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Features of surgery for prostate cancer

According to statistics, prostate cancer is on the list of the most diagnosed male diseases.

It can affect people of all ages, and mortality rates from this disease are in third place.

About the disease

Cancer of the prostate gland (prostate) is a malignant neoplasm arising from the tissues of the prostate glands due to changes in prostate cells in the DNA. Modern medicine still does not know the exact causes of prostate cancer. You can read more about this here.

You can identify some factors that increase the risk of a tumor:

  1. Age. Over the years, the likelihood of a tumor increases. It is extremely rare for men in the age category up to 40 years old, after 50 the possibility of the disease is growing every year.
  2. Heredity. The likelihood of acquiring prostate cancer is higher in men who have relatives with such a disease (if there are sick blood relatives, the risk of developing the disease increases by 8 times).
  3. Nutrition. Excessive consumption of animal fats contributes to the formation of a tumor. In obese men, prostate cancer is detected more often.
  4. Smoking. Tobacco smoke contains cadmium, which contributes to prostate cancer.
  5. Ultraviolet radiation. It contains vitamin D3, which suppresses the movement of cell growth.

In the oncological structure of many countries, prostate cancer is located in 2-3 places, giving way to cancer of the stomach and lungs.

The disease tends to appear in mature men (after 40-50 years), after 60-70 years, its frequency increases.

About 40% of men of this age have latent (latent) prostate cancer, and only in 10% of cases the latent form begins to manifest itself in a clinical picture and can lead to death.

A distinctive feature of prostate cancer is characterized by its slow development, due to the absence of symptoms at the initial stage.

Treatment options

Localized prostate cancer needs about 2-3 years to double the volume of the tumor. Moreover, it is able to persist within the gland.

A common treatment for prostate cancer seems to be radiation therapy (x-ray therapy) - a technique for the treatment of malignant neoplasms using ionizing radiation. Cancer cells multiply much faster than simple ones, and radiation from radiation therapy disrupts cell division and DNA synthesis.

The advantage of x-ray therapy is the lack of surgery for a prostate tumor in men, the disadvantage is the inability to control the development of the tumor throughout life. According to studies after the use of radiation therapy, the ability to maintain a normal level of matter in the cells of the prostate is only 10%. After surgery - 70%.

Other options for treating prostate cancer:

  1. Chemotherapy - treatment of cancer with the use of medications, which allows to reduce the growth of cancer cells, while healthy cells are affected. Such hormone therapy lowers testosterone levels and slows down the course of the disease.
  2. Immunotherapy - a technique based on the use of drugs that activate the activity of the immune system. Weak cancer cells are introduced into the body, and the immune system begins to destroy them, taking them for foreign cells.
  3. High Intensity Focused ultrasound ablation - a method in which tissues are heated by intense ultrasound and tumor cells are affected. Side effects from this procedure are minimal.

Often, with the formation of prostate cancer, doctors use complex treatment, combining chemotherapy with radiation.

Radical removal of the prostate: what is it? Radical removal of the prostate - The most common operation to remove the prostate gland (with oncology). Its purpose is the operation to remove the tumor within healthy fields, and to maintain control over the urethra and sexual activity. Surgery for prostate cancer is performed for people whose cancer has not passed to neighboring organs.

Doctors, prescribing therapy by the method of surgery, rely on the ability of each organism to withstand surgery, which is a serious procedure. This procedure has become the most popular in the treatment of prostate cancer, because without eliminating the disease it is radically impossible to control its transition to neighboring organs.

And if this happened, the cancer cannot be cured and stopped. In the presence of bone metastasis, the expected life expectancy is no more than 3 years.

Indications

Absolute indications for removal of the prostate are:

  • stopped prostate cancer (stages 1 and 2) in the absence of metastases and regional lymph nodes,
  • urinary tract obstruction (difficulty in the outflow of urine), accompanied by stage 3 prostate cancer,
  • advanced form of prostate adenoma, not amenable to other treatment, which is rare.

In which cases the operation is indicated

The attending physician can recommend a man a radical treatment of the prostate gland if other methods cannot improve his condition. An operation to remove the prostate is indicated at the progressive stage of cancer, when the symptoms of the disease become pronounced. Before sending the patient to the operating table, the specialist must carefully assess the risks that the surgical intervention or its absence will have.

Removal of the prostate or part thereof is highly desirable for cancer and the following pathological conditions:

  1. Advanced inflammation in the prostate
  2. Extensive kidney damage,
  3. Suppurations in the prostate gland
  4. Complicated course of acute prostatitis.

A malignant tumor in the prostate is the main indication for surgical intervention. Especially without such therapy, it is impossible to dispense with patients who failed to get rid of the neoplasm at an early stage of its development.

The operation is indicated if the cancer is localized in the gland and there is no metastasis.

Types of surgical treatment for prostate cancer

The operation to remove overgrown prostate cancer is carried out in various ways. Decide what type of surgery to use, should be the attending physician who monitors the course of the patient's disease. When choosing a technique, he takes into account such data as the stage of tumor development, its size and localization.

Surgery for prostate cancer is performed exclusively on direct indications. Radical treatment is prescribed if the patient does not have metastases in other departments. Subject to this condition, surgery can be indicated even with grade 4 oncology.

Cancer removal of the prostate and its consequences

How to remove the prostate? There are several ways to remove prostate cancer. More effective is considered radical prostatectomy.

Radical prostatectomy - An operation to remove prostate cancer, carried out with a localized disease. It is the main treatment with preservation of urethra and erectile function.

When performing an operation to remove prostate cancer, a huge skill of a doctor is required, because at the edges of the prostate are sphincters of the urethra and small nerves that are responsible for erection, which must be preserved.

Often after prostatectomy, complex therapy is used, combining radiation and hormonal treatment.

In addition to radical prostatectomy, there are several modern surgical methods for removing the prostate gland:

    Transurethral resection of the prostate (TUR). The safest method of removal, carried out with mild forms of the disease, when the kidneys are not damaged, and the bladder is able to empty. TOUR is painless.

Surgery for prostate cancer is accompanied by the insertion of a thin endoscopic device into the urethra, called a resectoscope.

When exposed to the prostate gland, blood vessels are removed and coagulated. The operation to remove the prostate gland takes place under general anesthesia or spinal anesthesia, and only when the volume of the prostate gland does not exceed 80 ml.

The likelihood of complications is determined by the duration of the operation. Possible complications include bleeding, penetration of fluid to flush the urethra into the vascular bed.

TUR can not be performed with exacerbation of diabetes mellitus, disorders in the cardiovascular and respiratory systems, the use of drugs that thin the blood. Open adenomectomy. It is used in severe forms of diseases when the prostate gland reaches large volumes, there is no emptying of the bladder, there is renal failure.

