What Is A Radical Prostatectomy
Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.
The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.
What Types Of Surgery Are There
Radical prostatectomy involves removing the prostate, part of the urethra and the seminal vesicles. After the prostate is removed, the urethra will be rejoined to the bladder and the vas deferens will be sealed.
Some people are able to have nerve-sparing surgery, which aims to avoid damaging the nerves that control erections. Your doctor will discuss whether this is an option for you. Nerve-sparing radical prostatectomy is more suitable for lower-grade cancers and is only possible if the cancer is not in or close to these nerves. It works best for those who had strong erections before diagnosis. Problems with erections are common even if nerve-sparing surgery is performed.
Cancer cells can spread from the prostate to nearby lymph nodes. For intermediate-risk or high-risk prostate cancer, nearby lymph nodes may also be removed .
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.
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Making Decisions About Surgery
Talk to your surgeon about the surgical methods available to you. Ask about the advantages and disadvantages of each option. There may be extra costs involved for some procedures and they are not all available at every hospital. You may want to consider getting a second opinion about the most suitable type of surgery. See more about Making treatment decisions.
The surgeons experience and skill are more important than the type of surgery offered. Compared to open surgery, both standard laparoscopic surgery and robotic-assisted surgery usually mean a shorter hospital stay, less bleeding, a smaller scar and a faster recovery. Current evidence suggests that the different approaches have a similar risk of side effects and no difference in long-term outcomes.
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.
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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.
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
1. Cancer Council NSW. https://www.cancercouncil.com.au/wp-content/uploads/2014/05/Prostate-2016-Web-Lo-Res.pdf Understanding Prostate Cancer https://www.cancercouncil.com.au/wp-content/uploads/2014/05/Prostate-2016-Web-Lo-Res.pdf . 2. Prostate Cancer Foundation of Australia. Managing treatment side effects of advanced prostate cancer . http://www.prostate.org.au/media/166976/apca3_sideeffects_final.pdf .3. Andrology Australia. Prostate cancer treatment . https://www.andrologyaustralia.org/prostate-problems/prostate-cancer-treatment/ .
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How Do Doctors Perform Prostate Removal
During prostate removal the prostate gland and some tissue around the gland, including the seminal vesicles, are removed. A prostatectomy takes about two hours and is performed under general anesthesia.
There are two approaches used for a prostatectomy:
- Robotic surgery
- Minimally invasive procedure with faster recovery time
- Uses smaller incisions and robotic technology
The surgical process is as follows:
- The doctor will make a small incision to gain access to the prostate
- The prostate is removed
- The bladder is reconnected to the urethra
- A catheter is connected to the bladder to allow urine to drain while the area heals
Prostate Cancer Treatment: Radiation Therapy
Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.
Low Dose Rate Brachytherapy
In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.
High Dose Rate Brachytherapy
High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.
Both methods have side effects that can include erectile dysfunction, urinary tract problems, diarrhea, and other side effects.
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Why Is Radical Prostatectomy Done
Radical prostatectomy is a treatment for prostate cancer that prevents cancer from spreading outside the prostate gland. It may cure prostate cancer by removing it completely.
For patients diagnosed with prostate cancer, additional tests may be needed to determine the how far the cancer has spread. These tests help your provider decide if you are a candidate for radical prostatectomy:
Fast Facts On Bph Surgery:
- Surgery is rarely the first line of treatment for BPH.
- A doctor who specializes in the urinary tract does most TURP surgeries.
- TURP is considered a fairly safe, effective procedure for treating BPH.
According to the American Urological Association, transurethral resection of the prostate or TURP is the most common type of surgery used to treat BPH. Every year, doctors perform it on around 150,000 American men.
Surgeons perform most TURP procedures when the patient is under general anesthesia and unconscious or asleep.
Alternatively, they use spinal anesthesia, where a needle is placed in the spine to stop any sensation below the waist.
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What Is The Prostate Gland
The prostate gland is about the size of a walnut and surrounds the neck ofa man’s bladder and urethrathe tube that carries urine from the bladder.It’s partly muscular and partly glandular, with ducts opening into theprostatic portion of the urethra. It’s made up of three lobes, a centerlobe with one lobe on each side.
Researchers don’t know all the functions of the prostate gland. However,the prostate gland plays an important role in both sexual and urinaryfunction. It’s common for the prostate gland to become enlarged as a manages, and it’s also likely for a man to encounter some type of prostateproblem in his lifetime.
Many common problems that don’t require a radical prostatectomy areassociated with the prostate gland. These problems may occur in men of allages and include:
Cancer of the prostate is a common and serious health concern. According tothe American Cancer Society, prostate cancer is the most common form ofcancer in men older than age 50, and the third leading cause of death fromcancer.
