التعريف والنظرة العامة
Prostatectomy, or prostate resection, is a surgical procedure that removes a part (simple) or the entire prostate gland. In some cases, the surrounding tissues and lymph nodes (radical prostatectomy) are also removed. It is performed to treat localised prostate cancer, remove blockages, reduce swelling, and prevent further infections.
The prostate gland is a small male organ that releases fluid for the nourishment of the sperm. If it encounters problems that affect the male urinary system, one of the treatment options is to remove it. Different techniques can be used when performing prostate surgery depending on whether the procedure is simple or radical.
Prostatectomy comes with certain risks and complications including male sexual dysfunction. Hence, doctors exhaust all non-invasive methods including therapies and medicine before it is even recommended.
من يجب أن يخضع للنتائج المتوقعة
Prostate removal is recommended for men with:
Localised prostate cancer – This means that the cancer has originated in the prostate and has not spread or metastasised to other organs and tissues yet. Radical prostatectomy is done in this case. The procedure can be performed before other treatment like العلاج الكيميائي and radiation therapy are given.
Enlarged prostate – An enlarged prostate occurs when there’s a benign growth in the gland that blocks the flow of urine and causes the bladder to become very sensitive. Some of the common signs and symptoms of this condition are frequent need to urinate, urinary changes (such as dribbling or leaking), incontinence, pain, and blood in the urine. In this case, simple open prostate resection is done to remove the blockage.
*Recurrent infections *
It is expected that by performing prostatectomy, the patient will:
Decrease the possibility of metastasis
Increase his mobility
Restore the function of his urinary system
كيف يعمل هذا الإجراء؟
Prostatectomy, or prostate cancer surgery, is performed by a surgeon with an extensive background in urology, the medical field that focuses on the male reproductive system.
Prior to the procedure, the patient undergoes various tests including:
PSA test – A blood test that measures PSA levels. PSA, or prostate-specific antigen, is found in the semen and produced by both cancerous and noncancerous tissue in the prostate.
Cystoscopy – A diagnostic test that checks the condition of the urinary system such as the bladder, urethra, and prostate.
Prostate biopsy – This test is used to determine the stage of prostate cancer. The information obtained is used to predict prognosis and determine the best treatment method. A Gleason score is given based on its microscopic appearance. The higher the Gleason score, the more aggressive the prostate cancer is.
During the procedure, the patient is placed under general anaesthesia with his vital signs monitored by a machine and an anaesthesiologist.
In a radical prostate resection, the incision is made in the perineum or scrotum base and the anus (perineal) or in the lower part of the abdomen (retropubic). Using surgical tools, the glands and seminal vesicles are removed. If the blood vessels that promote erection are left, the procedure is called nerve sparing. If the lymph nodes are also removed, it can be called limited or extended lymph node dissection, depending on where the lymph nodes are located. The urethra that runs through the prostate is then reattached to the bladder before the incisions are sutured closed.
In an open simple prostatectomy, a cystoscope is used, which is inserted through the penis until it reaches the prostate area. An incision is then made around the bladder to access the prostate and to remove the blockage or the mass. The incision is then sutured closed. While the patient is recovering, a catheter is left to drain the urine.
In the last couple of years, more hospitals are adopting minimally invasive techniques such as robot-assisted (robotic prostatectomy) and laparoscopic methods, which use significantly smaller incisions instead of a large one and microsurgical instruments. This promotes faster healing and recovery time as well as minimal surgical pain and bleeding.
Depending on the procedure, the surgery may take at least an hour.
المخاطر والمضاعفات المحتملة
Common surgical risks and complications of prostate removal surgery are bleeding, infection of the wound site, and laceration of the stitches. In certain instances, the complications can be life-threatening, such as a blood clot formation or stroke. However, these are very rare. Moreover, minimally invasive surgeries decrease these common risks from happening and hasten recovery time.
The biggest possible complication is erectile dysfunction, which can happen if the blood vessels and nerves that encourage erection are damaged during the procedure.
Cunningham GR, et al. Transurethral procedures for treating benign prostatic hyperplasia. http://www.uptodate.com/home
Wein AJ, et al., eds. Radical retropubic and perineal prostatectomy. In: Campbell-Walsh Urology. 10th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com.
ما هو استئصال البروستاتا: نظرة عامة ، الفوائد ، والنتائج المتوقعة
Welcome to our comprehensive guide on prostatectomy. In this article, we will provide you with a detailed overview of what prostatectomy is, its benefits, and the expected results of this surgical procedure. Prostatectomy, also known as prostate removal surgery, is a common treatment option for prostate conditions such as prostate cancer and benign prostatic hyperplasia (BPH). We will explain the various types of prostatectomy, discuss the benefits of the procedure, and outline what you can expect during the recovery phase. So, let’s dive in!