It is also used for complications of prostate adenoma in the form of stones in the bladder. The operation on the prostate tumor is open, and is traumatic.

Open adenomectomy requires general anesthesia or regional anesthesia. During the operation to remove the prostate, an incision is made in the bladder, presenting to the eye of the doctor the affected area of ​​the prostate. A catheter should be inserted into the bladder to allow fluid to flow out.

For young men, prostate adenomectomy is fraught with impaired potency. Open adenomectomy is not used in cases of concomitant serious illness with a threat to life. Transurethral incision of the prostate (TUIP). The operation takes place in the presence of frequent or difficult urination, inability to empty the bladder completely, regular inflammatory diseases of the urinary tract, provided that the prostate is small.

The procedure improves urine outflow and eliminates manifestations of prostate adenoma.

Surgical intervention is performed under general anesthesia or spinal anesthesia. A resectoscope with a knife at the end is inserted into the urethra. The surgeon makes two incisions in the prostate gland, while not excising the tissue.

Complications after TUIP are sexual disorders in the form of retrograde ejaculation. Surgery is contraindicated in case of a large prostate.

Postpartum prostatectomy

A lateral prostatectomy is a surgical technique that involves the complete removal of the prostate gland. This operation is prescribed for tumors and adenocarcinoma. In some cases, it is carried out to patients with oncology in the last stages.

Prostate cancer surgery is recommended for patients who have the following indications for it:

  1. Lack of metastasis,
  2. The level of prostatic specific antigen does not exceed 20 ng / ml,
  3. Limited extracapsular cancer growth,
  4. Differentiation of the neoplasm does not exceed 7 points according to Gleason.

During the operation, the surgeon uses the abdominal technique. He makes an incision in the area below the navel. Through it, the glandular organ, lymph nodes and seminal vesicles are removed.

This procedure is not suitable for cancer patients who have the following contraindications:

  • Obesity,
  • Urogenital infections
  • Severe urinary incontinence,
  • Heart or pulmonary failure.

The behind-the-curtain technique allows several times to reduce the development of cancer. It is most effective during the treatment of prostate cancer, which proceeds at the initial stage.

On the left - the scheme of the post-ciliary prostatectomy, on the right - perineal

Perineal prostatectomy

The classic way to remove a cancerous tumor in the prostate. Its main advantage is its easy accessibility to the prostatic capsule. During surgery, the risk of severe blood loss is eliminated. Also, this surgical intervention does not have such a contraindication as overweight and obesity, which is also its significant advantage.

The perineal technique for excising a cancerous tumor in the genitourinary system is characterized by a high percentage of positive results at the end of treatment. Rehabilitation after removal of a malignant neoplasm in this way takes a little time, as the patient quickly returns to normal.

Unfortunately, the treatment technique has a number of disadvantages that do not allow it to become a universal way to eliminate cancerous tumors in the prostate gland. We are talking about these nuances:

  • Not suitable for stopping the lymph nodes that are located in the affected area,
  • It requires the complete removal of the glandular organ, which increases the likelihood of damage during the operation of the nerve plexuses.

Because of this, this type of surgical intervention is recommended to be used only in extreme cases. For example, it is indicated for patients who, for certain reasons, do not perform back-surgery.

Complications

Removing the prostate in men contributes to instant relief lasting for many years.

But such an extreme measure in treatment has a high risk of undesirable complications after prostate cancer surgery - consequences:

  1. Bleeding. The most dangerous and well-known complication, which can result in clogging of the urethra with blood clots and severe blood loss.
  2. Intoxication with wash water. A serious complication caused by the ingress of fluid used during surgery to flush the urethra.
  3. Acute urinary retention. May develop after clogging of the urethra with blood clots or changes in the muscle structure of the bladder.
  4. Urinary incontinence. The situation may be continuous, and may begin only with physical stress.
  5. Other problems with urination: urine leakage, soreness and frequent urination after removal of the prostate in cancer.
  6. Potency disorders. This complication occurs in 4-10% of cases.
  7. Retrograde ejaculation. It is expressed in the absence of sperm eruption during orgasm and its discharge into the bladder. This complication is not dangerous, because semen leaves the body with urine.
  8. Inflammatory diseases. Every fifth operation begins. Consequences of this nature are blocked by the use of antibiotics.

Rehabilitation

Despite the well-being of the patient after surgery to remove the prostate, the body will need a lot of time to fully recover.

Rehabilitation after prostate cancer surgery:

  • in the first postoperative week you need to be extremely careful, not to allow sudden movements and leave the exercise until better times,
  • during the recovery period, you need to drink a lot of water to wash the bladder, about 8 glasses a day, this will speed up recovery,
  • try to strain less during bowel movements,
  • lifting is not allowed during the recovery period, as well as driving a car,
  • do not forget about the prescribed diet to prevent constipation (if it occurs, you need to consult a doctor regarding the administration of laxatives),
  • with normal healing of the incision, the sutures are removed from it for 9-10 days, after which you can take a shower (the possibility of taking baths, visiting the pool after surgery, prostate cancer should be discussed with your doctor).

To prevent recurrence of prostate cancer after radical prostatectomy, you should visit a urologist at least once a year and undergo digital rectal diagnostics.

After removal of the prostate gland, you can forget about the disease for up to 15 years. In some cases, repeated surgical intervention is required. Subject to medical recommendations, passing the necessary procedures and a timely visit to the doctor, life expectancy can be increased.

A prostate tumor can appear in any man. The main thing is not to miss the moment and diagnose the disease in time. Modern medical technologies allow in most cases to defeat the disease and continue to enjoy life.

How is the operation performed

Through laparoscopic prostatectomy (an incision is made in the lower abdomen or an incision in the perineum). Thanks to the development of medicine, laparoscopic prostatectomy can also be performed through the da Vinci robot (such an operation costs about 20 thousand euros and is carried out mainly in Western European medical institutions). In certain cases, TUR (transurethral resection of the prostate) is used.

Laparoscopic method

Laparoscopic prostatectomy is a neat and gentle method for excising a diseased prostate. As part of the operation to remove the prostate in cancer through laparoscopy, the possibility of microbes and infections getting reduced to min, as well as the rehabilitation period. As part of this type of surgical intervention, certain surgical instruments neatly pass through several openings of a minimum size into the abdominal cavity. Accurate incisions in the lower abdomen allow you to insert an endoscope and other surgical instruments necessary for a successful operation.

Often, simultaneously with the prostate, nodes are also cut out along which lymph flows. But if the tumor is small, and the likelihood of relapse (re-cancer) is minimal, experts advise not to cut out the nodes along which the lymph flows.

