Surgical removal of prostate cancer

Removal of the prostate gland: operation, consequences

Many older men suffer from diseases of the reproductive or urinary system. The most problematic organ in them, as a rule, is the prostate gland. Sometimes pathologies can be cured by conservative methods, without resorting to radical surgical intervention. However, there are cases when the removal of the prostate gland is the only chance to get rid of a serious illness. Due to what pathologies do doctors prescribe this operation? What are the indications and contraindications for it? How is the removal process going? How to behave in the rehabilitation period? Let's try to answer these questions in our article.

Indications for removal of the prostate

Removal of the prostate gland is a serious surgical intervention, which is performed only when there is no other way to cure the patient. Therefore, it is prescribed only for serious pathologies, which cannot be eliminated in the traditional way for any reason. According to statistics, older men are most often operated on, who initially went to the doctor with complaints of problems with urination. As a rule, they are diagnosed with benign or malignant tumors.

Let's list the main indications for this procedure:

• chronic prostatitis, accompanied by frequent urination and sharp pains in the lower abdomen;
• prostatitis complicated by the presence of stones in the prostate gland;
• prostate adenoma is a benign tumor that usually does not threaten human life;
• frequent urination or urinary retention;
• persistent severe hematuria (presence of blood in the urine);
• false urge to urinate, not amenable to conservative treatment;
• prostate cancer - surgery is usually performed on patients with the first or second stage of this disease, when the tumor has not spread beyond the organ.

Contraindications for surgery

An operation is a serious blow to the body that not all patients can endure. Therefore, removal of the prostate gland can not be performed for all people. The neglect of the disease is the most common reason for refusing surgery. Also, the presence of serious chronic diseases or even the age of the patient can become the basis. The final decision is made by the attending physician or medical commission, based on the patient's medical history and the results of his tests.

The most common reasons for refusing to perform this operation are the following contraindications:

• inflammatory diseases of the genitourinary system in acute form;
• viral diseases and fever;
• severe chronic pathologies of the cardiovascular and respiratory systems;
• advanced malignant tumors, accompanied by numerous metastases throughout the body;
• thyroid or pancreas disorders, including diabetes mellitus, goiter, and hypothyroidism;
• old age - the operation is contraindicated for men over 70;
• diseases that cause bleeding disorders, including hemophilia;
• taking drugs that thin the blood - in this case, the operation is performed only after they are completely removed from the body.

Types of surgery

Depending on the severity of the disease, doctors use different methods of surgical intervention. Sometimes only 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 an incision is the main advantage of this method. The rehabilitation period is also significantly reduced.
• Transvesical adenomectomy is an open surgery in which the surgeon makes an incision between the navel and the pubis. It is used when removing an adenoma or a large malignant tumor.
• Laparoscopic resection - during the operation, the doctor makes several punctures on the anterior abdominal wall, where he inserts a device equipped with a camera. In this way, you can remove the entire prostate or only part of it.

Preparing for surgery

Before proceeding with the operation, it is necessary to conduct a thorough diagnosis of the body in order to prevent the occurrence of complications. The patient must pass a general and biochemical blood test. Blood tests are also carried out for the Wasserman reaction (detection of syphilis), HIV and viral hepatitis. The patient is also obliged to provide doctors with information about his blood type and Rh factor.It is necessary to pass a general urine test and make it a separate crop for sensitivity to antibiotics. To assess the state of the cardiovascular system, an ECG is performed. To exclude tuberculosis and other pathologies of the lungs, it is necessary to do a fluorography.

Removal of a prostate tumor begins with an ultrasound of the genitourinary organs to determine the presence of residual urine. Then the patient visits the therapist, urologist and anesthesiologist. In the evening before the operation, the patient is required to do an enema, as well as shave the pubic hair. From now on, he cannot eat or drink.

Removal of the prostate gland: consequences

The appearance of possible complications during surgical intervention depends on the neglect of the disease. So, the 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.

Let's list the main postoperative complications that patients most often face:

• 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 resulting in difficult deurination ;
• Retrograde ejaculation is the reflux of semen into the bladder cavity.

