Understanding prostate cancer surgery
Posted on: 28 November 2016
Prostate cancer surgery, also known as prostatectomy is a procedure carried out by a surgeon to remove the prostate gland along with the cancer contained within it. Usually, the operation also involves the removal of the tubes that carry semen (seminal vesicles). It is a major operation, and therefore, it is not suitable for everyone with prostate cancer. Rather, it is recommended for younger, otherwise fit men whose cancer has not spread beyond the confines of the prostate gland or those with a high grade, fast growing tumour. In view of the possible side effects, it is not recommended for older men with slow growing prostate cancer and possibly other health problems. Such patients are more likely to die from other medical conditions or old age than causes attributable to the cancer itself. It is an alternative to external beam radiotherapy or brachytherapy.
Carrying out prostate cancer surgery
Laparoscopic or keyhole surgery is a minimally invasive method of removing the prostate gland. The procedure may be carried out in two ways. The first is by hand. The operator inserts a laparoscope, a lighted tube carrying a tiny camera and special surgical tools, into the abdomen via small incisions made in the abdominal area. The second option is robot-assisted surgery. The surgeon carries out the operation by inserting three robotic arms, one carrying a tiny camera and the other two carrying special surgical tools into the abdomen. The robotic arms are remotely controlled by the surgeon from a computer.
The retro-pubic prostatectomy is an open surgical method involving a single surgical incision made by the surgeon in the abdominal area to access the prostate gland. Perineal surgery, another form of open surgery, involves accessing the prostate gland through the perineal area. An incision is made in the area between the testicles and the back passage. This method is now rarely used by surgeons.
Preparing for surgery
In preparation for the operation, tests will be carried out on the patient to ensure fitness for surgery. Blood thinning medications such as warfarin must be discontinued at least one week before surgery to prevent excessive bleeding during the operation. Post-operative urinary problems may be alleviated by undertaking pelvic floor exercises a few weeks prior to surgery.
Knowing the complications of prostate cancer surgery
Apart from the usual complications associated with any major operation, bleeding is a major risk factor in prostate cancer surgery and there is a possibility that blood transfusion will be required. Pulmonary embolism, a condition in which a blood clot travels from the legs to the lungs, is also a well-known risk associated with this operation. Some patients experience problems with erection post-operatively but the surgeon will discuss the likelihood and the possible extent of this with the patient before surgery.
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