As part of the removal of the prostate in cancer, the doctor must take into account the general condition of the patient. The patient should know everything about the upcoming surgical intervention and its risks, about how long recovery from prostate cancer surgery will last. The patient must (with the help of the attending physician) be mentally prepared not only for the operation itself, but also for the long follow-up treatment.

Operation using the da Vinci Robot

An operation to remove prostate cancer as part of a laparoscopic prostatectomy can be realized through the specially invented, know-how in the surgical world, the da Vinci robot. This robot is a unique laparoscopic technique, all movements of which are supervised by a surgeon. This method is very popular because of its effectiveness and accuracy. But it is carried out mainly in Western European hospitals, because the da Vinci robot is a very expensive equipment.

This will reduce the chance of adverse effects of surgery. It is important that such a clinic also use other methods of treating prostate cancer without surgery (radiation, chemotherapy, as well as taking hormonal drugs). These methods are often used not only before but also after prostate cancer surgery. And if it turns out that there are factors that prohibit the operation to remove the prostate using a new generation of robotic technology.

Transurethral resection of the prostate. This method is often used to excise non-cancerous growths - adenomas. As part of prostate cancer, surgery through TUR is done exclusively in the late, already inoperable stages. At such stages, the diseased prostate disrupts the process of ridding the patient of urine and provokes the onset of pain. With TUR, the incision size will be small, which alleviates the symptoms of cancer. But as the main treatment, this method is not used, because there is no certainty in the absolute excision of the neoplasm. In addition, with the help of TUR there is no chance to get rid of already diseased nodes along which lymph flows.

The surgical (radical) method of getting rid of the cancer of the prostate is accompanied by a high probability of absolute recovery (especially at stages 1.2).

The benefits of surgery

During the surgical procedure, the patient’s body is able to get rid of the primary source of the cancerous tumor. Doctors say that the likelihood of recurrence of prostate cancer with absolute excision of the prostate is much less than in the framework of surgical intervention that preserves the organ. And if the patient has no contraindications for surgery, he will be strongly advised to prostatectomy.

Types of Prostate Cancer

Prostate carcinoma is not a benign neoplasm that is permanently increasing. Oncological disease of the prostate has a variety: it can be localized, that is, located exclusively on the gland, without the formation of metastases) and metastasizing. An operation to remove prostate cancer at the beginning of the disease can remove all cancer cells from the patient. Total prostatectomy is indicated for those patients whose estimated lifespan is at least ten years.

Nerve-Saving Prostatectomy

Nerve-saving surgery is a minimally invasive method for stopping a malignant tumor in the prostate cavity.

A positive result after a nerve-sparing operation is usually observed when removing a localized form of prostate cancer. Unfortunately, after its holding there is a high probability of relapse. This is the main disadvantage of this radical technique.

If a man prefers to remove a malignant neoplasm in the prostate gland using this type of surgery, he should trust a competent specialist. After all, it depends on his actions, such an effect will have a surgical intervention. Today, many surgeons practice the use of robotic technology that performs this procedure. Thanks to this, high accuracy of the basic manipulations is ensured.

Preparation for surgery

It is important to make sure that the cardiovascular system is able to undergo surgery

If oncology is detected in the absence of contraindications, the man is sent to the operating table. During the procedure, various methods are used to eliminate malignant neoplasms in the prostate. Before starting a prostatectomy, the patient must undergo special training. The initial result of surgery depends on the correct fulfillment of this requirement.

Before prostatectomy begins, do the following:

  1. A few days before the scheduled operation, the patient should pass a sample of urine and blood for analysis. He will also need to undergo a chest x-ray, an electrocardiogram and an ultrasound examination of the affected area. Additionally, the man should be re-examined by the surgeon. The results of the tests will confirm the need for surgery or help identify contraindications to such a procedure,
  2. Shortly before surgery, you need to stop taking medications that can thin the blood,
  3. For 1-2 days, the patient is placed in the ward. He will have a conversation with the surgeon who will perform the removal of the tumor, and with the anesthetist. Doctors will tell the man in detail about the features of the operation. They must warn him of possible complications. If the patient has questions during the conversation, the doctors will give an exhaustive answer to them,
  4. The patient must sign his consent for surgery. This is recorded in the document, which also confirms that the patient is aware of the consequences of the procedure for removal of the prostate in cancer,
  5. 1 day before surgery, the patient will have to switch to liquid food. The last meal should be in the evening before the procedure. On the appointed day, a man should not eat and drink.

The anesthesiologist will prepare the patient an appropriate anesthesia. General or regional anesthesia is usually chosen. Patients are offered epidural and spinal anesthesia, which has minor complications.

What is prostate removal?

A prostatectomy is a surgical operation to remove a prostate or part of it. The gland secretes a special secret that stimulates the motor activity of sperm and prolongs their viability outside the male body. The prostate significantly increases the chances of natural fertilization. Organ removal does not mean automatic infertility. Modern surgery involves several surgical techniques. The choice of the most effective method is individual and remains at the discretion of the attending physician and patient.

Possible complications

The operation to remove a malignant neoplasm in the prostate is not always successful. Many patients may experience unpleasant symptoms due to the nature of the procedure itself, improper behavior, or a surgeon’s mistake.

The complication of radical treatment of the prostate is of a different nature. The negative effects of surgery to remove prostate cancer are usually presented in the form of disruption of the urinary and reproductive systems.

A prostatectomy can lead to the following complications that prevent a man from feeling healthy after getting rid of a malignant tumor:

  • Cicatricial pain
  • Hematuria, which is temporary in nature (during urination, small inclusions of blood in urine become noticeable),
  • Water intoxication,
  • Acute pains that are felt in the area of ​​the lower part of the peritoneum,
  • Urinary incontinence after surgical removal of prostate cancer, caused by severe trauma to muscle tissue and nerve endings of the internal organ,
  • Erectile dysfunction,
  • Infertility development
  • Excessive blood clotting and the development of blockade thrombosis in large blood vessels,
  • Severe pain during intimacy (accompanied by an unexpressed orgasm or its complete absence),
  • Reflux of seminal fluid during orgasm into the bladder,
  • Genitourinary infection
  • Damage to the rectum.

The surgical procedure, which is indicated for prostate cancer, has very serious consequences directly for the urinary and reproductive systems. However, most complications go away after some time. To achieve this result, it is necessary to undergo a full recovery after surgery, in which prostate cancer is removed. Some negative consequences disappear on their own, without requiring outside help. But there are more severe cases in which systemic complications develop. They have to fight with them, involving drug therapy in this process.

In most cases, unpleasant manifestations go away on their own

Contraindications

Surgical removal of a malignant tumor in the prostate is not suitable for all cancer patients. This procedure is contraindicated in the following diagnoses:

  • Diabetes,
  • Diseases of the respiratory and cardiovascular systems,
  • Testicular varicose veins,
  • Decompensated pathology of internal organs,
  • Blood clotting problems.

