Our Summary

This research paper delves into the history and technical progression of retropubic prostatectomy, a surgical procedure used to treat prostate cancer. The first prostatectomy might have been performed in the early 1800s. The retropubic approach, where surgery is performed through the lower abdomen, was introduced by Millin in 1945. Memmelaar (1949) then structured a backward surgical approach known as retrograde prostatectomy, followed by Campbell who developed the forward surgical approach, antegrade prostatectomy, in 1959. Thanks to anatomical studies, Walsh was able to design a retrograde prostatectomy in 1983 that preserved sexual function. After around 80 years of developments, the Walsh technique is now considered the standard for retropubic prostatectomies.

FAQs

  1. What is retropubic prostatectomy and when was it first introduced?
  2. Who developed the forward surgical approach, antegrade prostatectomy, and when was it developed?
  3. What is the Walsh technique and why is it considered the standard for retropubic prostatectomies?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostatectomy is to talk to their doctor about potential side effects and complications, as well as any concerns they may have about sexual function following the procedure. It is also important for patients to follow their doctor’s post-operative instructions carefully to ensure proper healing and recovery. Additionally, discussing options for post-operative care and support, such as physical therapy or counseling, can be beneficial for overall well-being.

Suitable For

Patients who are typically recommended for a prostatectomy are those who have been diagnosed with prostate cancer that is confined to the prostate gland and has not spread to other parts of the body. Additionally, patients who have a life expectancy of at least 10 years and are in good overall health may also be considered for this surgical procedure. It is important for patients to discuss all treatment options with their healthcare provider to determine the best course of action for their individual case.

Timeline

Before a prostatectomy, a patient will typically undergo a series of tests and consultations with their healthcare team to determine the best course of treatment. This may include a digital rectal exam, prostate-specific antigen (PSA) test, biopsy, imaging tests, and discussions about the potential risks and benefits of surgery.

On the day of the surgery, the patient will be admitted to the hospital and prepared for the procedure, which may involve fasting, IV fluids, and anesthesia. The surgery itself can take several hours, during which the surgeon will remove the prostate gland and, in some cases, surrounding tissues if the cancer has spread.

After the prostatectomy, the patient will spend time recovering in the hospital, typically for a few days to a week. They may experience pain, discomfort, and side effects such as urinary incontinence and erectile dysfunction. Physical therapy and follow-up appointments will be scheduled to help the patient regain strength, manage any complications, and monitor for signs of cancer recurrence.

In the months and years following the prostatectomy, the patient will continue to have regular check-ups and screenings to monitor their health and ensure that the cancer has not returned. They may also undergo additional treatments, such as radiation therapy or hormone therapy, if necessary. The goal of the prostatectomy is to remove the cancerous cells and improve the patient’s quality of life, but it is important for them to stay vigilant and proactive in their ongoing care.

What to Ask Your Doctor

  1. What is the success rate of the retropubic prostatectomy procedure in treating prostate cancer?
  2. What are the potential risks and complications associated with retropubic prostatectomy?
  3. How long is the recovery period after undergoing retropubic prostatectomy?
  4. Will retropubic prostatectomy affect my sexual function or urinary continence?
  5. Are there any alternative treatment options to consider before undergoing retropubic prostatectomy?
  6. How experienced is the surgical team in performing retropubic prostatectomy procedures?
  7. What is the likelihood of needing further treatment or follow-up care after retropubic prostatectomy?
  8. Are there any lifestyle changes or precautions I should take before or after the surgery?
  9. What is the long-term outlook for patients who undergo retropubic prostatectomy?
  10. Are there any clinical trials or research studies related to retropubic prostatectomy that I should be aware of?

Reference

Authors: Herranz-Amo F. Journal: Actas Urol Esp (Engl Ed). 2020 Jul-Aug;44(6):408-416. doi: 10.1016/j.acuro.2020.03.003. Epub 2020 May 29. PMID: 32475688