How is prostate surgery performed?

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

You can also remove it in an open way. The prostate gland 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 he removes the overgrown part of the prostate with his hands. The rehabilitation period after this type of operation lasts much longer.

Features of surgery for cancer removal

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

Initial rehabilitation period

After the operation, the patient is connected to a continuous bladder emptying system in order to timely remove the accumulated fluid and blood clots from there through the catheter. Through it, the organ is washed with a special solution, for example, furacilin. 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 food intake 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 a man's ability to have an erection. If the surgeon manages to avoid damage to them 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, potency returns to the man 4-5 weeks after the resection.

Life after prostate 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.An operation to remove prostate adenoma or cancer requires a long recovery under the supervision of doctors. At first, a man will be forbidden to supercool and engage in hard physical labor. Loads can be restored 1-2 months after resection. A week after discharge, the patient can return to work.

Summing up

Thus, removal of the prostate gland can be called a non-hazardous procedure. Its consequences entirely depend 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 carried out in the early stages. In this case, the survival of patients after removal of prostate cancer is 90-100%. Choose a trusted clinic and a surgeon who has a lot of positive reviews to reduce the likelihood of medical errors and possible complications.

Prostate cancer - types of operations, indications and rehabilitation period

When diagnosed with prostate cancer, surgery for a tumor that has not yet gone beyond its borders is indicated for carrying out at stages 1 and 2. But cases are not ruled out when an operation is prescribed to remove prostate cancer at stage 3 with large areas of damage. A surgical removal of a tumor of the prostate, in particular the male gland, is performed in men, along with the surrounding tissues and vesicles that make up the composition.

Types of surgery performed to remove the prostate

Treatment for prostate cancer - surgical or conservative. In the first case, medications and hormone therapy are prescribed. But it gives good results only in the early stages of cancer development.

In advanced cases, when metastases spread to other nearby systems and organs, one cannot do without surgical intervention to excise the affected organ and destroy cancer cells. Otherwise, rapid cell division will later spread to nearby organs.

In addition, after the operation, patients will be prescribed a course of chemo-radio-radiation therapy. Treatment, as a rule, for prostate cancer is complex. But the tactics are selected by the doctor, taking into account the age of the patient, the presence of other chronic recurrent diseases in the body.

In the future, additional conduction is possible:

• laparoscopy;
• ultrasonic method of influencing the tumor;
• lymphadenectomy for excision of metastases;
• radical prostatectomy to remove the prostate or part of an organ;
• Cryosurgery to destroy cancerous growths with cold by lowering temperatures.

The choice of one or another method of surgery is directly affected by the stage of cancer, the location of the pathological focus, the degree of damage, as well as the characteristics of the body and the presence of metastases.

If prostate cancer is diagnosed, then a doctor may prescribe:

• radical prostatectomy through small incisions in the lower abdomen;
• laparoscopy by removing the male gland;
• minimal invasive laparoscopic prostatectomy;
• radical prostatectomy.

• at retirement age;
• with low effectiveness of previous radiation therapy;
• in the presence of chronic ailments, when radical removal of the tumor is impossible;
• with the predominance of a prostate tumor at stage 1 or 2.

The procedure involves general anesthesia with a duration of up to 2 hours. The result is a survival rate of more than 5 years in patients. The method is safe, does not affect neighboring organs, is aimed at eliminating only the pathological focus.

Among the shortcomings, it is worth noting:

• the possibility of further urinary incontinence;
• fusion of the walls of the prostate;
• development of rectal dysfunction of the prostate

Indications for surgery

Surgical intervention in one way or another is prescribed for the diagnosis of cancer in the tissues of the prostate with the progression of the degree of the cancerous tumor and pronounced symptoms of cancer. It is important for doctors to evaluate all the risks and possible complications, harm done to the body during the removal of the prostate gland.

