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Why Would You Remove Prostate

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Urinary Problems After Surgery

What is a Positive Margin After a Prostatectomy?

Leaking urine

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.

Difficulty urinating

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

Erection problems

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.

Treatments May Have Side Effects

The treatment options for early-stage prostate cancer fall into three broad categories: surgery, radiation therapy, and active surveillance. Your doctor will make a treatment recommendation based on your numbers as well as a mathematical tool known as a nomogram, which can help you and your doctor better assess how extensive your cancer is likely to be and whether it is likely to become active in the future.

Yet clinical studies have not provided any evidence that one treatment is better than another or that any treatment at all actually prolongs life: The average 5-, 10-, and 15-year survival rates are virtually the same for all treatment options in early-stage prostate cancer, including active surveillance. Its also important to understand that no mathematical model is foolproof, and some men diagnosed with early-stage, locally confined disease will later find out that their cancer was more extensive than originally believed.

If you are diagnosed with early-stage prostate cancer, you have a number of treatments to choose from. A brief comparison is listed in Table 2.

Enlarged Prostate Surgery: The Real Risks And Side Effects

Enlarged prostate surgery unfortunately has real risks and side effects that are often downplayed or minimized by urologists making you the guinea pig with very possible impotence and incontinence as a result.

Furthermore, you will often have to repeat the operation later on as your prostate continues to grow because the real causes of this prostate disease have not been addressed by radical surgeries.

Also known as a TURP surgery or BPH surgery, this is the gold standard of prostate surgeries for enlarged prostate symptoms.

TURP stands for Transurethral Resection of the Prostate. The surgery consists of passing a flexible instrument up your penis and into the prostate gland to shave off pieces of the prostate.

The bloody pieces are removed allowing more space for the urethra tube to pass urine from your bladder.

The operation is done under anesthesia⦠and you will usually spend a couple of days recovering. You will have to wear a catheter for some time while you heal, and then it can be removed.

It would be great if that was all there was to it. Yet, itâs not so simpleâ¦

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What Are The Risks Of A Turp

As with any surgery, certain complications can occur with TURP. Somepossible complications may include:

  • Bladder injury
  • Painful or difficult urination
  • Retrograde ejaculation

There may be other risks depending on your condition. Be sure to discussany concerns with your healthcare provider before the procedure.

Transurethral Resection Of The Prostate

Would Removal Of Prostate Result In Erectile Dysfunction ...

This operation is more often used to treat men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia . But it is also sometimes used in men with advanced prostate cancer to help relieve symptoms, such as trouble urinating.

During this operation, the surgeon removes the inner part of the prostate gland that surrounds the urethra . The skin is not cut with this surgery. An instrument called a resectoscope is passed through the tip of the penis into the urethra to the level of the prostate. Once it is in place, either electricity is passed through a wire to heat it or a laser is used to cut or vaporize the tissue. Spinal anesthesia or general anesthesia is used.

The operation usually takes about an hour. After surgery, a catheter is inserted through the penis and into the bladder. It remains in place for about a day to help urine drain while the prostate heals. You can usually leave the hospital after 1 to 2 days and return to normal activities in 1 to 2 weeks.

You will probably have some blood in your urine after surgery.

Other possible side effects from TURP include infection and any risks that come with the type of anesthesia used.

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Treatment By Stage Of Prostate Cancer

Different treatments may be recommended for each stage of prostate cancer. Your doctor will recommend a specific treatment plan for you based on the cancers stage and other factors. Detailed descriptions of each type of treatment are provided earlier on this same page. Clinical trials may also be a treatment option for each stage.

Early-stage prostate cancer

Early-stage prostate cancer usually grows very slowly and may take years to cause any symptoms or other health problems, if it ever does at all. As a result, active surveillance or watchful waiting may be recommended. Radiation therapy or surgery may also be suggested, as well as treatment in clinical trials. For those with a higher Gleason score, the cancer may be faster growing, so radical prostatectomy and radiation therapy are often recommended. Your doctor will consider your age and general health before recommending a treatment plan.

ASCO, the American Urological Association, American Society of Radiation Oncology, and the Society of Urologic Oncology recommend that patients with high-risk early-stage prostate cancer that has not spread to other areas of the body should receive radical prostatectomy or radiation therapy with hormonal therapy as standard treatment options.

