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What Happens If The Prostate Is Removed

Does Incontinence Go Away On Its Own After Prostate Surgery

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For most men, urinary incontinence will go away within about 1 year. The time frame varies depending on how severe your incontinence is, and what types of treatments youre using to manage it. Some men may recover from leaks within weeks, whereas others will take months for the bladder leaks to subside. Performing pelvic floor exercises, also known as Kegels, which help strengthen the muscles that are located in the base of the pelvis between the pubic bone may help to speed the recovery process along.

Difficulty Getting An Erection

Impotence is more likely to happen if you are older. Nerve sparing surgery and robotic surgery may reduce the risk for some men. Speak to your doctor before you have surgery to get an idea of your risk of problems afterwards.

What Happens During My Operation

A general anaesthetic will be used you will be asleep throughout the procedure. During surgery, you will be given antibiotics by injection.

Robotic-Assisted Laparoscopic Prostatectomy

Robotic surgery is performed via keyhole incisions and uses sophisticated mini-instruments which are under the control of the surgeon. The robot mimics and assists the surgeons movements it does not do the operation. The technique is now widely used because of its high degree of surgical accuracy, and because your recovery is faster than it is for open surgery.

Six small incisions are made into the abdomen through which the robotic instruments are inserted. The robot is placed beside you in the operating theatre. The robot has four arms three for instruments and one for a high magnification 3-D camera to allow the surgeon to see inside your abdomen. The robotic instruments are small approximately 7mm in width. The surgeon sits in the same rooms but away from the patient and with the robotic technology is able to carry out more controlled and precise movements in a small space within the body.

The muscle fibres and nerves that control continence are preserved.

The skin is closed with absorbable sutures which are located under the skin and are not visible and the outside is sealed with skin glue.

Blood loss is usually less than 200mL and the risk of a blood transfusion is < 2%.

Open Prostatectomy

Blood loss is usually around 500mL. The risk of a blood transfusion in my hands is < 2%.

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Side Effects From Radiation

Urinary symptoms from radiation treatment for prostate cancer are different from those caused by prostate surgery. Its more like a urinary tract infection-increased urgency and frequency, and men may some have bleeding or pain when they urinate, Calvaresi said. These problems often go away once treatment is complete.

Radiation also may cause bowel changes, such as constipation, loose stools or both. These can be managed by over-the-counter medication. Men may also see some blood in their stool during treatment-if so, let your health care provider know about this.

Men undergoing radiation are likely to have ED, but not immediately. It slowly sets in after radiation treatment, Calvaresi said. Treatments for radiation-related ED are the same as ED caused by prostate cancer surgery.

What To Do Next

Prostate surgery

Learning that your PSA level is higher than it should be can be very stressful. Talk to your doctor about what your results mean and your next steps. You may need more treatment, or you might be able to wait and have regular PSA tests to watch your cancer.

Its important to remember that your PSA test doesnt tell the whole story. Levels can go up and down, and theyre different for each person. Even if you do still have cancer or your cancer has come back, it may not spread for a long time.

If your cancer does come back, treatment options include radiation in the area where your prostate used to be, and hormone therapy. Having these treatments can reduce the risk that your cancer will grow and spread.

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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.

Considerations When Opting For Surgery

Before agreeing with any surgery, knowing its benefits and risks is vital. It is even more important when the surgery is not urgent, like in the cases of proctectomy.

Thus, one should ask a doctor about various treatment options, prostate surgery recovery, and what to expect after prostate surgery.

Sometimes prostate surgery is one of the options. Thus, it is important to ask a doctor if it would be better to have some watchful waiting.

If one goes for prostate removal, one should know about the benefits, prostate surgery complications, the side effects of living without a prostate, how long prostate cancer surgery is, its impact on sex life, etc.

Additionally, one should inquire about all the surgical options available and consider the risk and benefits of each of the options.

Quite often, doctors may also help in making the decision. Here good communication with a healthcare provider is the key.

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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:

  • Wash your hands with soap and water.
  • Remove the tape at the joint of the catheter tube and bag.
  • Swab all connecting areas with alcohol pads.
  • Drain, then remove the big drainage bag.
  • How Can I Improve Incontinence After Prostate Surgery

    Video 12 – Four Weeks After Surgery – Mark’s Prostate Cancer Experience

    Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery. Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively. To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions . For a complete guide on performing a mens kegel, click here.)

    Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

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    Open Or Laparoscopic Radical Prostatectomy

    In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.

    In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.