Cost

Having learned about their diagnosis, men first of all want to know the cost of surgery to remove a cancerous tumor in the prostate. The price of this procedure depends on many factors, including the variety of methods, the experience of a specialist and the level of the clinic.

The average cost of a lateral prostatectomy is 68,000 rubles. Perineal surgery costs 52,000 rubles. The most expensive operation is considered, in which robotic equipment is involved. Its average price is 75,000 rubles.

Forecast

The prognosis and life expectancy after surgical removal of a malignant tumor in the prostate gland depends on many factors:

  1. Current state of the patient
  2. The form and stage of his illness,
  3. Compliance with postoperative rules.

Usually treating cancer with a prostatectomy reduces the likelihood of a relapse in the first 5 years after removal of the tumor. External radiation and brachytherapy on this indicator are much inferior to surgical intervention. For 5 years, the survival rate of cancer patients with this diagnosis is almost absolute. In the first 10 years, it decreases to 70-90%.

Mortality during the first 10 years after surgery is determined by the patient’s age, stage of his cancer and the presence of complications after removal of the affected organ.

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Methods of surgical treatment

In medical practice, there are three key ways to perform surgical measures to remove the prostate. The choice of methodology is based on the available evidence, the stage of development of cancer and the personal structure and structure of the man’s body. Ways to remove the prostate gland:

  • Open intervention - the method is performed in rare situations. Among diagnosed cases, the method is carried out in 2-3% of patients. Indications for therapy are an enlarged prostate size and other complicated processes. The rehabilitation period lasts three weeks. The body is subjected to more harm and trauma compared to other techniques.
  • Transurethral resection - the method is less traumatic. Therapy is performed through the urethra. At the end of the procedure, a catheter is inserted through the canal, which prevents the formation of infectious and viral foci of infection. The man's well-being improves on day 5.
  • Endoscopic therapy is a radical treatment. The operation scheme involves the use of a laser. Cancer cells burn through the urethra. Rehabilitation of the body takes the minimum time.

In addition to medical indications for surgical therapy, the attending doctor takes into account the patient's personal desires. Regardless of the level of medicine, surgical manipulations expose the body to severe stress, which can provoke consequences and side effects.

Features of prostatectomy

Before the operation to remove the prostate, a list of features is calculated to determine a more suitable access to the prostate.

  1. Suprapubic pathway. An incision is made on the anterior abdominal wall. The prostate appears during surgery. Partial removal of the gland is performed without bandaging the vessels associated with the prostate. The technique is used in rare situations due to the increased likelihood of tissue injury.
  2. The side track. The technology is similar to the previous version. Access to the tumor is created along the anterior abdominal wall, retreating from the navel to a distance of less than 2 cm, and to the pubic region.At the same time, the surgeon makes a ligation of the vessels that feed the gland, and finally remove the prostate gland. The indicated path allows the doctor to easily bypass nerve cells and blood vessels that affect urination and erectile function. The duration of the operation reaches 4 hours.
  3. Crotch path. An incision is made between the scrotum and the anus. Access has many destructive properties and negative aspects compared to advantages and benefits. It is difficult to pass to the gland, regular trauma to nerve endings and vascular structures is noted, there is no possibility of removal of these lymph nodes. The advantage of perineal notching technology is the location of scars in invisible places. The duration of the operation is two hours.

Surgery for prostate cancer: consequences after removal, recovery and prognosis

  • Urologist andrologist of the 1st category Pyotr Viktorovich
  • 43617
  • Update Date: October 2019

Surgery for prostate cancer is one of the most effective methods of combating a malignant neoplasm, the tissues of which are located within the genital gland. In some cases, this treatment option is considered with the advanced course of oncology. Surgical intervention is prescribed in the presence of appropriate indications and a high probability of improving the quality of life of the patient after removal of the cancer.

Methods for stabilizing urination

Failure and disruption of the urethra and inability to retain urine bring serious problems to every man. It was noted that with an increase in the patient's age, the degree of the course of the disease is complicated. A man at a relatively young age will recover and rehabilitate faster. Also, young patients remove a suprapubic catheter during the first days after the end of a surgical event.

Patients older than 60 are more difficult to tolerate partial elimination of the urethra. Older men will need a longer postoperative period to restore physical, emotional, and psychological health. Postoperative devices that help urinate are in the patient’s body for 14-28 days, depending on the complexity of the situation.

An elderly person is very uncomfortable due to the need to use an urinal and a prominent odor. Such discomfort can provoke social maladaptation. After removal of prostate cancer, urinary incontinence is noted in each patient. In frequent cases, the situation stabilizes from 1 month to six months.

Pelvic floor exercises

The rehabilitation period includes a set of physical measures and exercises aimed at training the pelvic floor muscular system. The program is an effective supportive measure for drug therapy and the treatment of urination. Exercise activates and accelerates blood in the pelvic area and is conducive to reducing the duration of recovery. High efficiency is noted with a strong-willed repetitive effort aimed at the muscular work of the pelvis.

The technique creates the necessary degree of load on efferent fibers, which provokes an increase in the activity of sphincters. As a result of regular observance and exercise, the muscular system of the pelvic floor is strengthened. This has a positive effect on the restoration of urination.

Loop structures

Medications and exercise are not able to guarantee 100% normalization of urination function. In the absence of the expected effect throughout the year, the doctor prescribes surgery. The method involves the surgical establishment of an adjustable sling. The apparatus consists of two thin filaments fixed in the bulbous region of the urethra. In violation of the sphincter, loop systems are powerless.

Effects

The consequences of prostate removal in cancer: problems with urination (incontinence) and erection dysfunction. With a small tumor, during the removal of the prostate in cancer, erectile dysfunction can be avoided - the potency will remain. But problems with an erection can be unequivocal.

Involuntary urination will occur after surgery - after removing the urinary catheter. But this does not mean that urinary incontinence after removal of prostate cancer will remain a constant problem. After a couple of months, or even weeks, going to the toilet will return to normal.

During the operation to remove the prostate cancer and immediately after it, the operated catheter is inserted and left for some time in the bladder, due to which it is released as urine builds up and without urges. A catheter is a necessity that helps to avoid stagnation in the urinary bladder, which can provoke a new inflammation. When the catheter is removed, the muscle tissue of the bladder will still be relaxed, and the patient will still not feel the urge. This is one of the causes of incontinence. Incontinence appears in the lion's share of operated patients. Therefore, it is prudent to be prepared for such an unpleasant consequence of surgical intervention by learning exercise therapy exercises.

