Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks, such as urinary incontinence and erectile dysfunction.
In extremely rare cases, problems arising after surgery can be fatal.
Its possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
Studies have shown that radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery.
You may want to ask your doctors about storing a sperm sample before the operation so it can be used later for in vitro fertilisation .
Schedule An Appointment To See A Urologist
To schedule an appointment with a urologist at University of Utah Health, call 801-213-2700. You do not need a referral from your primary care provider or another care provider to schedule an appointment with our urologists. However, some insurance plans do require a referral in order for HoLEP to be covered. Talk to your insurance carrier about your specific plan requirements.
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Tips For Coping With An Enlarged Prostate
When a man reaches about age 25, his prostate begins to grow. This natural growth is called benign prostatic hyperplasia and it is the most common cause of prostate enlargement. BPH is a benign condition that does not lead to prostate cancer, though the two problems can coexist.
Although 50% to 60% of men with BPH may never develop any symptoms, others find that BPH can make life miserable. The symptoms of BPH include:
- a hesitant, interrupted, weak urine stream
- urgency, leaking, or dribbling
- a sense of incomplete emptying
- more frequent urination, especially at night.
As a result, many men seek treatment. The good news is that treatments are constantly being improved. Patients and their physicians now have more medications to choose from, so if one doesnt do the trick, another can be prescribed. And thanks to some refinements, surgical treatments are more effective and have fewer side effects than ever before.
But there are some things men dealing with BPH can do on their own. When symptoms are not particularly bothersome, watchful waiting may be the best way to proceed. This involves regular monitoring to make sure complications arent developing, but no treatment. For more troubling symptoms, most doctors begin by recommending a combination of lifestyle changes and medication. Often this will be enough to relieve the worst symptoms and prevent the need for surgery
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What Is Focal Laser Ablation
Patient Dr. Michael Bedecs tells his story
Laser ablation generates intense heat that completely encompasses the targeted area. Under real-time MRI guidance, a special optical fiber is guided precisely into place at the core of the tumor. When activated, the laser emitted at the tip of the fiber destroys the tumor within minutes while special tracking called thermometry confirms the proper temperature. Afterward, multi-parametric MRI scans reveal that the destruction is complete, and the laser fiber is removed.
Did you know Focal Laser Ablation can ease the symptoms of BPH?
Surgery To Remove Prostate Cancer
Surgery is one of the main treatments for prostate cancer. You usually have surgery to remove your prostate gland. This is a radical prostatectomy.
A radical prostatectomy is a major operation with some possible side effects. You may not need this type of surgery if you’re an older man with a slow growing prostate cancer. This is because your cancer might grow so slowly that you’re more likely to die of old age or other causes than from prostate cancer.
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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
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What Side Effects Will I Have
During your treatment, radiation must pass through your skin. You may notice some skin changes in the area exposed to radiation.
Your skin may become red, swollen, warm, and sensitive, as if you have a sunburn. It may peel or become moist and tender. Depending on the dose of radiation you receive, you may notice hair loss or less sweat within the treated area.
These skin reactions are common and temporary. Theyâll fade gradually within 4 to 6 weeks after you finish your treatment. If you notice any skin changes outside the treated area, tell your doctor or nurse.
Long-term side effects, which can last up to a year or longer after treatment, may include:
- A slight darkening of the skin
- Skins feels more or less sensitive
- A thickening of tissue or skin
Other possible side effects of external beam radiation therapy are:
Tiredness. Your fatigue might not lift until a few weeks or months after you finish getting radiation therapy.
Lymphedema. If radiation therapy damages the lymph nodes around your prostate gland, the fluid can build up in your legs or genital area. That can bring on swelling and pain. Physical therapy can usually treat lymphedema, but it might not go away completely.
Urinary problems. Radiation can irritate your bladder, and that could lead to a condition called radiation cystitis. You might:
- Have to pee more often
- Feel like it burns when you pee
- Notice blood in your urine
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Open Rp Versus Robotic
The ability to perform robotic-assisted laparoscopic RP was first described in 2000. Over the past decade, RALRP has gained widespread acceptance and now is the dominant approach to RP in the United States. Many attribute the adoption of the RALRP to marketing as opposed to any objective outcomes data showing superiority over the open approach.
All of the intermediate- and long-term HRQOL outcomes reported in the literature are limited to open RP. The question is, are these findings relevant to RALRP?
Unfortunately, there are no randomized studies comparing HRQOL outcomes following open versus robotic RP. The majority of studies comparing HRQOL outcomes between the two techniques are flawed in design. First, the level of experience of surgeons performing the two techniques and their patient volume are often not comparable. In addition, validated instruments for capturing outcomes are usually not employed. Surgeons are sometimes involved in the data acquisition, entry, and interpretation, which can introduce bias. There are several studies that have examined large administrative databases, which often mitigate bias, but the quality of outcome measures is subject to criticism. A few studies stand out as objective and worthy of comment.
Barocas and colleagues compared men undergoing open and RALRP and failed to show any advantages of either approach for preventing biochemical recurrence.
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Help Managing Cancer Treatment Side Effects
The team at Compass Oncology is experienced in helping patients treat prostate cancer and manage the side effects of treatment. If you live in the Portland-Vancouver area, have more questions about the side effects of prostate cancer treatment, or need help managing your side effects, request an appointment at one of our locations that’s convenient for you. We’re here with you every step of the way.
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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
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The Importance Of Prostate Massage
Prostate massage is a treatment that addresses the root cause of most prostate issues. Treatments like surgery and medications only provide temporary relief by treating the symptoms and not the cause.
