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What Does Prostate Surgery Entail

How Do I Use A Night Drainage Bag

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The night drainage bag is larger than the leg bag and holds more urine. It is made to hang on the side of a bed or chair, or to be attached to any loose-fitting pants . The drainage bag may have hooks to fasten to your bed frame. If you are using a safety pin to fasten the catheter to your bed sheet or your clothing, make sure the safety pin goes around the catheter tube and not through it. Leave some slack in the tube so the catheter will not be pulled when you move your leg. You need to keep your urine collection bag below the level of your bladder. Whenever you are spending a lot of time lying down or sitting still, the night bag will work better. The night bag should always be used at night while you are sleeping. Do not put the bag on the floor. Before you go to sleep at night, you should change your leg bag to a night drainage bag.

To use a night drainage bag:

To empty the night drainage bag:

When you aren’t using your night bag, it should be washed out with soap and water and hung up to dry. This should be done once a day.

What Is The Life Expectancy After Prostate Removal

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What is the life expectancy after prostate removal?

In addition, radiation can be given after surgery if necessary, with a limited risk of any additional side effects. Patients who choose radical prostatectomy should: Be in very good health. Have a life expectancy exceeding 10 years.

Does prostate removal shorten life expectancy?

After 23 years the men treated with radical prostatectomy gained a mean of 2.9 extra years of life. The researchers found that the absolute benefit associated with radical prostatectomy increased by a factor of more than two from 10 to 23 years follow-up in terms of overall mortality and disease specific mortality.

Can you live a long life after prostate cancer? You can live a long time with prostate cancer. If you catch and treat it early, you might even be able to cure it. Staying as healthy as possible plays an important role.

What are the side effects of living without a prostate?

The two prominent quality-of-life issues associated with living without a prostate are the loss of urinary control and the loss of erectile function.

Treatment Options For Prostate Stones

Most men with prostate stones will not require any treatment, again due to lack of symptoms. Also, sometimes, prostate stones may pass on their own in a mans urine. However, if they do become infected and are causing prostate or urinary tract problems, then they may require antibiotics. In more severe cases, they can be removed surgically. Prostatic calculi can be easily removed with a transurethral electro-resection loop or holmium laser if they cause difficulty in urination or chronic pain.

Any man, having urinary symptoms or pain in the lower pelvic region, needs to see his doctor right away for a thorough examination and diagnosis of what the problem may be.

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The Morning Of Your Surgery

Instructions for drinking before your surgery

You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Take your medications as instructed

If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.

Shower with a 4% CHG solution antiseptic skin cleanser

Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.

Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.

Things to remember

  • Wear something comfortable and loose-fitting.
  • If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
  • Dont wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
  • Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
  • Leave valuable items at home.

What to bring

Once youre in the hospital

Get dressed for surgery

When its time to change for surgery, youll get a hospital gown, robe, and nonskid socks to wear.

Meet with a nurse

Transurethral Resection Of The Prostate

Injection of 99m Tc

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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During Surgery For Bph

The vast majority of BPH surgeries are performed using a transurethral technique, of which there are several types. With each, a tube-like instrument called a cystoscope or resectoscope reaches the prostate gland via the urethra.

Some transurethral techniques include:

  • Transurethral resection of the prostate : An electrified wire loop is used to remove prostate tissue. This is the most common surgery used to treat BPH.
  • Transurethral electrovaporization of the prostate : Electrical energy applied through an electrode is used to heat and vaporize an area of enlarged prostate tissue.
  • Transurethral incision of the prostate : No prostate tissue is removed, but two deep cuts are made starting in the bladder neck . The purpose of these cuts is to widen the urethra in order to improve urine flow.
  • Laser energy is used to vaporize prostate tissue.
  • Laser enucleation of the prostate: A holium or thulium laser is used to remove excess prostate tissue that is blocking urine flow.
  • Transurethral microwave therapy : A specialized urinary catheter with a small microwave antenna is used to heat and destroy prostate tissue.