Types of Prostatectomy
Prostatectomy can be performed using different techniques, depending on the patient’s condition and the surgeon’s expertise. The three main types of prostatectomy are:
- Radical Retropubic Prostatectomy
- Robotic-Assisted Laparoscopic Prostatectomy
- Transurethral Resection of the Prostate (TURP)
Each type has its own advantages and considerations, and the choice of procedure will depend on factors such as the patient’s overall health, the stage of the prostate condition, and the surgeon’s recommendation. Let’s take a closer look at each type:
Radical Retropubic Prostatectomy
This is the traditional approach to prostatectomy and involves making an incision in the lower abdomen. The surgeon removes the prostate gland and, if necessary, surrounding tissues such as lymph nodes. This procedure allows for a thorough examination of the prostate and the surrounding area, helping to determine if the cancer has spread. However, this technique may lead to more pain and longer recovery time compared to other methods.
Robotic-Assisted Laparoscopic Prostatectomy
Robotic-assisted laparoscopic prostatectomy is a minimally invasive technique that uses robotic technology to assist the surgeon during the procedure. The surgeon operates robotic arms, which control small surgical instruments. This method offers several advantages, including smaller incisions, reduced blood loss, and faster recovery compared to traditional surgery. However, access to this technique may vary depending on the availability of robotic surgical systems.
Transurethral Resection of the Prostate (TURP)
TURP is a procedure primarily used to treat benign prostatic hyperplasia (BPH). Instead of making an incision, the surgeon accesses the prostate through the urethra. A special instrument called a resectoscope is inserted through the urethra, allowing the surgeon to remove the excess prostate tissue. This procedure is less invasive than other types of prostatectomy and may result in a shorter hospital stay. However, it is not suitable for treating prostate cancer.
Benefits of Prostatectomy
Prostatectomy offers several benefits for patients with prostate conditions. Here are some key advantages:
- Treatment of Prostate Cancer: Prostatectomy is a widely used treatment option for localized prostate cancer. By removing the prostate gland and surrounding tissues, the surgery aims to eliminate the cancerous cells and prevent the spread of the disease.
- Relief from Symptoms: For patients with BPH, prostatectomy can provide significant relief from urinary symptoms such as frequent urination, weak urine flow, and incomplete bladder emptying.
- Potential Cure: In cases where prostate cancer is detected early and has not spread beyond the prostate gland, prostatectomy offers the potential for a cure, effectively removing the cancer and preventing its recurrence.
- Improved Quality of Life: Following prostatectomy, many patients experience an improved quality of life due to the resolution of symptoms and the removal of cancerous cells. This can lead to a renewed sense of well-being and confidence.
The expected results of prostatectomy will vary depending on the patient’s condition, the type of procedure performed, and other individual factors. Here are some common outcomes and expectations:
Recovery and Healing
After prostatectomy, you can expect to stay in the hospital for a few days for observation and recovery. The healing process may take several weeks or even months, during which you may experience the following:
- Incision Healing: If you underwent an open surgery like radical retropubic prostatectomy, you will have a larger abdominal incision. Proper care of the incision site is crucial to prevent infections and ensure optimal healing.
- Urinary Incontinence: Temporary urinary incontinence is common after prostatectomy. However, bladder control gradually improves over time, and most patients regain full or near-full continence within a year.
- Erectile Dysfunction: Erectile dysfunction is a potential side effect of prostatectomy, depending on the patient’s age, overall health, and the extent of nerve damage during surgery. It may take several months to regain erectile function, and additional treatments may be required.
Follow-Up Care and Monitoring
Following prostatectomy, regular follow-up appointments with your healthcare provider are essential. These appointments may include:
- PSA Testing: Prostate-specific antigen (PSA) blood tests will help monitor your cancer status and detect any potential recurrence. Your healthcare provider will determine the appropriate frequency of PSA testing based on your individual case.
- Continence Rehabilitation: If you experience persistent urinary incontinence, your healthcare provider may recommend pelvic floor exercises and other therapies to strengthen the muscles and improve bladder control.
- Sexual Health Support: If you continue to experience erectile dysfunction after prostatectomy, your healthcare provider may discuss treatment options such as medications, vacuum erection devices, or penile implants to help restore sexual function.
Prostatectomy is a surgical procedure commonly used for the treatment of prostate conditions, particularly prostate cancer and benign prostatic hyperplasia. It offers various benefits, including the potential for a cure, relief from symptoms, and improved quality of life. The expected results of prostatectomy can vary, but with proper care, most patients can achieve successful recovery and regain their normal daily activities. Regular follow-up care and monitoring are crucial to assess the outcome of the surgery and address any post-operative complications. If you or a loved one is considering prostatectomy, it is important to consult with a healthcare professional who can provide personalized advice and guidance based on your specific circumstances.