What Causes An Enlarged Prostate
We still dont really know all the things that cause the prostate to grow. But we do know about two risk factors that can increase your risk of having an enlarged prostate.
Your risk of having an enlarged prostate increases as you get older. Many men aged 50 or over have an enlarged prostate, but they dont all get symptoms. And some men have symptoms that dont bother them.
The balance of hormones in your body changes as you get older. This may cause your prostate to grow.
Some studies show that obese men and men who have diabetes may be more likely to develop an enlarged prostate. Regular exercise may help to reduce your risk of urinary symptoms. But we still need more studies into the causes of enlarged prostate to know for certain if, and how, we can prevent it.
There is also some research that suggests you may be more at risk of developing an enlarged prostate if your father or brother has one. Again, further studies are needed to confirm this.
Treating Cancer Of The Prostate Include:
Active surveillance or careful waiting: You do not get treated immediately. Rather, your physician watches your signs and symptoms or does regular DRE and PSA tests to check on for cancer growth.
Surgery: A process known as a radical prostatectomy removes the prostate and a few of the tissue around it.
Radiotherapy: Radiation uses high-energy X-sun rays to eliminate cancer of the prostate. Youre uncovered to radiation from the machine outdoors the body. Or have it through small radioactive pellets or seeds placed within your prostate.
Cryotherapy: Laser hair removal uses intense cold to eliminate prostate tissue.
Hormone therapy: You are taking medicine to bar a mans hormones that fuel the development of cancer of the prostate.
Will I Have Erectile Dysfunction
Whether or not you experience erectile dysfunction after radical prostatectomy will depend largely on your age, your health and what your erections were like before the operation. This side effect may occur if nerves were injured during the operation.
There are two main nerves running through the pelvis that branch into many nerves covering the prostate. Urologists call them neurovascular bundles because they really are bundles of many nerves. Urologists always aim for nerve-sparing surgery, and we rarely need to remove the neurovascular bundles. But sometimes the bundles are stretched and some of the thousands of nerve fibers within an individual nerve can be damaged, says Mohler. In most men, both neurovascular bundles can usually be spared. If the cancer is advanced, sometimes one or both cannot be.
Benefits of Robotic Radical Prostatectomy
Have more questions about radical prostatectomy? Our experts give you the answers.
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Prostate Problems Symptoms And Warning Signs
Its common for men over the age of 50 to have prostate problems. The prostate gland produces semen. Common conditions that affect the gland are enlarged prostate , acute and chronic bacterial prostatitis, chronic non-bacterial prostatitis, and prostate cancer. Talk to your doctor if you think you may have problems urinating or pain with urination.
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The First Few Days After Surgery
After the successful completion a robotic prostatectomy you will stay in hospital for one to two nights. You will be mobilised early. Most patients wake up with a catheter tube and a small drain. You will be prescribed painkillers as well.
You can expect to have this catheter in place for a week, however, some patients will require it for longer, depending on the specifics of the surgery. Your urology specialist will detail how to care for your catheter and will assist in its removal when ready.
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Different Symptoms Of Bph Vs Prostate Cancer
Other than skin cancer, prostate cancer is one of the most common cancers for American men. One in nine men will be diagnosed with prostate cancer during his lifetime, according to data from the American Cancer Society.
Just because prostate cancer is so common, that doesnt mean the symptoms youve been experiencing are, in fact, cancer. Many symptoms of prostate cancer are the same for other conditions like infections or abnormal cell growth, also known as BPH. The symptoms of BPH vs prostate cancer can be similar. This is what you need to know and when to see a doctor.
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Improving Sensitivity Of Psa Testing
Prostate-specific antigen testing with a cutoff of 4.0 ng/mL has a sensitivity of 67.5-80%, which implies that 20-30% of cancers are missed when only the PSA level is obtained. Sensitivity can be improved by lowering the cutoff or by monitoring PSA values so that a rise in PSA level of more than 20-25% per year or an increase of 0.75 ng/mL in 1 year would trigger performance of a biopsy regardless of the PSA value.
The specificity of PSA at levels higher than 4.0 ng/mL is 60-70%. Specificity can be improved by using age-adjusted values, PSA velocity , and the ratio of free PSA to total PSA . Another method is to adjust the PSA according to the size of the prostate or volume determinations of the transitional zone, which produces most of the PSA, and the peripheral zone, which produces less PSA but a majority of prostate cancers.