The second reason is that the excretory and reproductive systems of the representative of the strong half of humanity interact with each other. After all, the location of the prostate is next to the urethra, which, in turn, is located in front of the entrance to the bladder. In the same place is the internal sphincter. This muscle, thanks to the cramps produced, stops the emission of urine and is responsible for the urge to visit the toilet. The effects of anesthesia are also one of the causes of urinary incontinence. If the anesthetist incorrectly calculated the dose of anesthesia, the patient will struggle with the consequences of such negligence for more than one month. Recovery after removal of prostate cancer lasts at least a month. In terms of getting rid of urinary incontinence, recovery will be faster if you adhere to at least a partial bed rest. At rest, recovery from surgery can be much faster.

Another unpleasant consequence of the operation of radical prostatectomy is a stricture of the urethra or narrowing of the canal through which urine descends. Shortening of the penis is possible. As part of perineal prostatectomy, injury, rectal wounds, or fecal incontinence are possible. In the framework behind the pubic access to the prostate during surgery, neuropraxia (damage to peripheral nerves) is possible.

Postoperative period

Recovery after removal of prostate cancer consists of:

  • Physiotherapy,
  • Physical Therapy,
  • Magnet Therapy
  • Radio wave therapy.

What does exercise therapy for urinary incontinence in the period after surgery consist of? In relaxation and tension (in turn) of the bottom of the abdominal cavity. You need to do this while lying down. So muscles swing, and the urge to go to the toilet appears again. It is prudent to conduct this kind of exercise under the guidance of an instructor, in order to avoid severe consequences for so shaky health.

This is associated with pain, which, however, will pass after removing the catheter. The doctor, if the patient wishes (with severe spasms), can prescribe painkillers.

As before surgery, after it the patient takes antibiotics in order to minimize possible infection. The course of antibiotics is selected individually after reviewing the results of the examination. Do not be alarmed if after surgery during urination you see blood clots in the urine - this is normal. If there is a lot of blood, the doctor will prescribe an adequate treatment. The recovery period depends on the stage of the cancer, the conditions of the operation, the patient’s immunity and ranges from 10 days to a month.

1 degree

Grade 1 prostate cancer is when an x-ray does not show a tumor. But cancer cells are found in tissues taken as part of surgery for gland hyperplasia. Cancer cells can also be detected by biopsy, it is prescribed for elevated levels of prostate-specific antigen in a blood test. The prognosis for patients with cancer of the 1st degree after surgery is survival for 10 years (with adequate and timely treatment).

Physical activity

Patients after removal of a malignant tumor in the prostate gland are shown bed rest. So, their physical activity during the rehabilitation period should be minimal.

Experts strongly recommend that patients change their posture every 2 hours and gradually move their lower limbs. Such an easy exercise allows the prevention of blood clots.

Already on the first day, if necessary, a man can get out of bed. Recovery from surgery that can cure prostate cancer will take some time. To speed it up, you should adhere to a number of simple rules:

  • It is recommended that you get out of bed gradually in the first days after surgery. Haste in this matter is useless. It is advisable to support the seam on the stomach with a pillow. This method allows you to reduce the severity of pain. At first, the patient may feel dizzy after getting out of bed. This is a normal reaction to a change in body position in the postoperative state.
  • When permission to walk freely is obtained, the patient will be able to take off the compression stockings. You need to increase the duration of your walks along the corridors or ward. Do not travel long distances. It is best to be limited to the area next to the bed.
  • Exercise during the rehabilitation period is strictly prohibited.

If you feel very tired, it is better to go to bed to rest. Overexertion of the body to the benefit of health will not work, but only worsen the condition of the patient.

Nutrition

At first sugar is contraindicated

The issue of patient nutrition during the rehabilitation period deserves special attention. He will need a diet after removing the cancer.

Important! The patient is given some drinking water 3-4 hours after the operation. It is forbidden to eat on the first day.

From the second day of rehabilitation, a patient is offered a diet in which the tumor was removed by a radical method. It provides for the use by patients of the following foods:

  1. Dairy products, in which there is no sugar.
  2. The eggs.
  3. Steamed meat or fish.
  4. Not a rich broth.

On the next day, it is allowed to add boiled beets and prunes to the menu to improve the intestines.

Methods for removing adenoma

Surgery has developed several methods for prostatectomy. To date, all of them apply. When choosing, the patient's age, concomitant diseases, stage of the disease and PSA levels in the blood (prostatic specific antigen) are taken into account. Of great importance is the qualification of the surgeon. There is the following choice of surgical intervention:

  1. Transurethral resection of the prostate. It is carried out with a benign enlargement of the prostate. Partial removal surgery is performed laparoscopically through the urethra.
  2. Prostate Incision The method of intervention for prostate adenoma, in which normal urine outflow is restored. It is carried out when the prostate is enlarged slightly, the risk of early complications in the form of retrograde ejaculation is high (sperm is not exposed outside, but inside the bladder).
  3. Radical prostatectomy. The method is used for tumors and for the removal of benign hyperplasia. Together with the prostate, lymph vessels and nodes are removed.
  4. Laser removal of the prostate gland. A progressive method, which due to its low invasiveness is especially indicated for elderly people. The effectiveness of laser resection is proven by a relatively small number of postoperative complications.

How do prostate surgery

In the preoperative period, all the recommendations of the doctor must be strictly observed. It is necessary to stop taking medications that thin the blood (clopidogrel, warfarin, aspirin and others). Preoperative preparation is individual depending on the chosen method of operation. To get a complete picture of the patient's condition before surgery, the attending physician may prescribe a number of tests:

  • PSA analysis
  • transurethral ultrasound,
  • biopsy (at the discretion of the doctor),
  • rectal digital examination.

Transurethral resection

Before the operation, it is necessary to conduct a urine and blood test. Local anesthesia is practiced for pain relief. Since surgical instruments require direct power supply, an electrode for grounding is located under the patient’s thigh. During the operation, a resectoscope is inserted through the urethra into the patient's bladder.

Adenomas are removed using a device called a loop. The neoplasm is removed gradually, as if “scraping” it until only healthy tissue remains. At the end of the operation, pathological tissue in the form of “chips” is located in the bladder. These fragments are washed with a special device. Operation standards are designed for a duration of not more than one hour. During the postoperative period, a special catheter is inserted to restore urination.

Incontinence Prevention Exercises

Sometimes patients who have had a prostatectomy encounter such an unpleasant phenomenon as urinary incontinence. In men, this disorder occurs even after the correct removal of cancer in the prostate gland. Special exercises for the prevention of incontinence help to cope with the problem.

Exercise can begin after removal of the catheter. During training, the pelvic floor muscles that control urination are used. To detect them, it is necessary to hold the stream during emptying of the bladder.

