Surgery is a procedure option chosen to treat the condition of prostate cancer, in cases when the physician believes it can turn out helpful and there is no outspread of cancer beyond the gland.
The radical prostatectomy is one of the main types of surgery which is done to treat prostate cancer. In this procedure, the surgeon entirely removes the prostate gland along with some affected tissue and seminal vesicles around it.
The procedure of prostate removal involves several different ways like manual keyhole surgery which is done by hand, robot-assisted, and open surgery.
As per the recent studies, all the three surgeries are equally efficient in the treatment of prostate cancer. However, each one of them has their own pros and cons and the physician can suggest the best as per the person’s condition.
Keyhole surgery: This procedure is also known with names like laparoscopy surgery or minimally invasive surgery. It mainly is of following two types:
Keyhole surgery performed by hand: In this, the surgeon makes five to six small incisions in the abdominal region and later removal of the prostate gland is done using special surgical tools. Among the tools, there is a thin, lighted tube with a small camera attached over the tip because of which image appears on the screen and enables the surgeon to see whatever he is doing.
Robot-assisted keyhole surgery: In this, the surgeon has the access to tools via a robotic control with four to five arms in the operating room. The operation is done by the surgeon but with the help of the da Vinci Robot, which is essentially designed for this purpose.
The robot-assisted keyhole surgery is the most recent technique, which is being followed to treat the prostate cancer.
The few advantages of keyhole surgery, done both by hand or with robot-assistance involves:
Open surgery: In this, the surgeon makes a single cut in the lower abdominal region, just below the belly button to reach out the prostate gland for the surgery. However, in this procedure, there is a risk of losing an excessive amount of the blood.
Preparing for surgery
A week or little more prior your operation schedule date, you will have to undergo few tests at the hospital to ensure you are fit enough to undergo the surgical procedure. Always discuss your medical history even drugs you are taking before surgery. The physician might even temporarily stop few medications of yours like warfarin, in case you are taking it for any medical reasons.
You must get your home organized before surgery to make everything available within your easy reach after the surgery during your recovery period. You may also seek an help from your friend or relative to stay with you and help with daily house chores for a few days, while you recover from the surgery.
Also, you must do some pelvic exercises for a couple of weeks prior your operation. It will enable you to recover quickly post surgery from any urinary problems which may arise after the procedure.
On the day of surgery
You might have to reach the hospital on the operation day or even a day prior to the surgery. go into hospital on the day of your operation or possibly the day before. The surgery will be done under a general anesthesia to avoid pain sensation during the operation. The whole procedure usually takes around two to four hours however, it might take even longer sometimes. The seminal vesicles are also removed, which stores some semen fluid which carries sperm. The two bundle of nerves which usually helps in erections are also sometimes removed although, the physician tries the best to save them if possible by doing the nerve-sparing surgery as well.
Although the removal of these nerves won’t affect any feeling in the penis or even orgasms. But it will certainly cause a problem in erection.
After the surgery, when you will wake up you will feel pain in your abdomen. There might also be a thin tube inserted into your lower abdomen to drain out fluid from the area of your prostate gland post its removal. This tube is usually removed after 24 to 48 hours post operation. There will also be a catheter inserted to help drain out urine from your bladder. You will also be prescribed with oral or intravenous pain-relief medications to help with pain. You might even develop some swelling or bruising around your penis and testicles which will subside within few weeks. You will also be asked to follow a diet chart during the recovery process. To avoid any blood clots formation you will be encouraged to get out of the bed and start moving little by little.
The discharge usually depends upon the recovery status of the patient and is done normally within 5 to 7 days post surgery.
After you go home, you will have to take proper care of the inserted catheter to avoid any infections, and you will be given proper instructions for the same. Like you can wear the catheter bag inside your trousers or even attach it to the leg with the help of strap, ensuring tube is not bend or blocked, keeping proper hygiene of the catheter and its tip by washing it twice a day with unscented soap, washing hands before and after touching the catheter, drinking 1 to 2 liters of water, and eating sufficient fiber diet to avoid any constipation issues.
You may go for a follow-up checkup in case you have any troubles or else for catheter removal 1 to 3 weeks post surgery. In case of open surgery stitches sometimes needs a removal so a followup checkup for the same can be done as per schedule provided. Starting with light walking and avoiding any exertion exercises helps in speed up recovery process.
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Q: What are the major risks involved in the prostate cancer surgery?
A: Few risks which rarely cause major troubles include anesthesia reactions, excessive bleeding, nearby organ damage, blood clots in the legs, and infections at the site of surgery.
Q: What are the side effects of surgery?
A: It might sometimes cause urinary continence including issues like stress incontinence, overflow incontinence, and urge incontinence. In very rare cases continuous incontinence might happen.
Q: Can the bladder control get back to normal post surgery?
A: The control over urinary bladder usually returns within several weeks or at times in months. Its recovery occurs over the time slowly.
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