple options to choose from. Our panel of Harvard experts discusses the most common options, which are briefly defined below. See Table 3 for a comparison of recovery rates and other considerations.|
The panel consisted of these experts:
Transurethral resection of the prostate . Still the most common form of surgery, TURP is often inelegantly referred to as the Roto-Rooter technique. This procedure takes place in an operating room under general or spinal anesthesia. During the procedure, the surgeon uses an instrument called a resectoscope to view the prostate . The surgeon threads the resectoscope through the penis to the prostate, then uses the electrical loop to cut away the overgrown tissue thats pressing against the urethra.
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Prostatectomy: What To Expect During Surgery And Recovery
If youve been diagnosed withprostate cancer, your doctor will consider many factors before recommending the besttreatment. For many men, that may mean a prostatectomy. In this surgery,doctors remove the entire prostate.
The Johns Hopkins Hospital performs more of these procedures than almostanywhere else in the world. One of the most common questions they hear frompatients: What should I expect after surgery?
Johns Hopkins urologistMohamad Allaf, M.D., explains the surgery and recovery.
Getting Ready For 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 youre not 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 problems, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other problems 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:
- Be honest with your healthcare providers about how much alcohol you drink.
- Try to stop drinking alcohol once your surgery is planned. Tell your healthcare provider right away if you:
- Get a headache.
- For information about being a health care agent, read How to Be a Health Care Agent.
- If you have more questions about filling out a Health Care Proxy form, talk with your healthcare provider.
Male Sexual and Reproductive Medicine Program
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Urgent Signs And Symptoms
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.
What Research Efforts Are University Of Florida Surgeons Involved In To Enhance Result Of Robotic Prostatectomy
University of Florida robotic surgeons are involved in several exciting research projects pertaining to robotic pertaining to robotic prostatectomy. First, we are involved with prospective collection of perioperative outcomes for each patient undergoing robotic prostatectomy. In this way, our robotic surgeons track quality of life and cancer outcomes following surgery to assess trends in outcomes and the effects of changes in surgical technique or new technology on these outcome measures. Second, we are investigating new imaging modalities to identify the precise course and location of the neurovascular bundles as well as cancer sites during this procedure using novel MRI technology. Lastly we are developing a robotic surgical simulator to help better prepare and train residents and fellows on the technical nuances of robotic surgery.
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Surgery For Prostate Cancer And Ed
Prostate cancer tends to be a slow-growing cancer. Surgery may be a good option if your doctor believes the cancer is contained in the prostate gland. Surgery is also dependent on age, overall health, and other factors.
A radical prostatectomy involves the removal of the prostate gland. The prostate gland is a donut-shaped gland that surrounds the urethra just below the bladder. The urethra carries urine and semen out from the body through the penis.
There are some risks associated with surgery. Two small bundles of nerves on either side of the prostate are vulnerable to injury during the operation. A type of operation called nerve sparing surgery may be possible. This depends on the size and location of the cancer.
Surgery may require removal of some nerves if theres a chance the cancer has invaded one or both sets of nerves. If both sets of nerves are removed, you may not be able to achieve an erection without the assistance of medical devices.
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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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.