Panama Medical Vacations
Finding Your Health with a Radical Prostatectomy in Panama
Problems related to prostate health are growing concerns especially older men. In cases where cancer has invaded the prostate, a radical prostatectomy is an operation to remove the prostate gland and some of the tissue around it. This operation may be done by open or laparoscopic surgery.
The Procedure
A radical prostatectomy can be performed either as an open procedure or a laparoscopic surgery. The procedures differ and are based on the needs of the patient and the recommendation of the surgeon.
Open surgery
In open surgery, the surgeon makes a large incision to reach the prostate gland. Depending on the case, the incision is made either in the lower belly or in the groin between the anus and the penis. When the incision is made in the lower belly, it is called the retropubic approach. A radical prostatectomy using the retropubic approach is the most common treatment for prostate cancer. In this procedure, the surgeon may also remove lymph nodes in the area so that they can be tested for cancer.
When the incision is made in the groin, it is called the perineal approach. The recovery time after this surgery may be shorter than with the retropubic approach. If the surgeon wants to remove lymph nodes for testing, he or she must make a separate incision. If the lymph nodes are believed to be free of cancer due to the results of various tests, the surgeon may decide against removing any lymph glands.
Laparoscopic surgery
In laparoscopic surgery, the surgeon makes several small incisions in the belly. A lighted viewing instrument called a laparoscope is inserted into one of the incisions. The surgeon uses special instruments to reach and remove the prostate through the other incisions.
Men who have laparoscopic surgery tend to lose less blood during the operation and to recover faster than men who have open surgery. Laparoscopic prostatectomy is not yet widely available, and because it is a relatively new technique, no results from long-term follow-up after treatment are available.
The main goal of either type of surgery is to remove all the cancer. Sometimes that means removing the prostate as well as the tissues around it, including a set of nerves to the penis that affect the man's ability to have an erection. Some tumors can be removed using a nerve-sparing technique, which means carefully cutting around those nerves to leave them intact. Nerve-sparing surgery sometimes preserves the man's ability to have an erection.
After your surgery
Radical Prostatectomy usually requires general anesthesia and a hospital stay of 2 to 4 days. A thin flexible tube called a catheter usually is left in your bladder to drain your urine for 1 to 3 weeks. Your doctor will give you instructions about how to care for your catheter at home. Bladder control can be poor for a few months after the catheter is removed.
While radical prostatectomy often removes all cancer cells, it is important to receive follow-up care, which may lead to early identification and treatment if your cancer comes back. Once you return home, your regular follow-up program with your family doctor may include:
- Physical exams.
- Prostate-specific antigen (PSA) tests, to monitor PSA levels and to measure the speed of any changes in those levels.
- Digital rectal exams.
- Biopsies as needed, to examine suspicious tissue.
Risks
The risks associated with a radical prostatectomy include:
- Erection problems – This risk varies according to previous problems with erectile dysfunction and age. Approximately 50% of men over 65 experience problems after surgery, while only 25% of men under 60 have problems.
- Urinary incontinence – Nearly 50% of the men who have a radical prostatectomy experience urinary incontinence. In some cases this problem is no more than occasional dribbling and others require use of incontinence pads. Problems that last more than one year require treatment.
- Damage to the urethra.
- Damage to the rectum