The muscles in the perineum need to be reduced by 2 seconds, and then relax by 5 seconds. This action is recommended to be performed 10 times three times a day.

Radical prostatectomy

If a significant part of the prostate is affected by oncology, minimally invasive methods are considered unpromising. The doctor is forced to opt for a radical cavity prostatectomy, which involves the removal of the prostate. The duration of the operation is approximately 2-3 hours. There are three technologies of this type of surgical intervention:

  1. In cases of a strong enlargement of the prostate, an incision is made in the lower abdomen, access to the gland is ensured with its subsequent removal.
  2. For patients with overweight or already injured operations with excision of the abdominal or pelvic cavity, access to the prostate is through an incision in the perineum.
  3. The laparoscopy method involves several small sections of the abdominal wall for the introduction of instruments and a laparoscope, which is equipped with a video camera.

Endoscopic resection

A less common type of operation is simultaneously highly effective. Removal occurs using a laser beam under local anesthesia. No incisions are required for this; burning of damaged tissue is done through the urinary canal. The advantages of the operation include the absence of blood loss, low morbidity and a reduction in the recovery period.To facilitate the process, surgeons use a camera at the end of the instrument.

Laser vaporization

Laser vaporization using the properties of a green laser is considered the newest method of removal of the prostate gland. It is distinguished by its photosensitivity to hemoglobin, it affects only those tissues of the gland that have good vascularization. The laser beam penetrates into the tissue only 1 mm, so vaporization is done in layers. The patient is given local anesthesia through the urethra. The advantages of the process include a minimal risk of bleeding.

Recovery of potency after removal of the prostate

Weakening or loss of an erection in men is a side effect of removing the prostate gland. Of particular difficulty are cases if during the operation the nerve fibers responsible for the occurrence of an erection were damaged. If the operation was successful, and there were no problems before the intervention, then the recovery, according to reviews, takes from three months to a year. Substantial drugs for potency based on sildenafil and tadalafil, mechanical devices (pumps and erectile rings) will provide significant rehabilitation assistance.

Artifact sphincter

An artificial sphincter will help get rid of a problem with complicated urinary incontinence. According to medical statistics, in 90% of patients, the need for laying is reduced to 0-1 pieces per day. But the artifact apparatus is accompanied by complications:

  • urethral erosion with resulting atrophy,
  • tissue injury
  • urethral infection process.

The described treatment regimen for urethral dysfunction is considered expensive and rarely used.

Sex life

Rehabilitation after surgical removal of prostate cancer involves a number of rules. These include recommendations regarding the conduct of an intimate life at the end of surgery.

Restore temporarily lost erection allows independent stimulation of the genitals or the commission of these actions partner. Return to intimate life should be no earlier than 2 months after surgery. Up to this point, sex can lead to negative consequences.

After surgery during an orgasm, a man will lack ejaculation. This is due to the fact that during the radical treatment of cancer, the seminal vesicles and prostate gland are removed. It is she who is responsible for the production of the liquid component of seminal fluid.

Electrical stimulation

Electrical stimulation acts on the group of urethral and periurethral muscle structures, from which activation of the activity of the sphincter is observed. In practice, two methods of electrical stimulation procedure are used:

The physiotherapeutic method is recommended to be carried out in conjunction with a set of other methods for stabilizing the patient's body. Complex treatment allows you to achieve the desired result.

Types of Surgery

Depending on the severity of the disease, doctors use different methods of surgical intervention. Sometimes only a part of the organ is removed, and not the entire prostate gland. The removal operation can be carried out by the following methods:

  • Transurethral removal of the prostate - is carried out through the external opening of the urethra. With the help of a resectoscope, a gradual removal of the prostate gland or only its affected part occurs. The absence of a cut is the main advantage of this method. The rehabilitation period is also significantly reduced.
  • Transvesical adenomectomy is an open operation in which the surgeon makes an incision between the navel and the pubis. It is used to remove adenomas or large malignant tumors.
  • Laparoscopic resection - during the operation, the doctor makes several punctures on the anterior abdominal wall where the device equipped with the camera enters. In this way, you can completely remove the entire prostate or only part of it.

Surgery for prostate cancer: is there life after it?

Treatment of a malignant tumor of the prostate through its removal involves surgery for prostate cancer. An indication for surgical intervention is finding the neoplasm within the borders of the prostate, that is, at stages 1 and 2 of the disease. However, often operations are performed in the case of the spread of the tumor into the surrounding tissue.

Method Definition

Before the operation, the oncologist-surgeon determines the volume of the necessary intervention, relying on the data of instrumental and diagnostic studies, gives a preliminary forecast.

It is 100% impossible to predict the result of the operation, since it can lead to the infiltration of tumor structures into adjacent tissues or nerve fibers that extend beyond the boundaries of the estimated volume of the neoplasm.

The degree of tissue excision is affected by the stage of germination of the malignant tumor. The main goal of the surgeon is to completely remove it while maintaining the integrity of nearby healthy tissues.

Surgical removal of a prostate tumor is done by post-ciliary or perineal techniques. Thanks to the latest technology in the field of medicine, it has become possible to conduct sparing nerve-saving operations. The following methods of surgical intervention for prostate cancer are:

  • Removal of the prostate gland while maintaining the integrity of the prostatic capsule,
  • Absolute excision of the gland together with the capsule, seminal vesicles and nerve bundles.

Among the types of interventions, operations are distinguished:

  • Laparoscopic
  • Radical nerve-sparing,
  • Transrectal resection.

The doctor selects the most suitable surgical technique for each patient individually, taking into account the following criteria:

  • Stage of the oncological process,
  • Localization and volume of malignant formation,
  • Features of the pathology,
  • Patient age
  • The severity of characteristic symptoms,
  • The general condition of the body of a man,
  • The presence of systemic diseases,
  • Preliminary forecast.

Surgery for prostate cancer is performed in the presence of direct evidence. Surgical treatment at stages 1 and 2 of oncology involves the absence of metastases and tumor growth outside the capsule.

When deciding on the choice of an acceptable operation, the surgeon is based on various indicators that determine the effectiveness and feasibility of surgical intervention.

Rehabilitation period

In cancer centers in Russia, specific stages of monitoring patients who have survived the surgical process in prostate cancer are prescribed. A comprehensive group of procedures consists of:

  • systematic testing for PSA,
  • in the first year after surgical intervention, undergo a prophylactic examination once every 3 months,
  • Pelvic MRI every 6 months.

Monitoring the condition of the male body in the postoperative period is important for the timely detection of a likely relapse of the cancerous tumor. Doctors have a wide range of drugs to inhibit the development and spread of malignant cells at an early stage. In rare situations, it is impossible to block the formation of oncological formations. However, it will always be possible to reduce the rate of cell multiplication in prostate cancer.

