Our Summary

This research paper is about radical prostatectomy, which is a surgery to remove the prostate gland in order to treat prostate cancer. The success of this operation is typically determined by three factors: whether all the cancer was removed, whether the patient can control their bladder, and whether the patient can still have sex. The prostate gland has a complex structure and is closely related to many nerves, muscles, and tissues, making this surgery difficult and skill-demanding. This paper suggests several strategies that can be used during the surgery to improve the chances of successfully removing the cancer and preserving the patient’s bladder control and sexual function.

FAQs

  1. What are the key factors considered in judging the results after a radical prostatectomy?
  2. Why is radical prostatectomy considered a challenging and technically demanding surgery?
  3. What are some intraoperative strategies proposed to optimize oncological and functional outcomes after radical prostatectomy?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostatectomy is to engage in penile rehabilitation exercises post-surgery to improve erectile function and overall sexual health. This can include pelvic floor exercises, using vacuum erection devices, and possibly medication or injections as recommended by your healthcare provider. It’s important to discuss these options with your doctor to create a personalized plan for recovery.

Suitable For

Patients who are typically recommended for prostatectomy are those with localized prostate cancer who have a life expectancy of at least 10 years and are in good overall health. Additionally, patients who have not responded to other treatments such as radiation therapy or hormone therapy may also be candidates for prostatectomy. It is important for patients to discuss their individual case with their healthcare provider to determine the best treatment option for them.

Timeline

Before prostatectomy:

  1. Patient is diagnosed with prostate cancer through a biopsy and imaging tests.
  2. Patient meets with a urologist to discuss treatment options, including radical prostatectomy.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are a candidate for surgery.
  4. Patient may undergo counseling and education on what to expect before, during, and after the surgery.
  5. Patient may need to make lifestyle changes, such as quitting smoking or losing weight, to optimize surgical outcomes.

After prostatectomy:

  1. Patient undergoes the surgery, which involves removal of the prostate gland and surrounding tissues.
  2. Patient is monitored closely in the hospital for complications and recovery.
  3. Patient may experience side effects such as urinary incontinence and erectile dysfunction immediately after surgery.
  4. Patient may need to participate in physical therapy or pelvic floor exercises to regain urinary control.
  5. Patient may undergo penile rehabilitation to improve erectile function.
  6. Patient undergoes regular follow-up appointments and monitoring to check for cancer recurrence and assess functional outcomes.
  7. Patient may need ongoing support and counseling to cope with the physical and emotional effects of the surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with prostatectomy surgery?
  2. What is the expected recovery time and follow-up care after the surgery?
  3. Will I need any additional treatments, such as radiation or hormone therapy, after the surgery?
  4. How likely is it that the cancer will be completely removed with this surgery?
  5. What are the potential long-term side effects of the surgery, such as urinary incontinence or erectile dysfunction?
  6. Are there any specific lifestyle changes or medications I should consider before or after the surgery?
  7. What is the success rate of this type of surgery for patients with similar characteristics to mine?
  8. Will I need to undergo any additional tests or screenings before the surgery?
  9. How experienced is the surgical team in performing prostatectomy procedures?
  10. Are there any alternative treatment options that I should consider before proceeding with surgery?

Reference

Authors: Pedraza AM, Pandav K, Menon M, Khera M, Wagaskar V, Dovey Z, Mohamed N, Parekh S, Tewari AK. Journal: Urol Oncol. 2022 Mar;40(3):79-86. doi: 10.1016/j.urolonc.2021.12.003. Epub 2022 Jan 7. PMID: 35012823