What degree of harm will be caused to the body in case of its resection. Perhaps an inflammatory process is taking place that is not amenable to treatment with medications or has appeared in the kidneys and the patient suffers from nighttime urinary incontinence or its discharge with a delay and in small portions. In this case, there are all signs of hematuria, the presence of blood in the urine. The operation is also assigned when:

• acute course of prostatitis along with complications;
• infection of the genitourinary system;
• kidney damage;
• obesity and overweight.

In what cases is prostate removal contraindicated

Resection of the gland is not performed if the patient has:

• diabetes;
• problems with the cardiovascular and respiratory system;
• at the stage of decompensation of other ailments in the urinary system;
• malignant neoplasms in the body;
• varicose veins of the testis;
• testicular varicocele;
• inflammatory processes in the hip joint;
• thyroid diseases;
• hypothyroidism;
• goiter.

In addition, surgical removal of the prostate gland is prohibited for people over 65 years of age, with hemophilia (blood disease), taking medications to thin the blood the day before. They should be stopped 10 days before the operation.

What is the preparation

When diagnosing prostate cancer, patients should undergo a series of preparatory procedures:

• taking a blood and urine test for biochemistry, coagulation;
• X-ray;
• ultrasound;
• biopsy.

Based on the results of the tests, the doctor will select the appropriate acceptable method for the operation. Testing must be carried out no later than a week before the appointment of the operation.

You also need to inform the doctor about the need to take medication the day before to thin the blood (in particular, aspirin), other predisposition to bleeding, and individual intolerance to some components.

It is possible to be redirected to an interview with an anesthesiologist, a surgeon to choose an acceptable tactic during the operation to remove the prostate and minimize possible complications.

The day before, it is recommended to eat food only in a liquid state. In the evening or in the morning, put a cleansing enema to empty the intestines. In the morning you can not eat and drink water. If necessary, take medicine, drink water only in small sips

What after the operation

In the post-rehabilitation period, the patient is shown bed rest, staying on a movable bed for the purpose of transportation, if necessary, to the place of intensive care.

First of all, the doctor monitors the restoration of general well-being, the patient's coming to consciousness, the normalization of the respiratory system, the rhythm of the heart, pressure and pulse. After recovering from anesthesia, wounds and sutures are treated with antiseptics until they are completely. healing. Vitamins are prescribed, sparing nutrition.

The main thing for men after prostate surgery is to restore an erection. If the nerves are not damaged, then this is quite possible. Restorative Kegel procedures are applicable to strengthen the pelvic muscles, improve the functionality of the reproductive system, and normalize urination. Frequent sexual intercourse, masturbation or oral medications, such as Viagra, Cialis, lead to the restoration of sexual activity.

The recovery period takes up to 1 year. As with any operation, complications are possible

Further, it is possible to reflux sperm into the bladder, as well as partial or complete retrograde ejaculation, i.e. exit of semen along with urine. This is not dangerous and does not pose a threat to the life of the patient, but with conception, of course, it is already difficult

Before carrying out the operation, it is important to carefully analyze the acceptable method for yourself and consult with your doctor. The prostate itself is small in size, but it can cause many problems for men.

Only timely preparation for the operation, in compliance with all the conditions and prescriptions of the doctor, as well as the recovery period, will help to overcome prostate cancer, establish a full sex life, and general well-being.

Informative video

Removal of a prostate tumor by surgical methods: consequences

According to statistics, prostate cancer is one of the most diagnosed diseases in men.

It can affect people of all ages, and the mortality rate from this disease is in third place.

About the disease

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

Some factors that increase the risk of developing a tumor can be identified:

Age. Over the years, the likelihood of developing a tumor increases. It is extremely rare for men in the age group under 40 to get sick, after 50 the possibility of the disease is growing every year. Heredity. The probability 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). Nutrition. Excessive consumption of animal fats promotes tumor formation.In overweight men, prostate cancer is detected more often. Smoking. Tobacco smoke contains cadmium, which contributes to the development of prostate cancer. Ultraviolet radiation. Contains in its composition vitamin D3, which inhibits the movement of cell growth. In the oncological structure of many countries, prostate cancer ranks 2-3, behind stomach and lung cancer.

