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Robotic Surgery For Enlarged Prostate

What About Problems With Urinary Continence

Aquablation: Surgical Robot Treats Enlarged Prostate | NBC4 Washington

Urinary continence depends on the internal, involuntary sphincter and the voluntary striated external sphincter. The internal sphincter is removed during all forms of prostatectomy, as it is anatomically at the junction of the prostate and bladder. Performing specialized Kegel exercises after surgery to strengthen muscles enables patients to control their external sphincter and gain continence . This takes several weeks to several months. Overall, significant urinary leakage occurs in only 0.5 percent of UC Davis patients. About 15 percent of patients report mild stress incontinence.

The Only Prostate Health Guide Trusted By Doctors

“A comprehensive review on the underpinnings of prostate disease… a must read for any man over 40”

Dr Eric Wood

“…should be used in health classes to teach all men what to do to avoid all prostate disease.”

Dr Donna Schwontkowski

“…help navigate the maze of medical opinions you will encounter after being diagnosed with prostate cancer.”

Dr Phranq Tamburri

The Nasty Truth About Prostate Drugs

BPH is a more serious condition than many men realize.Men with BPH have an 8X higher risk of developing prostate cancer.The largest study ever done on this was conducted over 30 years and examined over 3 million patient records, noting that men with BPH had a 200% higher chance of dying of prostate cancer.Having an enlarged prostate is like a ticking- time-bomb.Every day that you let it go untreated is another day of straining in the bathroom, waking up in the middle of the night and running the risk of the condition becoming more serious…

For BPH, doctors will often prescribe drugs that work by relaxing the bladder sphincter or the smooth muscles of the prostate gland to improve urine flow.But the relief is temporary.These drugs cover up the symptoms without treating them.Its like putting a fresh coat of paint on a damaged old house. Sure, it looks better. But it doesnt fix any of the damage. Sooner or later the walls will come crashing down.Secondly, these drugs come with nasty side effects like headaches, fatigue, and sudden fainting.The truth is that…Prostate drugs do not work.At best they hide the symptoms but only for a short while. And at worst they come with a whole bunch of nasty side effects.

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What Are The Warning Signs Of Prostate Cancer

Risk factors for prostate cancer include age, family history, race, and obesity. You may be at higher risk for prostate cancer if you are over age 50, have a family history of prostate cancer, are overweight, or if you are a Black man. See your doctor if you have any of these symptoms:

  • Trouble passing urine

What Is The Difference Between Robotic And Laparoscopic Radical Prostatectomy

Benign Prostatic Hyperplasia (BPH) Specialist

Both are minimally-invasive techniques of performing radical prostatectomy for cancer. In laparoscopic radical prostatectomy, the surgeon stands by the operating table and himself manipulates the instruments. In robotic prostatectomy the surgeon is seated at a robotic console near the patient from where he drive the robotic instruments to perform the operation. The robot faithfully and accurately reproduces the surgeon’s sophisticated maneuvers.

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Side Effects Of Robotic

The rates of major side effects from robotic-assisted laparoscopic radical prostatectomy are about the same as open surgical approaches. The most common side effects include the following:

  • Urinary incontinence : Similar to open surgery, urinary incontinence can occur following a robotic prostatectomy. However, this side effect often improves over time.

  • Erectile dysfunction : The return of erectile function following prostatectomy is based on the patients age, degree of preoperative sexual function and whether the nerves were spared during surgery. Unless cancer is suspected in the nerve tissue, surgeons will use nerve-sparing techniques during robotic prostatectomy to minimize the surgical impact on sexual function.

Robotic Prostate Surgery | Q& A

Thanks to advances made by surgeons like Dr. Patrick Walsh, The Brady Urological Institute at Johns Hopkins offers unparalleled prostatectomy expertise. Learn more about prostate cancer surgery and the difference between open and robotic procedures from Dr. Mohamad Allaf.