    Surgery For Prostate Cancer

    Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.

    The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.

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    How Can A Prostatectomy Impact Your Quality Of Life

    Prostatectomy is not life-threatening, but prostate removal significantly affects the quality of life, and it may cause problems like urinary symptoms, bladder issues, erectile dysfunction, and more. T

    These issues may last for several months and even years, something patients should be ready for if they decide to have the surgery.

    However, a lot depends on the patients age and the kind of surgery done. Studies show that about 60% of patients would make an almost complete recovery within 3 months with no long-term complications. By 12-months, almost 90% of patients can expect to feel much better and nearly normal.

    Unfortunately, improvement is slow for some people, and they need 2-3 years to revive their sexual function and get rid of urinary issues. Regretfully, these issues may continue to haunt some for a while.

    Here it is vital to understand that the above data is for radical proctectomy . The outlook is better after partial proctectomy.

    Why Is Radical Prostatectomy Done

    Robotic Radical Prostatectomy

    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:

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    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 youre an older man with a slow growing prostate cancer. This is because your cancer might grow so slowly that youre more likely to die of old age or other causes than from prostate cancer.

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    How Fast Will I Become Totally Continent After Prostate Surgery

    During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.

    The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.

    It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.

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    Life After Prostate Removal

    For many men with prostate cancer, prostate removal is never needed because the cancer is often slow-growing and managed with non-surgical treatments. But, if the cancer has grown beyond the prostate, the oncologist may recommend prostate removal surgery, also called a prostatectomy. If you are going to have prostate removal surgery, this information can help you in your discussion with the doctors.

    Urinary Problems After Surgery

    What to Expect After Prostate Cancer Surgery

    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 Pauls story for one mans experience of managing urinary problems after surgery below.

    Sexual problems after surgery

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    How Serious Is My Cancer

    If you have prostate cancer, the doctor will want to find out how far it has spread. This is called the stage of the cancer. You may have heard other people say that their cancer was stage 1 or stage 2. Your doctor will want to find out the stage of your cancer to help decide what types of treatment might be best for you.

    The stage is based on the growth or spread of the cancer through the prostate, and if it has spread to other parts of your body. It also includes your blood PSA level and the grade of the cancer. The prostate cancer cells are given a grade, based on how they look under a microscope. Those that look very different from normal cells are given a higher grade and are likely to grow faster. The grade of your cancer might be given as a Gleason score or a Grade Group . Ask your doctor to explain the grade of your cancer. The grade also can helpdecide which treatments might be best for you.

    Your cancer can be stage 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread outside the prostate.

    If your cancer hasnt spread to other parts of the body, it might also be given a risk group. The risk group is based on the extent of the cancer in the prostate, your PSA level, and the results of the prostate biopsy. The risk group can help tell if other tests should be done, and what the best treatment options might be.

    What Happens To A Man When He Has His Prostate Removed

    The location of prostate is such that, if the patient experiences BPH then it might lead to urethral compression causing difficulty in urination and leading to LUTS . Unfortunately, BPH is a common problem in adult men and the chances of BPH drastically increases after the age of 60 years. A growth in size of prostate is also a sign of prostatic cancer.

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    What Is Urinary Incontinence And How Is It Related To Prostate Cancer Surgery

    Urinary incontinence is the loss of the ability to control urination . Urinary incontinence sometimes occurs in men who’ve had surgery for prostate cancer.

    If youve had prostate cancer surgery, you might experience stress incontinence, which means you might leak urine when you cough, sneeze or lift something that is heavy. This happens because of stress or pressure on the bladder. There is also a type of incontinence that is called urge incontinence. When this happens, you are hit with a sudden need to urinate right away and have leakage before you can make it to the bathroom.

    What Do The Test Results Mean

    Prostate enlargement

    PSA tests can be difficult to interpret. Tests can also vary from laboratory to laboratory. To ensure accurate comparison, its important to use the same lab each time youre tested.

    If your PSA level is low and not rising after repeated tests, its probably not a cancer recurrence. Thats because other cells in your body can produce small amounts of PSA.

    Ideally, your post-prostatectomy PSA will be undetectable, or less than 0.05 or 0.1 nanograms of PSA per milliliter of blood . If thats the case, your doctor may call it a remission.

    If the result is greater than or equal to 0.2 ng/mL and its risen on two separate tests taken at least two weeks apart, its called a biochemical relapse. You still have PSA in your bloodstream. Theres a chance that cancer has recurred.

    A PSA level higher than that may indicate a locally advanced tumor.

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