Why Might I Need A Urinary Catheter

To help you understand why you might need a urinary catheter, you need to learn how your bladder works. Your bladder holds urine until you have the need to urinate . Urine flows out of the bladder, and leaves your body through your urethra. Your urethra is a tube that carries urine and semen through your penis to the outside of your body. Urination happens when the muscles in the wall of your bladder tighten, forcing urine out of your bladder. As the muscles in your bladder tighten, the muscles around your urethra relax and let you urinate. The prostate gland surrounds the urethra. If your prostate is enlarged or you have had treatment for your prostate cancer you may need a urinary catheter. The catheter is used when you cannot urinate by yourself or when your bladder or urethra need time to heal. This may happen for a number of reasons, such as:

If you need a urinary catheter, your doctor or health care team will show you how to care for your urinary catheter.

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Immediately After A Prostatectomy

After the operation, you can expect that:

  • Nurses will monitor your vital signs.
  • You may be given oxygen for up to 24 hours following surgery.
  • You will probably be given antibiotics to prevent infection.
  • For a day or so, you will have a catheter in your urethra and bladder with a continuous wash-out. This is to prevent blood building up and clotting, which could cause a blockage.
  • If you had an open prostatectomy, your wound will be dressed and you will have a tube draining your abdomen. The tube will be removed after several days.
  • Pain will be managed with injections, tablets or both. Pain is rarely a significant problem following TURP.

Urinary Problems After Surgery

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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.

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What Happens During Surgery

The aim of surgery is to make the prostate gland smaller so that it no longer pushes against the bladder and urethra. In most of the approaches, tiny instruments are guided through the urethra until they reach the prostate, where they are used to remove tissue or widen the urethra. This kind of procedure is known as keyhole surgery. If the prostate gland is very large, it may be operated on from the outside, through a cut in the abdominal wall . This is rarely necessary, though.

Many different surgical techniques and many different instruments and devices can be used to remove prostate tissue in different ways.

How Turp Is Performed

TURP is carried out using a device called a resectoscope, which is a thin metal tube containing a light, camera and loop of wire. This is passed along your urethra until it reaches your prostate, which means no cuts need to be made in your skin.

The loop of wire is then heated with an electric current and used to cut away the section of your prostate causing your symptoms. A thin tube called a catheter is then inserted into your urethra to pump fluid into the bladder and flush away pieces of prostate that have been removed.

General or spinal anaesthesia is used during the procedure so you don’t feel any pain while it’s carried out.

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Within 30 Days Of Your Surgery

Presurgical Testing

Before your surgery, youll have an appointment for presurgical testing . The date, time, and location will be printed on the appointment reminder from your surgeons office. Its helpful to bring the following things to your PST appointment:

  • A list of all the medications youre taking, including prescription and over-the-counter medications, patches, and creams.
  • Results of any tests done outside of MSK, such as a cardiac stress test, echocardiogram, or carotid doppler study.
  • The name and telephone number of your healthcare provider.

You can eat and take your usual medications the day of your appointment.

During your PST appointment, youll meet with a nurse practitioner . They work closely with anesthesiology staff . Your NP will review your medical and surgical history with you. You may have tests, such as an electrocardiogram to check your heart rhythm, a chest x-ray, blood tests, and any other tests needed to plan your care. Your NP may also recommend that you see other healthcare providers.

Your NP will talk with you about which medications you should take the morning of your surgery.

Complete a Health Care Proxy form

If you havent already completed a Health Care Proxy form, we recommend you complete one now. If youve already completed one or have any other advance directives, bring them to your next appointment.

Sperm banking

Male Sexual and Reproductive Medicine Program

Do breathing and coughing exercises

Exercise

Follow a healthy diet

Prostate Surgery With Urology Specialist

Transurethral Resection of the Prostate (TURP)

Dr Arianayagam is highly experienced in all aspects of prostate surgery, in particular robotic radical prostatectomy.

Dr Arianayagam performs robotic radical prostatectomy at both Macquarie University Hospital and Nepean Public Hospital. Dr Arianayagam has performed over 250 robotic cases. He is a proctor for Device Technologies, who supply the Da Vinci Robotic System in Australia. Being a proctor means Dr Arianayagam is qualified to teach other surgeons to use this technique.

If you have any questions regarding prostate surgery, or would like to book an appointment, please feel free to contact Urology Specialist here.