What Are My Chances Of Having Problems With Bph

Its estimated that about one-third of men over age 60 will have moderate-to-severe problems related to BPH. By age 80, about one-half of all men experience significant problems.

Other factors that increase your risk of BPH include:

  • Family history of prostate problems in a brother or father
  • Personal medical history of diabetes or heart disease
  • Use of certain medications, such as beta-blockers for high blood pressure

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Histopathological Analysis Of The Specimens

All prostate specimens were processed in accordance with a well-established protocol and reviewed by a pathologist . The pathologist recorded the tumor location, extracapsular extension , seminal vesicle invasion , vas invasion, pathological Gleason score, pathological stage, and positive surgical margin. A positive surgical margin was defined as a cancer gland reaching the inked margin.

Robotic Simple Prostatectomy: Not So Simple

Robotic Prostate Surgery Benefits

So if you are new to Dr.Bevan-Thomas.com or you are just getting started here, one common theme that you will notice is that prostate size really does matter. It may not be something to brag about when you go to the barber shop, but its important nonetheless. A larger prostate does not always mean that a man will get BPH symptoms or have a higher IPSS score however, they are at higher risk of developing BPH symptoms in the future.

If you are a man with BPH symptoms or an enlarged prostate, it is imperative that Dr. B-T evaluate the size of the prostate. The minimally invasive options are great for men with smaller- to medium-sized prostates, but once the prostate gets larger than 100 grams, these are no longer options that get results.

Remember the IPSS questionnaire. These 100 gram-plus sized prostates are twice the size of the average prostate and usually require a different approach. Dr. Bevan-Thomas specializes in robotic surgery, so he has you covered. Dr. B-T has removed prostates up to 6 times the average size!

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What Are The Advantages Of Cleveland Clinic’s Prostate Surgery Program

These procedures are performed through small key-hole incisions that do not cut muscle. Laparoscopic and robotic prostatectomy offer surgeons unparalleled visualization of the area, thus permitting precise removal of the prostate. Patients also experience significantly less blood loss. Additionally, patients benefit from:

  • Reduced hospital stay after surgery and faster healing
  • Less postoperative pain and virtually no need for pain medication
  • Earlier removal of catheter
  • Shorter recovery time
  • Quicker return to normal activity and work
  • Smaller “Band-aid” incisions and less scarring

Less Time Under Anesthesia With Open Prostatectomy

An open prostatectomy, however, is a much shorter surgery than the robotic procedure, which means patients spend less time under anesthesia. Length of anesthesia for an open prostatectomy is 2 to 3 hours, compared to 4 to 7 hours for a robotic prostatectomy.

In several measures, there is no demonstrated difference between open and robotic prostatectomy. The risk of blood transfusion for an open prostatectomy is less than 1 percent, and fewer than 1 percent of patients have wound complications. Post-operative pain on the morning following surgery is typically 2 on a 10-point scale. The patients length of stay in the hospital is 1½ to 2 days. Approximately 85 percent of patients regain excellent urinary control, and three-quarters retain sexual potency.

While all precautions are taken to reduce the likelihood of complications, no surgical treatment is completely without risk. Potential complications of open and robotic prostatectomies include infection, bleeding requiring blood transfusion, urinary incontinence, erectile dysfunction and injury to adjacent organs.

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Postoperative Care After Prostate Surgery

After a healthy operation and discharge, there are some rules that you must follow. There is a risk of bleeding for the first several months after surgery. Therefore, there are some points to take into consideration. The length of the recovery period after prostate cancer surgery varies depending on some conditions. There are factors such as the type of surgery, the stage of disease, and the patientâs health status. However, overall recovery time is short.

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The Initial Causes Prostate Robotic Surgery

Urology and Prostate Cancer Services And Treatments San Jose

One of the first symptoms of prostate issues is pain or tenderness in the groin or lower back. This can be the result of a noncancerous condition called enlarged prostatic tissue, or it could be an infection of the bladder. In either case, its important to see a doctor as soon as possible. If youre suffering from prostate pain, you may want to consider reducing your caffeine intake.