In the European Randomized Study of Screening for Prostate Cancer, Schroder et al studied a strategy for the early detection of prostate cancer that excluded digital rectal examination results and used a PSA cutoff of 3.0 ng/mL as the only indication for a biopsy. This protocol was compared with one in which a PSA level of 4.0 ng/mL or higher or the presence of a positive DRE or transrectal ultrasound was the indication for a biopsy. In a follow-up study, Schroder et al confirmed a substantial reduction in mortality from prostate cancer as a result of PSA testing.
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Psa Testing For Detection Of Prostate Cancer
The introduction of prostate-specific antigen testing into clinical practice has greatly increased the detection of localized prostate cancer and, by doing so, has decreased the diagnosis of regional and metastatic disease. PSA testing has had such a profound clinical effect that questions have arisen regarding the significance of the cancers that are being detected.
Stage, grade, tumor volume, and PSA testing are used to determine whether a prostate cancer is clinically significant or insignificant. However, there is no generally accepted precise definition for this distinction.
The goal of early detection of prostate cancer is to identify clinically significant cancers at a time when treatment is most likely to be effective. The risk of death from prostate cancer is significant in those with moderate- to high-grade tumors. This is especially true in younger men. Long-term survival is compromised when the cancer has spread beyond the confines of the prostate, into the regional lymph nodes, and to distant sites.
Several studies have shown that with a PSA cutoff of 4.0 ng/mL, clinically insignificant cancers are detected in fewer than 20% of men, but nearly 50% of all the cancers detected because of an elevated PSA level are localized, and these patients are candidates for potentially curative therapy. Only a small proportion of prostate cancers detected by PSA testing and treated with radical prostatectomy are low-volume and low-grade tumors.
Robotic Prostate Surgery Recovery Time
Whats the recovery period like after robotic prostate surgery? When can I go back to work after prostate surgery?
If you are considering the da Vinci robotic form of prostate surgery, I just went through it, and I can tell you how the recovery period went for me.
First, I spent a couple of days in the hospital could have been sent home after one night but I decided to stay. I had a private room, was getting great care, and was able to walk around the floor whenever I wanted to. Why go home?
After two nights in the hospital, I was discharged and sent home. Suggestion: make sure you know how to work the Foley catheter before you leave. The nurse should show you how to change it and empty it in a clean and antiseptic manner. The hospital provided me with 2 collection bags: a larger overnight bag and a smaller bag that attaches to your leg. I ended up using the larger bag 99% of the time at home, because the smaller collection bag just filled up too fast. I couldnt even get through watching one football game without having to empty it.
The first week at home, you have to take it very easy. You just had surgery and dont want something to go wrong and have to go back to the hospital to get it corrected. You read the newspaper, watch TV, take naps, convalesce. Get used to moving around the house holding your catheter collection bag, which is kind of red at first.
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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.
Prostatectomy: What To Expect
Many prostate cancer patients dont need surgery. But for young patients with prostate cancer that hasnt spread, a surgery called a prostatectomy can help them become cancer-free and put prostate cancer treatment behind them. John Davis, M.D., a urologist who performs hundreds of prostatectomies each year, explains what patients undergoing this procedure can expect, including prostatectomy side effects and risks.
What is a prostatectomy?
A prostatectomy is the surgical removal of all or part of the prostate gland. Prostate cancer surgery types include:
- Robotic prostate cancer surgery: In this procedure, called robotic radical prostatectomy, a surgeon makes several small incisions in the lower abdomen and uses a robotic device to remove the prostate.
- Open radical prostatectomy: The surgeon makes one large incision in the lower abdomen to remove the prostate.
Robotic radical prostatectomies have become increasingly common over the years, and most surgeons prefer to conduct the procedure this way because its a little easier on them. But its important to know that both methods are safe.
Who needs a prostatectomy?
For some patients, prostatectomies will be the only treatment they undergo. Others who may have a difficult time recovering from surgery or have more advanced cancer may also have chemotherapy or hormone therapy treatment as well.
How long does it take to recover from a prostatectomy?
What side effects do patients experience following prostate removal?
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Things You Should Expect After Prostate Surgery
Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.
In the immediate hours after surgery:
One Week After Surgery
After one week to ten days, your catheter will generally be removed by a urology nurse in the hospital. You will also meet Dr Arianayagam to go through the pathology results and discuss any extra treatments if needed. Pelvic floor physio therapy is restarted at this point and we also commence PDE5 inhibitors and penile vacuum devices as well to aid in recovery of erectile function. You should be active but still focus on your recovery as your body will still need to heal.