After removal of the prostate gland, a man should be observed by a urologist and oncologist until the end of his life. Screening is a precaution to restore quality and lifestyle and to relapse in a timely manner. According to oncological information, in 90% of cases, men after a prostate tumor return to their usual way of life.

Nerve-saving technique

At its core, this technique is a minimally invasive version of the elimination of malignant neoplasms of the prostate gland and is aimed at maintaining the reproductive function of the male body. With a successful operation to remove the prostate in a patient, dysuric symptoms are eliminated and potency is fully restored.

A positive outcome of nerve-sparing effects was diagnosed exclusively with localized tumors. Along with this, the risk of relapse remains high.

Modern nerve-saving operations are carried out using a Da Vinci robotic installation, which is able to provide maximum accuracy of tissue dissection. But, nevertheless, the results largely depend on the qualifications of the surgeon conducting the intervention.

Sexual intercourse after removal of the prostate

Adverse reactions and consequences are based on the severity of the course of the disease, which made a prescription for excision of the organ, age category of the patient and personal characteristics of the body. Existing disorders in sexual life before surgery will not go away after surgical procedures to remove the prostate gland. If problems were noted before surgery, excision of the organ will not eliminate the difficulty. However, the surgical procedure will not cause difficulties in intimate life.

An erection after removal of the prostate remains normal. In some situations, there is difficulty with ejaculation, infertility gradually develops. Similar problems are explained by the partial entry of sperm into the bladder. Violation of the urethra produces less resistance to movement of seminal fluid. With an early detection of the situation, it is possible to withdraw the fluid completely, having carried out the necessary drug treatment.

Responsible following the instructions of the attending physician will help to avoid unpleasant side effects and secondary surgery. Sexual life after surgery remains normal. It is important to correctly follow the therapy technology during the recovery period. Erectile dysfunction appears due to a strong psychological and emotional stress in a man due to the procedure.

Infertility

After diagnosing prostate cancer in men, questions arise about the ability to conceive children after removal of the prostate. In the normal course of recovery, difficulties with fertilization do not arise. A clean operation without the development of subsequent difficulties does not affect the functions of the body adversely. If there are difficulties with ejaculation, it is recommended to undergo a medical examination to select the appropriate medicinal medications that eliminate unpleasant symptoms.

In addition, you should seek medical help on time. This will help to avoid the development of the situation to the end point. Self-medication can cause serious harm and lead to loss of time. Judging by clinical examinations, not every type of prostatitis causes infertility. More often a man remains with the possibility of fertilization.

Diet and proper nutrition

Responsible following a number of medical recommendations and rules will help speed up the recovery and rehabilitation of the body, as well as return to your usual lifestyle faster:

  • drink plenty of fluids - water or green tea,
  • increase the amount of fruits and vegetables consumed,
  • remove fatty foods from the diet and add protein products to the menu,
  • eat fish at least once a week,
  • give up caffeine, salty foods and fast food,
  • it is required to clear food from red meat, fried foods and alcohol-containing liquids,
  • consume more dairy products.

Diet should be followed for many years after surgery. This contributes to the accelerated recovery of the man's body.

Prevention

In order to return a man to his usual regimen and quality of life after removal of the prostate gland for a year and decades, it is important to strictly observe the rules and prescriptions of the doctor. Regardless of the case, excision of the prostate leaves a negative mark on the health of men. Therefore, it is recommended to carry out a number of favorable preventive measures:

  • After the operation, a man should not wait for an independent restoration of erectile function. Early onset and frequent sexual intercourse will allow you to quickly restore normal erection.
  • In rare cases, men after removal of the prostate gland are able to fully return to sexual activities. Therefore, it is recommended to masturbate for the first couple of weeks with a woman. The method will allow you to normalize the emotional background that suffered due to the operation, and get used to new sensations of orgasm.
  • Do not carry heavy things, heavy things, do not strain the body strongly when going to the toilet.
  • Add activity to life, abandon the sedentary mode of life.
  • Once every 3 months for the next 2 years, take tests for a PSA test.
  • Perform Kegel exercise to restore urination.
  • Refuse strong physical exertion.
  • Use medications to normalize potency.
  • Refuse sexual intercourse for 1-2 months.
  • More often go for a walk to prevent the formation of blood clots.

After removal of the prostate gland, the patient is recommended to perform a group of exercises. Physical activity favors the normalization of the muscular system of the pelvic floor. Recommended exercises during the recovery period:

  • the development of the muscular structure of the pelvis,
  • elimination of tension in the muscles of the pelvis,
  • relaxation of the muscular system of the pelvis.

The listed Kegel exercises contribute to the new development of the muscular structure of the pelvic floor, and also allow you to stabilize the genitourinary system in men.

Removal of the prostate gland: consequences

The appearance of possible complications during surgery depends on the neglect of the disease. So, an operation to remove prostate adenoma usually does not have serious consequences. In addition, it is much more dangerous to carry out the procedure through an open incision. The risk of complications also depends on the skill level of the surgeon.

We list the main postoperative complications that patients most often encounter:

  • infections of the genitourinary system introduced into the body during resection,
  • the appearance of hematuria (the presence of blood in the urine),
  • temporary or permanent impotence,
  • relapse of the disease
  • narrowing of the urethra, which leads to difficult deurination,
  • retrograde ejaculation is the injection of sperm into the cavity of the bladder.

How is the operation to remove the prostate gland?

Depending on the complexity of the upcoming surgical intervention, either general or spinal anesthesia is used. The technique of the operation depends on the method by which it will be performed. So, with transurethral resection, an instrument with a lighting device and a camera is inserted into the urethra of the patient. Through it, he enters the bladder. The surgeon observes his manipulations on the monitor screen. With the help of a resectoscope, he slowly removes the prostate or part of it, pinching small pieces from it, while cauterizing the affected bleeding vessels. After resection, the doctor places a catheter into the bladder through which urine will subsequently enter the urinal. Laparoscopy is similarly performed. The main difference is that the resectoscope is not inserted through the urethra, but through small holes on the front wall of the abdominal cavity.

An open method can also be used for deletion. The prostate in this case, as a rule, is completely removed.The surgeon makes an incision between the pubis and the navel of the patient, passes through the muscle tissue and the walls of the bladder. Then, with his hands, he removes the overgrown part of the prostate. At the end of the operation, a catheter and a drainage tube are also inserted, which exits through the incision. The rehabilitation period after this type of operation lasts much longer.