Another symptom of a potentially enlarged prostate is difficulty starting a stream of urine, leaking, or dribbling. These symptoms are not serious, but theyre still alarming. Most men put up with an enlarged prostate for years before seeking medical attention, but they typically seek treatment as soon as they notice symptoms. Even if you dont have symptoms, its worth getting checked to determine if you have any prostate issues.

If you experience nightly bathroom runs, you may be experiencing an enlarged prostate. You may be having difficulty starting a stream of urine, or you may even be dribbling or leaking during the day. These problems arent life-threatening, but can become a nuisance. You should not ignore these signs and seek treatment as soon as you notice them. If you feel any of these symptoms, you should consult a doctor.

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Questions To Ask Before Surgery

As you think over the options for surgery, ask your doctor these questions:

  • Is there a good chance my condition will get better?
  • How much will it improve?
  • What are the chances of side effects from a treatment?
  • How long will the effects last?
  • Will I need to have this treatment repeated?

With newer technologies, doctors can do some minimally invasive procedures with tiny cuts or use tube-style instruments that they insert into you. These procedures may not treat the symptoms to the same degree or durability as more invasive surgical options, they do have faster recoveries, less pain afterward and have reduced risks.

Other times, the traditional and more invasive surgery may be needed. It all depends on your case and what you and your doctor decide is best for you.

Doctors can choose from these minimally invasive procedures, endoscopic, or open surgeries to treat moderate to severe symptoms. These procedures are also used if tests show that your ability to pee is seriously affected.

What Is A Robotic Prostatectomy

Robotic prostatectomy, or robotic-assisted laparoscopic radical prostatectomy, is the complete surgical removal of the prostate, seminal vesicles, and vas deferens for the treatment of prostate cancer. Compared with the traditional open operation, the procedure is performed through small incisions using the daVinci Surgical System.

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Top Prostate Cancer Surgeon

Dr. Razdan is considered by many as one of the Most Experienced Robotic Prostate Cancer Surgeons in the Worldwith over 8,500 procedures performed to date. He is considered a Pioneering Researcher and Surgeon on Prostate Cancer and has some of the best Robotic Surgery Outcomes in the world. Patients travel from all around the world to Miami to have Prostate Cancer Surgery with Dr. Razdan. From CEOâs of large corporations, celebrities, government officials and even other surgeons entrust Dr. Razdan and his unique set of skills and incredible outcomes. He was the First Surgeon in the World to USE HUMAN AMNIOTIC MEMBRANE for EARLY RETURN of ERECTILE FUNCTION after robotic prostate surgery. He founded and pioneered the technique of MAXIMAL URETHRAL LENGTH PRESERVATION for EARLY RETURN OF URINARY CONTINENCE after robotic prostate surgery which was also published Patients travel to Dr. Razdan for his leading outcomes in terms of Cancer Control, Urinary Continence and Erectile FunctionMost patients have full urinary control often within days of surgery and almost 98% are continent by 6 monthsMajority of patients have erections sufficient for sexual activity by 6 months

Facts Every Man Should Know Before Prostate Cancer Surgery

Robotic Surgery for BPH with Dr. Jaffe

Many men want to know what prostate cancer surgery is like, including what to expect before surgery and what to expect afterwards.

Here are my findings based upon more than 1,000 phone calls to men the day before surgery, almost 700 visits to men the day after surgery and hundreds of calls from men in the weeks following surgery.