Locally advanced prostate cancer

Watchful waiting may be considered for older adults who are not expected to live for a long time and whose cancer is not causing symptoms or for those who have another, more serious illness.

Active Surveillance And Watchful Waiting

If prostate cancer is in an early stage, is growing slowly, and treating the cancer would cause more problems than the disease itself, a doctor may recommend active surveillance or watchful waiting.

Active surveillance. Prostate cancer treatments may seriously affect a person’s quality of life. These treatments can cause side effects, such as erectile dysfunction, which is when someone is unable to get and maintain an erection, and incontinence, which is when a person cannot control their urine flow or bowel function. In addition, many prostate cancers grow slowly and cause no symptoms or problems. For this reason, many people may consider delaying cancer treatment rather than starting treatment right away. This is called active surveillance. During active surveillance, the cancer is closely monitored for signs that it is worsening. If the cancer is found to be worsening, treatment will begin.

ASCO encourages the following testing schedule for active surveillance:

  • A PSA test every 3 to 6 months

  • A DRE at least once every year

  • Another prostate biopsy within 6 to 12 months, then a biopsy at least every 2 to 5 years

Treatment should begin if the results of the tests done during active surveillance show signs of the cancer becoming more aggressive or spreading, if the cancer causes pain, or if the cancer blocks the urinary tract.

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What Typically Increases The Risk Of Complications From Prostate Cancer Surgery

Complication risks can be increased if prior surgery for unrelated reasons was done in the area or if we have to do extensive surgery to remove the cancer. But complication rates also go up dramatically when we do surgery on patients who have failed other prostate cancer treatments, such as radiation therapy.

Radiation is a very effective treatment for prostate cancer, but it doesnt work for everyone. In these patients, we often believe the cancer has recurred or persisted in the prostate without spreading, so removing the prostate following failed radiation treatment a procedure called salvage prostatectomy is potentially curative.

Salvage prostatectomy is more technically challenging than radical prostatectomy. Patients who have already had radiation therapy often have scarring in and around the prostate, which can make tissue in the area very difficult to separate while performing the operation. As a result, patients undergoing salvage prostatectomy have a much higher risk of urinary incontinence, and a higher rate of developing more scar tissue, strictures which is a narrowing of the urethra that blocks urine flow or injury to adjacent structures like the rectum.

Table 2 What Guides Treatment Recommendations

EXTRA – The Catheter – Everything You Need to Know – Mark’s Prostate Cancer Experience

Both of the situations below involve men diagnosed with a tumor that is small in size , yet who may require quite different treatments, based on their PSA level and Gleason score. Of course, many men have clinical profiles that vary from these two extremes.

Clinical profile Low PSA

Low Gleason score

80% of men with this profile probably have locally confined disease.

It is likely that fewer than 3% will have evidence of cancer in lymph nodes.

Surgery, radiation, or active surveillance . High PSA

High Gleason score

5% of men with this profile probably have locally confined disease.

More than 20% probably have evidence of cancer in the lymph nodes.

Systemic therapy rather than surgery .

Radical prostatectomy . The surgeon removes the prostate and seminal vesicles . In some cases, pelvic lymph nodes are also sampled. This is most often performed through an abdominal incision abdominal surgery may also be done with a laparoscope. A third option is the perineal technique, involving an incision in the area between the scrotum and the anus . The most common side effects are

  • impotence
  • mild to severe incontinence .

External beam radiation therapy. After a CT scan constructs a three-dimensional picture of the prostate and seminal vesicles, the radiation oncologist directs rays of high-energy radiation at the prostate tumor and sometimes at nearby lymph nodes. The most common side effects are

  • impotence
  • mild to severe incontinence .
  • impotence
  • mild to severe incontinence .

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How Important Is The Psa Test After Prostatectomy

The answer is: very . A major milestone in prostate cancer treatment is obtaining your PSA level close to zero after surgery. The expected result after prostatectomy is an undetectable PSA or level of 0. The surgery itself is a cornerstone of a mans life, but the tests that follow, especially the PSA test, can be very dreaded.