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How Is Cryosurgery For Prostate Cancer Performed
Cryosurgery for prostate cancer is done under either general or spinal anesthesia. Before the procedure, an ultrasound probe is placed in the rectum to give the surgeon a visual of the prostate. This allows the doctor to monitor the prostate and nearby organs/tissues during surgery.
Several probes may be placed in the prostate at locations determined before the procedure. These are positioned to avoid the area of the urethra, the tube which passes through the prostate as it carries urine out of the body from the bladder.
In addition, a warming catheter is inserted into the urethra to keep the urethra warm throughout the procedure. Other probes may be placed in and around the prostate gland in order to monitor the temperature and prevent damage to noncancerous tissue.
Cryosurgery takes under two hours and is done in two freezing cycles. In between these cycles, the prostate is allowed to warm, either on its own or with the aid of a warmer gas moving through the probe. After the second thaw, a catheter is inserted into the bladder to help with urination during the recovery period. This tube may be inserted through the urethra, or through a small cut in the lower belly. The catheter will remain in place for several days after surgery.
Doctor Visits And Tests
Your doctor visits will usually include PSA blood tests, possibly with digital rectal exams if your prostate hasnt been removed. These will probably begin within a few months of finishing treatment. How often you need follow-up visits and tests might depend to some extent on the stage of your cancer and the chance of it coming back. Most doctors recommend PSA tests about every 6 months or so for the first 5 years after treatment, and at least yearly after that. Bone scans or other imaging tests might also be done, depending on your medical situation and symptoms.
Prostate cancer can recur even many years after treatment, which is why its important to keep regular doctor visits and report any new symptoms .
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Hifu Benefits Series: Shorter Recovery Time
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What if there was a way to treat your prostate cancer, and actually be back up and around the very same day? One of the great benefits of Sonablate HIFU is a much shorter recovery time than surgery or radiation even the ability to be active on the same day as treatment.
The Sonablate HIFU is a non-invasive medical device that used focused heat to destroy cancerous prostate cells. This device can ablate, or destroy, just the cancerous cells, or your entire prostate, without a single incision. This device is game-changing in the field of prostate cancer.
Radical prostatectomies, made through an incision in the lower abdomen or in the perineum can expect a hospital stay of up to a week, and a home recovery time of 3-4 weeks or more. Often times a urinary catheter is left in place for 1-2 weeks, and bladder control can continue to be weak for a few months. There are risks and complications possible including damage to the urethra and rectum, and possible erectile problems. While radical prostatectomies are generally effective in treating prostate cancer that has not spread beyond the prostate, with such an invasive surgery comes a long healing time.
If a man is looking to get back to life quickly after prostate cancer treatment, he really cant beat HIFU for prostate cancer. HIFU allows men to return to work much faster, return to daily activities more quickly, and allows men to return to living their life as it was before a prostate cancer diagnosis.
What Are The Benefits To Patients Who Have Laparoscopic And Robotic Prostate Cancer Surgery
The benefits are similar between robotic and laparoscopic prostate surgery. Patients are usually able to go home the day after prostate surgery, and can return to daily living activities as early as 7-10 days after surgery. Patients undergoing open surgery generally have 4-6 weeks before they can resume routine daily living activities, generally experience less post-operative pain and discomfort and have a faster recovery. They also experience significantly less intraoperative bleeding. Robotic and laparoscopic prostatectomy uses small incisions and is highly precise the risk of incontinence is low and the surgical technique is continuously refined to improve potency.
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Open Radical Prostatectomy Vs Minimally Invasive Radical Prostatectomy
In 2003, only 9.2% of radical prostatectomies were done using a minimally invasive procedure. By 2007, that number had jumped to 43.2%. In 2009, researchers in Boston reported on a study that compared outcomes, benefits, and complications of open surgery vs. minimally invasive surgery:
- No difference was found in deaths or in the need for additional cancer therapy between the two approaches.
- The median hospital stay was two days for minimally invasive surgery and three days for open surgery.
- 2.7% of men having laparoscopic surgery required a blood transfusion compared with 20.8% of men having open surgery.
- There was more anastomotic stricture narrowing of the suture where internal body parts are rejoined for open surgery than for minimally invasive surgery .
- There were fewer respiratory complications with minimally invasive surgery than with open surgery .
- There were lower rates of incontinence and erectile dysfunction with open surgery. The overall rate was 4.7% for laparoscopic surgery and 2.1% for open surgery.
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.
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