  • Most men experience very little surgical pain â probably 80 percent are like meâ¦I had my surgery on a Monday by Friday I was at a graduation party . I got by with only Advil for pain relief. Itâs been described as feeling like they did too many sit-ups.
  • Men really fear the catheter. I let them know that they will be asleep when it is put in. They may be like me and sleep very well with it in. Changing bags from a large capacity night bag to a smaller capacity day bag is simple and doesnât involve removing the catheter. Walking with the day bag catheter is not a problem. Removal of the catheter is usually done in the doctorâs office after the prescribed timeframe and is relatively pain-free.
  • If all goes as planned, you will be walking the night of surgery and then the next day. Most men go home the following afternoon, unless they are otherwise directed by the doctor.
  • Your biggest discomfort may be from gas pains, hence the walking. For a robotic surgery, they have to fill the body cavity with gas to manipulate the equipment. Until we get rid of the gas in the normal way we do, there can be discomfort.
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    About Your Prostate Surgery

    A radical prostatectomy is a surgery to remove your entire prostate gland and seminal vesicles. Some of the lymph nodes in your pelvis are removed as well. This is done to prevent cancer from spreading from your prostate to other parts of your body.

    A radical prostatectomy can be done in 1 of 2 ways. One way is through an open incision , which is called an open prostatectomy. Another way is to use a laparoscope, which is a tube-like instrument with a camera. Your surgeon will talk with you about the best surgery option for you.

    Open prostatectomy

    In an open prostatectomy, your surgeon will make an incision that goes from your pubic bone towards your belly button . Theyll remove the pelvic lymph nodes first, followed by the prostate gland, and then the structures next to it.

    Figure 2. Open prostatectomy incisions

    Laparoscopic or robotic-assisted prostatectomy

    During a laparoscopic or robotic-assisted prostatectomy, your surgeon will make several small incisions in your abdomen . Theyll insert a laparoscope into 1 of the incisions and use gas to expand your abdomen. Surgical instruments will be inserted into the other incisions to remove the prostate. Some surgeons at MSK are specially trained to use a robotic device to assist with this procedure.

    Figure 3. Laparoscopic or robotic-assisted prostatectomy incisions

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    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:
  • I smoke or use an electronic smoking device, such as a vape pen, e-cigarette, or Juul®.
  • I use recreational drugs.
  • 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.

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    How Long Has Cleveland Clinic Been Performing Laparoscopic Prostatectomies

    Cleveland Clinic was the first in the United States to establish laparoscopic prostatectomy program in 1997 and routinely offer this procedure to patients. Our specialists have been performing robotic prostate surgery for the past 5-6 years.

    Robotic and Laparoscopic Surgery Offer Advantages in Treatment of Prostate Cancer

    Cleveland Clinic was the nation’s first medical center to routinely perform laparoscopic prostate surgery and amongst the first to perform robotic radical prostatectomy. Now laparoscopic and robotic surgery is enabling surgeons to perform this complex minimally invasive surgery with more precision, offering patients improved outcomes. Cleveland Clinic uses the state-of-the-art robotic surgical system that has been approved by the FDA for use in performing many surgical procedures, including radical prostatectomies, general laparoscopic surgery, thoracoscopic surgery, and thoracoscopically-assisted heart procedures.

    Control Of The Lateral Pedicles And The Veil Of Aphrodite

    Best Urology and Robotic Services In Delhi â Dr Rajesh Taneja

    The lateral pedicles at the prostate vesical junction are controlled using Hem-o-lock clips and/or bipolar coagulation. The clips are applied close to the prostate, and the pedicle is divided between them . Once the dissection enters the plane between the prostatic fascia medially and the levator fascia laterally, electrocautery is avoided and the anterior nerve-sparing dissection proceeds using sharp cutting with scissors and blunt dissection using the grasper . This dissection proceeds distally to the puboprostatic ligaments.

    Several authors have also advocated a completely cautery-free or athermal dissection of the lateral pedicles to avoid any inadvertent damage to the neurovascular bundle. This can be achieved with laparoscopic bulldog clamps and oversewing of the neurovascular bundle for hemostasis. Although results of this technique have not been validated in large series, minimizing the use of cautery or other thermal hemostatic instruments during dissection near the neurovascular bundle seems prudent.

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