The PSA test is a blood analysis that checks for the level of the prostate-specific antigen in the blood cells. The PSA is an enzyme secreted only by the prostate cells. When the PSA level is zero or close to zero after radical prostatectomy, the patient is reassured that he is cancer-free and can regain peace of mind. In the majority of cases, this is the scenario. There are also rare cases when the follow-up tests reveal an elevated PSA after prostatectomy. What to do if this is your case?

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Why This Man Removed His Healthy Prostate

When it comes to operating on a diseased organ, it’s a no-brainer. But what happens when we start removing healthy body parts because someday, somehow, they might kill us?

Fun fact number one: Half of all men who die in this country this year will be killed by heart disease, stroke, or cancer. Fun fact number two: Half of all doctors seem to have different ideas about how to prevent the biggest killers of men. We spoke to the best of them, and we’ve simplified, clarified, and prioritized their advice on minimizing the risks of dying before your time. For more tips, .

Plus: 3 Things That Can Happen When You Live Without a Prostate

Let us be lovers, let us be open to siren songs of death cheated and lives prolonged. Two and a half years ago, a well-known woman published an essay in The New York Times, “My Medical Choice,” about how she decided at thirty-seven years of age to prophylactically, preventively surgically remove her healthy breasts in order to reduce her chances of dying from cancer.

The patient was said at the time to have made medical history as the first man to undergo a preventive prostatectomy.

This was not exactly true.

Yavornik’s first stop was a local urologist in Dallas. After performing a PSA test and a digital rectal exam, and after taking six coreneedle biopsies with a staple-gun-like needle-coring device, the doctor found nothing. Biopsy came back clean PSA results were by-the-book normal. All fine.

He went to Florida.

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How May Erectile Dysfunction Affect My Sexual Relationships

Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.

If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.

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Figure 2 Why Understaging May Occur

#113 Teach Me Tuesday: Why you leak after prostate surgery ...

When the prostate is removed, a pathologist examines slices of the gland for evidence of cancer. A. Under a microscope, the pathologist can distinguish tiny tumors, consisting of clumps of visibly abnormal cells. B. With current imaging technology, it is not yet possible for a pathologist to identify micrometastases individual cancer cells shed from the primary tumor that have gone on to seed adjacent tissue. In this image, for example, cancer cells have already penetrated the capsule and migrated to adjacent tissue, even beyond the margin of tissue removed during surgery.

Individual prostate cancer cells can spread to more remote areas of the body in three ways . Whats more, they can do so without being detected with our current technology, essentially escaping under the radar. So its always possible even if you are diagnosed with early-stage prostate cancer that the cancer has already spread and will manifest in the coming years. How likely is it that an early-stage prostate cancer will become active without treatment? A small study provides some clues .

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What Happens After A Radical Prostatectomy

You may be required to stay in the hospital for up to four days after the surgery. Youll be able to drink and eat normally soon after the surgery.

While recovering in the hospital youll have dressings over your incision sites. Youll also have a drain to remove excess fluid from the surgery site. The drain will be removed after a day or two.

A catheter, or tube, will be threaded through the end of your penis and into your urethra. The catheter will drain urine into a bag while youre healing. Urine that drains from the catheter may be bloody or cloudy. You may have a catheter in place for one to two weeks.

During your recovery you may need to wear special socks. These will prevent blood clots in your legs. You may also need to use a breathing device to keep your lungs healthy.

If you have stitches in your incision, theyll absorb into your body and wont need to be removed. Youll be given pain medication both in the hospital and while recovering at home.

Any surgery carries a risk for potential complications, including:

  • blood clots in the legs
  • breathing problems

What Is Prostate Removal

A prostatectomy is a surgical procedure for the partial or complete removal of the prostate, which is a small gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum in men. The prostate supplies part of the seminal fluid , which mixes with sperm from the testes. Sperm needs this fluid to travel and survive for reproduction.

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What Does The Prostate Do Can You Live Without It And What Happens When You Have It Removed

All men have a prostate, yet many know little about what it does or what happens if it is removed. Here’s the lowdown…

  • 9:25, 20 Mar 2018

THE prostate is a male reproductive organ which surrounds the neck of the bladder which releases a fluid component of semen.

All men have a prostate, yet many know little about what it does or what happens if it is removed. Here’s the lowdown…

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