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.
Swollen Legs Or Scrotum
You might get swelling in the legs or the sack of skin around the testicles . The swelling is called lymphoedema . It happens when the lymph channels that drain fluid from the legs are damaged by the radiotherapy. The swelling can be uncomfortable.
You can do various things to lower your risk of getting lymphoedema. Early treatment can reduce the swelling and stop it from getting worse.
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 Paulâs story for one manâs 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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Study Population And Data Collection
The National Prostate Cancer Register of Sweden captures 98% of all newly diagnosed prostate cancer cases in the Swedish Cancer Registry, to which registration is compulsory and mandated by law . NPCR data include date of diagnosis, age, tumor stage, tumor differentiation, serum level of prostate-specific antigen and primary treatment. The Prostate Cancer data Base Sweden 3.0 has recently been described in detail . In brief, by record linkage using the unique Swedish personal identity number, information for men with prostate cancer in the NPCR and five prostate-cancer free men, randomly selected from groups of men in the background population matched for birth year and county of residence, was obtained from a number of national healthcare registries and demographic databases.
This study included men diagnosed with prostate cancer between 1997 and 2012 who had received curative RT or RP within 1 year after the date of diagnosis. Men who received salvage RT or RP ended their follow-up time at the date of secondary treatment and men with stage T4, N1 or M1 disease or serum PSA above 50ng/ml at diagnosis were excluded. In a modification of the National Comprehensive Cancer Network categorization, the following risk categories were defined: low risk , intermediate risk , localized high risk and locally advanced . The intermediate- and localized high-risk categories were merged into one group.
Date Of Treatment Comorbidity And Socioeconomic Factors
The National Patient Registry includes diagnoses and procedures from inpatient and outpatient care that have been found to be 8595% accurate . Data from the National Patient Registry were used to determine date of treatment and retrieved diagnoses and procedures as measures of adverse effects after treatment. The Charlson Comorbidity Index was calculated as previously described . Data on socioeconomic factors including marital status and educational level were retrieved for each subject from the Longitudinal Integration Database for Health Insurance and Labor Market Studies . The levels of education were low , intermediate and high . Data on type of RT were combined from NPCR and RETRORAD, an audit that collected information on type of RT, treatment time, total dose and fractionation directly from the RT verification/oncology information systems and local databases in oncology departments in Sweden .
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Advantages Of Ralp Over Traditional Surgery Include:
- Small incisions
- Less blood loss than in traditional surgeries
- Less pain than an open incision surgery
- Less risk of infection over other kinds of surgery
- Shorter stay in the hospital
- Faster recovery at home
The magnification system provides your surgeon with a clear view of the tiny blood vessels, nerves, and muscles surrounding your prostate to help minimize side effects after your surgery.
Not every man who needs prostate removal surgery will be a candidate for robotic surgery. Each prostate cancer patients situation is unique, with some patients requiring a different surgical method either traditional open surgery or, less frequently, radical perineal prostatectomy.
If you have recently been diagnosed with prostate cancer and are looking for a second opinion on treatment options before undergoing surgery, consult with one of the prostate cancer specialists at Compass Oncology located throughout the Portland-Vancouver area.
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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What The Results Showed
After five years, there were no significant differences in survival associated with any of the selected treatments. Just one man in the favorable risk category died from prostate cancer during the study, and there were eight deaths from the disease in the unfavorable risk group.
Many men in the study had initial problems with sexual, bowel, urinary, and hormonal functioning. Brachytherapy caused more irritative urinary problems during the initial six months than the other treatments, but then those symptoms steadily improved. Brachytherapy and EBRT were associated with minor bowel symptoms such as urgency, bleeding, frequency, and pain that resolved within a year in men from both risk groups.
Dr. Marc Garnick, Gorman Brothers Professor of Medicine at Harvard Medical School and Beth Israel Deaconess Medical Center, and editor in chief of HarvardProstateKnowledge.org, agreed the study provides a valuable resource that adds to existing information. Yet he cautioned against brachytherapy, warning that this particular treatment in some cases has long-term urinary side effects that can significantly alter a patients quality of life. I do not routinely recommend brachytherapy, Garnick said. This is especially true in patients with a pre-existing history of urinary tract infections or prostatitis.
About the Author
Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Radiation Therapy Side Effects
Because the prostate is close to several vital structures, radiation therapy can disrupt normal urinary, bowel, and sexual functioning.Short-term ComplicationsYou may experience some temporary urinary symptoms, such as waking up in the night and needing to urinate, needing to urinate more often during …
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How Radical Prostatectomy Affects A Relationship
A 2011 study of 63 men that had undergone a radical prostatectomy found that about 75 percent of them sought treatment for erectile dysfunction. Additionally, more than 50 percent reported having less sexual desire, and roughly an additional 40 percent were unable to have a satisfying orgasm.
The mental health effects of these symptoms were worse in highly sexually motivated participants. 52 percent reported that this had affected their self-esteem, and 36 percent said having performance anxiety.
Additionally, the last three items on the list above can vastly affect your relationship. Few women can tolerate a high degree of urine leakage during sexual activity, and few men can handle the pain during intercourse.