Features of surgery to remove cancer

The operation to remove prostate cancer is additionally accompanied by a complete resection of the abdominal lymph nodes to prevent the appearance and spread of metastases. Additionally, seminal vesicles are also removed. For small tumors of the early stages during the operation, they can use the Da Vinci robot, which performs precise laparoscopic actions, causing minimal damage to the patient. The surgeon and the anesthetist in this case are constantly next to the patient and monitor his condition. This method allows you to fully maintain potency in men.

Initial rehabilitation period

After the operation, the patient is connected to a continuous bladder emptying system in order to timely remove accumulated fluid and blood clots from there through a catheter. Through it, the organ is washed with a special solution, for example, furatsilinom. Depending on the complexity of the operation, the system can work from several hours to several days. 2 hours after the procedure, the patient is allowed to drink some water, and eating is resumed the next morning. In the first days after resection, it is recommended to drink at least 2 liters of water, and also to exclude fatty, fried, salty and smoked foods from the menu.

Is it possible to restore potency after removal of the prostate gland?

As a rule, resection (removal) does not always lead to a loss of potency. The prostate gland is surrounded by many muscles that are responsible for the man's ability to have an erection. If the surgeon manages to avoid damage during the operation, then the potency is restored over time. A negative prognosis is usually given to patients with extensive malignant tumors. In the absence of complications, the potency returns to the man 4-5 weeks after the resection.

Life after prostate removal surgery

After discharge from the hospital, the patient may still feel discomfort for some time. With simple surgical interventions, the patient is sent home after 4-5 days. Surgery to remove prostate adenoma or cancer requires a long-term recovery under the supervision of doctors. At first, a man will be forbidden to supercool and engage in heavy physical labor. Loads can be restored 1-2 months after resection. One week after discharge, the patient may return to work.

To summarize

Thus, removal of the prostate can be called a non-hazardous procedure. Its consequences depend entirely on the disease in which it was carried out. As a rule, after resection, the patient's condition improves, and he recovers over time. Even with organ resection in the presence of malignant tumors, there is a high probability of a positive outcome, especially if it was performed in the early stages. In this case, the survival rate of patients after removal of prostate cancer is 90-100%. Choose a trusted clinic and surgeon who has many positive reviews to reduce the likelihood of a medical error and the appearance of possible complications.

Lifestyle after prostate cancer removal

Radical excision of a malignant neoplasm certainly makes its own adjustments to the lifestyle of a man. The attending doctor will write in detail the recommendations that will contribute to an early recovery and prevent the oncology recurrence:

  1. Avoid exposure to direct sunlight, since ultraviolet has the property of provoking a relapse of the cancer process.
  2. Individually in the rehabilitation period, the patient is prescribed physiotherapy and exercise therapy. Physical activity plays a key role in preventing stagnation and improving blood supply to internal organs, especially those located in the pelvis. An alternative to exercise therapy can be yoga.
  3. After the operation, it is important for the patient to resort to proper nutrition, focusing on seafood, fresh fruits and vegetables, and also include in the daily diet plentiful drink (mineral water, fruit drinks, tea). Along with this, it is important to exclude alcohol, pastries, fried and fatty foods.
  4. Sexual life after removal of a prostate tumor resumes after 2.5-3.5 months. The abstinence period for each patient is individual, therefore, the attending doctor diagnoses the condition of the male body and, in the case of a complete restoration of the functions of the internal organs, gives permission for sex.

The main reason for the wide spread of prostate cancer is the lack of attention to the health of a strong half of humanity.

Thus, timely diagnostic measures, the correct preparation for surgical treatment and the recovery period are able to overcome oncology in a complex, as well as establish overall well-being and a full sexual life.

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Course of intervention

With prostate cancer, the principles of prostatectomy are the same for any technique:

  • a catheter is inserted into the bladder,
  • access the gland, followed by its isolation from the surrounding tissues,
  • cross the urethra,
  • the prostate is separated by a single block with seminal vesicles,
  • on the catheter, the urethra is sutured to the bladder, the catheter is not removed,
  • drainage is installed in the area of ​​operation - thin tubes for the outflow of wound.

Depending on the results of the preliminary examination, the pelvic lymph nodes may be removed or left intact. If the patient was able to have sex before surgery and allows the size of the tumor, during the prostatectomy they preserve the neurovascular bundles in which the cavernous nerve passes in order to maintain erectile function in the future.

General information

Before you go to the hospital, it is recommended to stock up:

  • spacious soft trousers to avoid pressure on the area of ​​the postoperative suture,
  • "Seat" with filler or foam to reduce the impact on the perineum when sitting,
  • urological pads or diapers - in the early postoperative period often the development of urinary incontinence (urinary incontinence).

The patient spends the first day after a prostatectomy in the intensive care unit. At this time, complaints about pain in the area of ​​the operation are frequent - you can ask the nurse for pain medication. Another common complaint is sore throat caused by an endotracheal tube. They can be alleviated with the help of any sucking candy.

  1. For the prevention of postoperative pneumonia, it is necessary to perform breathing exercises (a doctor will tell about them) or inflate balls.
  2. Drainage from the area of ​​operation is removed after the outflow of discharge is stopped.
  3. During coughing, it is better to squeeze the incision on the stomach with a pillow - this will reduce pain.

Extract

In some hospitals, the patient is discharged from the hospital before the catheter is removed, it is better not to prevent it - the risk of purulent-inflammatory complications increases during the stay in the hospital, as the nosocomial microflora is more aggressive than usual.

If the stitches have not been removed before discharge, they can be removed by the surgeon in the clinic, the attending physician will tell you when to do it. After removing the seams, you can take a warm bath and wash in the shower. The area of ​​the postoperative wound should be washed with soap and water, without using a washcloth, then blot the seam line with a soft cloth.

When you need to urgently see a doctor

  • the area of ​​the postoperative suture turned red, swollen, became hard,
  • the edges of the wound parted
  • fluid is released from the seam,
  • the temperature rose above 38, chills appeared,
  • in the urine there is a lot of mucus and sediment and / or clots and scarlet blood,
  • urine does not pass along the catheter, flowing abundantly past it,
  • dull lower back pain
  • weak stream
  • have to strain to urinate

Outpatient monitoring and prognosis

After the operation, the patient remains in the oncology clinic with an oncologist or a urologist at the place of residence for 5 years. It is necessary to regularly take an analysis for the level of prostate-specific antigen:

  • the first year - every 3 months,
  • the second - once every 6 months,
  • the third and further - once a year.

Since PSA is a protein of prostate tissue, it should not be determined after its removal. An increase in prostate-specific antigen will mean a recurrence of prostate cancer.

Five-year survival after radical prostatectomy 79 - 91%. It depends on the degree of tumor differentiation (Gleason sum), stage of oncopathology, preoperative level of prostate-specific antigen.

Watch the video: Prostate Cancer Surgical Treatment - Mayo Clinic (April 2020).

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