There are different ways to achieve the goal of removing the prostate glandwhen there’s cancer. Methods of performing prostatectomy include:
What Are The Side Effects Of Prostate Cancer Surgery
People often ask what happens if the prostate is removed? What to expect after prostate surgery? And can you have your prostate removed at all? The answer is yes it is possible to have the prostate removed.
Life without a prostate can be close to normal for some, though not free from the after effects of prostate removal.
There are few prostate surgery complications. Some are acute, and others chronic. Among acute side effects could be a reaction to anesthesia, bleeding issues, blood clots in legs, damage to nearby organs, and infection at the surgery site.
However, in most cases, people are interested in life after prostate removal, the pain after prostate surgery, and the long-term after effects of a prostatectomy.
There are two main side effects of prostate surgery. These are urinary incontinence and erectile dysfunction.
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What Necessitates Prostate Removal
Prostate cancer and sometimes benign prostatic hyperplasia can necessitate the removal of prostate gland. However, the most common cause is prostatic cancer as BPH can nowadays be managed with other treatment options. The prostate gland removal surgery is known as prostatectomy. The risks, benefits and side-effects of prostatectomy should be discussed with the patient, before making the decision to get prostate gland removed.
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What Happens After Radical Prostatectomy
Patients are usually discharged within 24 hours of surgery after radical prostatectomy.
You may have a drain that gets rid of excess fluid from the surgery site. If a drain is placed at the time of surgery, it is typically removed before you leave the hospital.
A urinary catheter continues to drain your urine into a bag. You may need to leave the catheter in place at home for a few days to one week.
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Going Home With A Catheter
It is normal for your urine to look cloudy for a few weeks after surgery. Occasionally, bleeding may occur around the catheter or be noticed within the urine. This also is common. If you see large clots â more than an inch in length â or if the catheter becomes plugged, contact your doctor. No anesthesia is required for catheter removal, and most patients experience only a little discomfort.
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Help To Continue The Work
The Prostate Cancer Free Foundation, reviews the results of hundreds of thousands of men treated for prostate cancer. Tracking them for years. This information is available to you, and others like you, to help find the best prostate cancer treatment. This work takes time, effort, resources all of it done by volunteers. Please help us continue. Please Donate!
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The Need For Further Treatments
There is a chance of the sudden swelling of the prostate gland right after surgery. Some men may need a follow-up treatment after laser ablative surgery because all the tissues are not removed or these tissues may grow back over time, resulting in the prostate gland to become enlarged again. If laser surgery fails to provide lasting results, then it may be necessary to undergo more invasive treatments such as an open prostatectomy surgery.
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Caring For The Catheter
You will be discharged with a Foley catheter, a tube that continuously drains urine from your bladder into a bag and that you will use for seven to 10 days. Before you leave the hospital, your nurse will teach you how to empty and care for your catheter and drainage bag. The catheter works with gravity and should be draining urine at all times, so you have to keep the drainage bag below your bladder at all times, even when you shower. If your urine is not draining, lower the bag and check the connection for kinks or loops. Loops can cause an air lock that prevents drainage. You can also try emptying the bag. Then try briefly disconnecting the catheter from the clear plastic tubing to allow a little air into the system. Your nurse will show you how to do this before your discharge.
To prevent infection, you must keep your catheter clean. This section explains how to clean the catheter, the area around the catheter and the drainage bag. It also explains how to apply your leg bag and secure the catheter to your leg.
We will provide most of the supplies you need to care for your catheter. They include:
- StatLock Foley catheter securement device
- Shaving supplies
You should empty the catheter bag when it’s half full. This helps prevent air locks from developing in the tubing.
To apply the leg bag:
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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Advantages And Disadvantages Of Surgery
What may be important for one person might be less important for someone else. The advantages and disadvantages of surgery may depend on your age, general health and the stage of your cancer.
Advantages
- If the cancer is completely contained inside the prostate, surgery will remove all of the cancer.
- The prostate is looked at under a microscope to give a clearer picture of how aggressive your cancer is, whether it has spread outside your prostate and if you need further treatment.
- Your health professionals can get a good idea of whether your cancer was completely removed during surgery. Your PSA level should drop so low that its not possible to detect it at six to eight weeks after surgery.
- If there are signs that your cancer has come back or wasnt all removed, you may be able to have further treatment.
- Some men find it reassuring to know that their prostate has been physically removed, although you will still need to have follow-up tests to make sure no cancer cells have spread outside the prostate.
Disadvantages
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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.
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How Do I Prepare For My Turp
You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.
You can prepare for TURP by:
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Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and at all times.
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Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a , EKG , blood tests, and other tests as needed.
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Losing excess weight before the surgery through a healthy diet and exercise plan
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Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
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Stopping as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
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Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen , and blood thinners.
Questions to ask your doctor
Facing surgery can be stressful. It is common for patients to forget some of their questions during a doctors office visit. You may also think of other questions after your appointment. Contact your doctor with concerns and questions before surgery and between appointments.
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