On the other hand, regular prostate massages encourage the gland to work without problems. A man will not be subjected to dangerous side effects from medication or complications from surgery. Massage also helps make the prostate stronger and more resistant from disease and infection.
Advantages Of Prostate Massage
Although regular prostate massage can help to eliminate or reduce the severity of any symptoms a man may have, it can also offer other benefits especially with improved sexual enjoyment and function.
It is a fact that modern medicine has not been able to determine the causes and treatments for many conditions related to the prostate. Even though prevention is the best medicine, prostate massage will help improve your prostateâs health and prevent existing conditions from becoming worse.
However, in the case of bacterial prostatitis, left untreated, can cause intense inflammation and increased bacterial growth.
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Pelvic Radiation Therapy Effect On Erections
Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
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Robotic Prostate Surgery Details
Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patients abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is much less invasive than a conventional radical retropubic prostatectomy, which involves an abdominal incision that extends from the belly button to the pubic bone.
During robotic-assisted radical prostatectomy, a three-dimensional endoscope and image processing equipment are used to provide a magnified view of delicate structures surrounding the prostate gland , allowing optimal preservation of these vital structures. The prostate is eventually removed through one of the keyhole incisions.
For most of the surgery, the surgeon is seated at a computer console and manipulates tiny wristed instruments that offer a range of motion far greater than the human wrist. The surgery is performed without the surgeons hands entering the patients body cavity.
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Compared with traditional open surgery, patients who undergo robotic-assisted radical prostatectomy experience:
Less blood loss
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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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Hormone Therapy Side Effects
Testosterone is the primary male hormone, and plays an important role in establishing and maintaining typical male characteristics, such as body hair growth, muscle mass, sexual desire, and erectile function, and contributes to a host of other normal physiologic processes in the body. The primary systemic …
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The Sperling Prostate Center Advantage
Our philosophy is to match the treatment with the disease. Our BlueLaser 3T mpMRI-Guided Biopsy is the most responsible and accurate way to know your disease before making a treatment decision. We help patients avoid the risk of under-treating aggressive disease, or over-treating insignificant disease that can safely be monitored. We pride ourselves on having attained international recognition for excellence in real-time MRI-guided prostate cancer diagnosis.
If BlueLaser 3T mpMRI detects cancer, a biopsy is essential because prostate cancer may not show early symptoms, though certain warning signs indicate increased prostate cancer risk:
- An elevated or rising PSA blood test result
- An abnormal digital rectal exam
- A family history of prostate cancer or breast cancer
- Being of African-American descent
- Exposure to certain cancer-causing toxins, e.g. Vietnam vets exposed to Agent Orange
- In later stages, prostate cancer may show symptoms such as urinary difficulties, blood in urine, pelvic or back pain, and bone pain. See a doctor if any of these symptoms occur.
Short Term Side Effects
Patients who receive any type of radiation therapy to treat their prostate cancer can have side effects. Short term side effects are ones that start during or shortly after your radiation treatment. Below is a list of possible short term side effects. Treatments can affect each patient differently, and you may not have these particular side effects. Talk with your care team about what you can expect from your treatment
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Changes In Your Sex Life
Most men experience some decline in erectile function after their prostate is removed, but this can be managed. It can take six months or even up to a year for the affected nerves to recover from surgery. But with proper therapy and treatment, most patients can have good erectile function again, says Dr. Fam.
Treatment options include:
Work with your doctor to find a treatment that is right for you.
Many Men Underestimate Prostate Surgery Side Effects
New research finds that men who undergo prostate removal often suffer more from incontinence and impotence than they expected, even when counseled beforehand about possible aftereffects.
The findings suggest theres a wide gap between what men with prostate cancer expect post-surgery and what actually happens and that many are shocked by the level of dysfunction after the operation.
After the surgeries, we find that men are very disappointed and very sad. Its as if they really didnt hear what was being told to them, said study lead author Daniela Wittmann, a sexual health coordinator at the University of Michigans prostate cancer survivorship program.
Removal of the prostate, a treatment for prostate cancer, is especially common among younger men, while older men often turn to radiation, said Dr. Stephen Freedland, an associate professor of urology and pathology at Duke University in Durham, N.C. The procedure can lead to urinary incontinence, sometimes to the point where men need to wear padding, as well as difficulty attaining and maintaining an erection.
Prostate cancer is also sometimes treated with hormonal therapy, which can also lead to impotence and other serious side effects, or by watchful waiting, which means having regular exams while doctors keep an eye on the tumor to see if it grows or spreads. The latter is usually recommended when physicians feel someones age will allow them to outlive the generally slow-moving cancer.
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Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
Treatment Options For Urinary Incontinence Can Include:
- Pelvic floor physical therapy. These specialized physical therapists are trained to help men strengthen their pelvic floor muscles. These muscles help you control the flow of urine. The exercises are called Kegel exercises just as you might do bicep curls to strengthen your arm muscles Kegel exercises help you learn to tighten and relax the muscles that control your flow.
- Bladder training. The bladder is a muscular organ that can be trained. A pelvic floor physical therapist or your urologist will provide simple behavioral changes to help retrain your bladder.
- Medication. Prescription medicines help the muscles in your bladder and sphincter . These medications work well for men with urge incontinence.
- Surgery. Surgery may be scheduled if you have a blockage. Other surgical procedures include injecting collagen to strengthen the urinary sphincter that controls urine release or implanting an artificial urinary sphincter.
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