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How To Do Active Surveillance Right

After a diagnosis of low-risk prostate cancer, you may be presented with a range of treatment options. Considering the slow progress of most prostate cancer, active surveillance is a reasonable choice for many men. Even if you live a long time after your diagnosis, your cancer may neverbecome aggressive and cause harm. Often, low-risk prostate cancer hardly progresses at all, even over decades.

If you choose to go the active surveillance route, do it the smart way. Dr. Hu recommends that for the first two years after your diagnosis

  • Get a PSA test every six months.
  • Have an office visit that includes a digital exam every six months.
  • Within the first two years after diagnosis, get at least one follow-up biopsy as well as magnetic resonance imaging and precision medicine tests to reduce the risk of missing more aggressive cancer.

What happens next depends on those first two years. If it looks like your cancer is stable and not progressing, your doctor may suggest less frequent follow-ups. But if there is evidence that the cancer is becoming more aggressive, then you can decide at that time whether radiation, surgery, hormone therapy or some combination of these treatments is right for you. You may never need treatment, but if you do, youll get it when its still highly effective.

Surgery To Remove Your Prostate Gland

You might have surgery to remove your prostate gland if:

  • your cancer hasn’t spread outside the prostate gland
  • you are younger and have a fast growing tumour
  • as part of treatment for locally advanced or high risk localised prostate cancer

The aim of a radical prostatectomy operation is to cure prostate cancer. It is major surgery with some possible side effects. If you’re an older man with a slow growing prostate cancer, this type of surgery may not be necessary for you. 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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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
  • Open surgery
  • Uses traditional incisions and tools
  • May be used for more complex cases
  • 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

    Side Effects Of Conventional Prostate Bph Treatments And Enlarged Prostate Surgery

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    If you are very lucky you may well have an improved urinary function and few side effects after enlarged prostate surgery. Unfortunately, that is not the case overall.

    If you think that BPH operations are harmless, think again. In my experience, side effects are not fully explained and are minimized. Why? Because doctors:

    • think they are providing the best treatment based on what they know and what they have available to offer,
    • often directly benefit financially from the procedures, and
    • are unaware of any other options.

    If they do know of alternative options, they could risk losing their medical license by offering those alternative treatments.

    All of the conventional treatment options I mention on this page have consequences of:

    • major discomfort to pain
    • possible incontinence
    • impotence and sexual difficulties
    • retrograde ejaculation
    • and often the treatment will need to be repeated at a future date with scarring occurring with each attempt, which makes each procedure less successful and exacerbates the side effects.

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    Approaches To Radical Prostatectomy Surgeons Can Use Different Approaches And Techniques Toremove The Prostate They Can Make A Large Incision To Reach The Prostate They Can Also Use Laparoscopic Orrobotic Techniques Which Are Done Through Smaller Incisions In The Pelvis Laparoscopicand Robotic Types Of Surgery Are Less Invasive Than An Open Radicalprostatectomy Men Often Have Shorter Recovery Times Less Blood Loss Lesspain And Shorter Hospital Stays With These Procedures Retropubic Radicalprostatectomy Is Done Through An Incision In The Lower Abdomen The Surgeoncan Also Remove Lymph Nodes From The Pelvis Through The Same Incision Incanada A Retropubic Radical Prostatectomy Is The Most Common Approach Toremoving The Prostate To Treat Cancer

    Perineal radical prostatectomyis done through an incision in the area between the scrotum and the anus. This surgery usually doesn’t take as long to do as aretropubic radical prostatectomy, but it may lead to more problems with gettingan erection . In addition, surgeons can’t removepelvic lymph nodes through the same incision so they would have to do aseparate procedure through a small cut in the lower abdomen to remove them.

    Laparoscopic radical prostatectomyuses a laparoscope and other surgical instruments passed through small cuts. A laparoscopicprostatectomy has some advantages over an open radical prostatectomy, includingless blood loss and pain, shorter hospital stays, faster recovery and less timewith a catheter.

    Robotic radicalprostatectomy is a type of robotic surgery. The surgeon sits near theoperating table and uses remote controls to move robotic arms. The robotic armshave tiny video cameras and surgical instruments that remove tissue throughsmall cuts. The robotic arms can bend and turn like a human wrist. A roboticprostatectomy also has advantages over an open radical prostatectomy includingless blood loss and pain, shorter hospital stays, faster recovery and less timewith a catheter.

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