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

Approximately 40% of men of this age have latent (hidden) prostate cancer, and only in 10% of cases the latent form begins to manifest itself as 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

It takes about 2-3 years for localized prostate cancer to double in size. At the same time, it is able to remain within the gland.

A common way to treat prostate cancer is radiation therapy (X-ray therapy) - a method of treating malignant tumors with the help of ionizing radiation. Cancer cells multiply much faster than ordinary cells, and radiation from radiation therapy disrupts cell division and DNA synthesis.

The advantage of X-ray therapy is the absence of a surgical operation 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 the substance in the cells of the prostate is only 10%. After surgery - 70%.

Other treatment options for prostate cancer:

Chemotherapy is the treatment of cancer with drugs to reduce the growth of cancer cells while also affecting healthy cells. This hormone therapy lowers testosterone levels and slows down the course of the disease. Immunotherapy is a technique based on the use of drugs that activate the immune system. Weak cancer cells are introduced into the body, and the immune system begins to destroy them, mistaking them for foreign cells. High Intensity Focused Ultrasound Ablation is a method in which tissues are heated with intense ultrasound and tumor cells are damaged. Side effects from this procedure are minimal. Often, in 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 is the most common operation to remove the prostate gland (for oncology). Its goal is to remove the tumor within healthy fields, and maintain control over urinary functions and sexual activity. Surgery for prostate cancer is performed on people whose cancer has not spread to neighboring organs.

Doctors, when 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, cancer cannot be cured and cannot be stopped. In the presence of bone metastases, the expected life expectancy is no more than 3 years.

The absolute indications for prostate removal are:

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

Removal of the prostate for cancer and consequences

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

Radical prostatectomy is an operation to remove prostate cancer, performed for localized disease. It is the main method of treatment with preservation of urinary function and erectile function.

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

Complex therapy is often used after prostatectomy, combining radiation and hormonal treatment.

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

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

Surgery for prostate cancer involves inserting a thin endoscopic instrument into the urethra called a resectoscope.

When exposed to it, the prostate gland is removed and the blood vessels are coagulated. The prostate removal operation is carried out under general anesthesia or spinal anesthesia, and only in the case 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 the urethral lavage fluid 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 kidney failure.

It is also used for complications of prostate adenoma in the form of bladder stones. Surgery for a prostate tumor is open and traumatic.

Open adenomectomy requires general anesthesia or regional anesthesia. During the operation of removing the prostate, an incision is made in the bladder, presenting the affected area of the prostate to the doctor's gaze. A catheter should be placed in the bladder to drain the fluid.

For young men, prostate adenomectomy is fraught with a violation of potency. Open adenomectomy is not used in cases of concomitant serious diseases 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, with a small prostate.

The procedure allows you to improve the outflow of urine and eliminate the manifestations of prostate adenoma.

Surgery 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 without excising the tissue.

Complications after TUIP are sexual disorders in the form of retrograde ejaculation. The operation is contraindicated for large prostates.

Complications

Removal of the prostate in men provides instant relief that lasts for years.

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

Rehabilitation

Despite the good health of the patient after the operation to remove the prostate, the body will take a long time to fully recover.

Rehabilitation after prostate cancer surgery:

In the first postoperative week, you need to be extremely careful, avoid sudden movements and leave physical exercises until better times; during the recovery period, you need to drink plenty of water to flush the bladder, about 8 glasses a day, this will speed up recovery; try to strain less during bowel movements; it is not allowed to lift weights 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 about taking laxatives); with normal healing of the incision, the sutures are removed from it on the 9-10th day, after which you can take a shower (the possibility of taking baths, visiting the pool after prostate cancer surgery should be discussed with your doctor). To prevent the recurrence of prostate cancer after radical prostatectomy, you should visit a urologist at least once a year and undergo a digital rectal examination.

After removing the prostate, you can forget about the disease for up to 15 years. In some cases, repeated surgery is required. If you follow the medical recommendations, undergo the necessary procedures and timely visits to the doctor, life expectancy can be increased.

A tumor of the prostate gland 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.