All about Prostatectomy

Although Prostate cancer is the second most leading cause of death due to cancer in men, the advancement of medical science has presented several types of treatments that have brought about a significant improvement in the survival rate. Surgery is the most common approach to treating this condition, where the prostate is removed entirely or partially. This process is better known as prostatectomy.

What is a prostatectomy? 

The term is used to describe the surgical procedure that removes the prostate gland, partially or completely. Typically, it involves a small surgical incision to accomplish it. There are two methods to do this: retropubic incision in the lower abdomen and a perineum incision done through the skin between the scrotum and the rectum. However, the approach will be determined depending upon your condition. 

Prostatectomy is a highly favored approach for the treatment of localized prostate cancer. Sometimes, it can also take place after radiation or hormone therapy. There are different options for this approach, such as radical prostatectomy, laparoscopic radical prostatectomy, and robot-assisted radical prostatectomy. 

Different types of radical prostatectomy 

Men who have been diagnosed with localized prostate cancer can opt for radical prostatectomy, which is used to surgically eradicate the entire gland and surrounding lymph nodes or a part of it. 

The several approaches to radical prostatectomy are-

Retropubic approach- This is the most commonly favored approach to conduct prostate cancer surgery. It is even effective if cancer has spread beyond the gland to the lymph nodes because the doctor can remove them easily by this procedure. However, if cancer has spread to other parts other than the lymph nodes, this form of surgery may not be sufficient to treat the condition. An incision is made in the abdomen to remove the prostate gland that is connected to the blood vessels. It is quite less invasive compared to the other types and ensures the recovery of the patient within a shorter time. 

Nerve Spring Prostatectomy- In highly complicated cases, cancer may get spread to the nerves that make it difficult for the surgeon to maintain the original structure or the proper functioning of the nerves. In fact, the nerves may be removed to get rid of cancer. However, if the nerve is cut from both sides, there is a high chance that the patient may face erectile dysfunction, which would not be getting better over time. Therefore, the most suitable approach is to cut and eliminate only one side of the nerve, if the situation permits that would let the patient have minor erectile functions left. In this way, the excellent network of blood vessels along the prostate gland will also be protected.  

Laparoscopic- Here, different small cuts are made, inside which thin tools are placed. A thin tube with a video camera is passed through a cut while several instruments are passed through others, which offer a clear vision to the doctor while performing the surgery. 

Robot-assisted procedure- This is nothing but laparoscopic surgery with the help of a robotic system. A robotic arm is controlled by the surgeon from a computer. Special sets of equipment are required to perform this surgery. 

Perineal approach- This procedure is favored not quite often due to the complications. However, if the nerve-sparing approach isn’t applicable in a certain condition, this can be helpful. It takes relatively less time, and the pain is also quite lesser compared to the other procedures. 

Reasons for getting a radical prostatectomy 

1. Treatment of localized prostate cancer
2. Recurring prostate bleeding 
3. Bladder stones 
4. Treating hydronephrosis 
5. Inability to empty bladder 

Risks factors

• Urinary incontinence
• Urine leakage
• Permanent erectile dysfunction 
• Sterility 
• Lymphedema

You are required to do the following before the surgery takes place-

• Fast for 8 hours
• Inform the doctor whether you are allergic to any anesthetic agents and latex, iodine, tape, etc.
• Inform the surgeon if you’re on any anti-coagulant medications
• Stop smoking 
• Remove any piece of jewellery from the body
• Empty your bladder completely 

Conclusion

Usually, regional anesthesia is preferred in this process. You are required to stay in the hospital for a couple of days after the surgery is over. Your diet will be monitored strictly, and you will gradually advance towards a solid food diet from liquid one. 

Read:- List of prostate cancer medications