Problems With Your Bowels And Back Passage
Your bowel movements might be looser or more frequent than before your treatment. You might need to take anti diarrhoea medicines, such as loperamide . Bulking agents, such as Fybogel might also help.
You might find that you need to avoid high fibre foods as it might make long term diarrhoea worse. Some people find it best to avoid high fibre vegetables, beans and pulses .
Inflammation of the back passage is another possible long term side effect. Proctitis can cause a feeling of wanting to strain whether or not you actually need to pass a bowel movement. You might also have bleeding from your back passage or a slimy mucous discharge.
Talk to your doctor or specialist nurse if you have any of these side effects. They will be able to refer you to a specialist team that can help you to find ways of controlling the effects.
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Treating Advanced Prostate Cancer
If the cancer has reached an advanced stage, it’s 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.
Can You Still Have An Erection If Your Prostate Is Removed
Yes, it is possible as the prostate gland does not play any direct role in erectile function or testosterone production. Erectile dysfunction after prostatectomy is mainly due to local inflammation and nerve injury.
How severe one would have prostate surgery-related issues would depend on the kind of surgery one had.
For example, if one had a minimally invasive surgery for partial prostate removal, the chances are slim that nerves involved in erection might be damaged.
Nevertheless, these nerves may not function well for a few months due to local inflammation. However, most men can expect to reach their prior erection quality in 3 months in such cases.
There are greater chances of nerve damage when it comes to radical prostatectomy because of localized prostate cancer than there are greater chances of nerve damage. 60% of men can expect their erectile function to reach the prior-to-surgery level within 3 months.
Regretfully, the road to recovery for the rest of 40% is prolonged. They might need months and even years of treatment. Some may need regular treatment for erectile dysfunction for the rest of their life after prostate removal.
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Prostate Cancer Treatments Carry Long
In the long run, the various side effects from treating prostate cancer with surgery versus radiation might not differ that much.
A new study published on Jan. 30 in the New England Journal of Medicine shows that while there were some differences in urinary, bowel and sexual function in the short term following prostate cancer treatment, there were no significant differences in side effects that were often present 15 years after treatment.
About 238,590 new cases of prostate cancer will be diagnosed in 2013, and 29,720 men will die from the disease this year, according to the American Cancer Society.
There has been recent debate between experts who say that prostate cancer should be routinely screened for and medical groups that argue men will suffer more and may not live longer if they treat the disease instead of leaving it alone. The U.S. Preventive Services Task Force, a non-federal panel of medical experts that advise government treatment guidelines, caused controversy in 2012 when it recommended that all healthy men should not be screened for prostate cancer because the PSA test used is not that accurate, and may pick up cancers too-slow growing to cause a problem. Meanwhile, the panel said prostate cancer treatments can carry risky side effects.
Erectile dysfunction was reported in 87 percent of the prostatectomy group, while 93.8 percent of the radiotherapy group experienced those problems.
Loss Of Bladder Control
You may have some light dribbling or trouble controlling your bladder after a radical prostatectomy. This is known as urinary incontinence or urinary leakage. You may need to use a pad to manage urinary leakage for some days or weeks after the operation. Bladder control usually improves in a few weeks but it can take up to a year after the surgery. For about 5% of people, incontinence is ongoing and may need an operation to fix. In rare cases, incontinence may be permanent.
For help managing these problems, see Urinary problems.
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What Are The Prostate Cancer Treatment Side Effects Of A Prostatectomy
The primary prostate cancer treatment side effects after a radical prostatectomy are incontinence and erectile dysfunction. These side effects are a product of the location of the prostate and the type of surgery performed. The prostate gland lies deep within the pelvis behind the pubic bone and in front of the rectum. The urinary bladder lies just above the prostate, the urinary sphincter control muscle is located just below it, and the erectile nerves lie just outside the prostate on either side. A patients age and overall health also influence the potential risks of radical prostatectomy just as it does with any major operation. Such risks include cardiac or pulmonary events, infections, blood clots, or injuries to structures around the prostate.
Following surgery, all men will have some urinary leakage. A good amount of bladder control is often regained within 12 weeks and continues to improve over 12 months. Multiple studies have shown that there is often a several month interval before a patient recovers normal erections, even with bilateral nerve-sparing surgery. Advantages to the Robot Assisted Laparoscopic Prostatectomy technique are a reduced risk of intra-operative bleeding and a shortened hospital stay.
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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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.
Radiation Therapy: What It Is
This therapy, also known as radiotherapy, is a cancer treatment procedure that uses high doses of radiation to kill cancerous cells and shrink the tumor as well. At low doses, this procedure is used as an x-ray.
This therapy can be internal or external or both form. For external beam, a machine that is outside your body aims at the cancerous cells. For internal therapy, the radiations are placed inside your body inside or near the cancer.
For radiotherapy for prostate cancer, high-energy rays are used to kill the cancer cells. This treatment procedure does not cause pain. However, it may result in various side effects that might cause pain and make you feel uncomfortable. The good thing is that there are numerous ways to manage radiotherapy side effects with the help of your radiation oncologist.
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