Day 171-Wednesday's Medical Minute-Radical Prostatectomy

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(Due to the nature of the subject matter, expect this to be a discussion of very sensitive matters)

As some of you are aware, my husband has been diagnosed with stage 1 prostate cancer. Monday morning, bright and early, he will undergo what is called a radical prostatectomy, which is the removal of the entire prostate gland and some of the surrounding tissue. This is the treatment for localized prostate cancer and was the most highly recommended option because of the many benefits it affords.

My husband is lucky to be having his surgery where they will be using a technique called robotic assisted radical prostatectomy, the preferred method for removing the cancer, yet sparing the nerves responsible for achieving erection. There is still a chance the doctor will not be able to spare the nerves, and there are likely to be issues involving sexual and urinary function, if only for a short period of time.

The surgery is done laparoscopically, through several small incisions in the belly with robotic arms that specially trained doctors operate. It is minimally invasive and offers many benefits including reduced scarring, trauma and pain, the possibility of infection is reduced, recovery is quicker and it only requires an overnight stay in the hospital. The robot is called the daVinci surgical Si HD System, the most advanced robotic treatment method for prostate cancer today.

Image showing the location of the prostate
Image showing the location of the prostate

Here are a few things you may or may not know about prostate cancer in general:

The prostate is a walnut sized gland that sits at the base of the bladder and is responsible for transporting the seminal fluid up through the penis. It is divided into lobes or “zones” and 70-80% of prostate cancer originate in the peripheral zone-which is the sub-capsular portion of the posterior aspect of the prostate gland that surrounds the urethra. The prostate is sheathed in the muscles of the pelvic floor, which contract during ejaculation. If the cancer is determined to be low risk and localized, radical prostatectomy is the preferred treatment option-resulting in a zero PSA count and requiring no further treatment such as chemo or radiation.

Once the surgery is done, depending on things like the age of the patient and fitness level,  recovery time and sexual and urinary function may or may not return to normal. The patient may experience some level of urinary incontinence for a few weeks following surgery and need to use pads or diapers in case of leakage. The patient may also experience some level of erectile dysfunction, although having nerve sparing surgery reduces this risk. After recovery, the patient should be able to achieve an erection, but will no longer ejaculate seminal fluid. For this reason, younger men may want to consider other options, such as chemo or radiation.

Discovering the cancer is done through a blood test called a PSA-prostate specific antigen and graded by the results of the biopsy. It is important for men to start having PSA testing in my opinion, way before the age of 50, the recommended age right now. Younger men are getting cancer these days and one should speak to their doctor if they are experiencing any symptoms or have a genetic concern. In my husband’s case, he had both. Studies have found that men who have the surgery for localized prostate cancer are less likely to die than men who have radiation therapy.

During recovery the patient will have to be catheterized, this should only be required for a week or two following surgery.  In some cases, like my husband’s, he will have a suprapubic catheter as well as a urethral catheter as well as special dressings covering the surgical incisions. He should go home with only one catheter after his brief hospital stay. The hard part will be keeping him down for the recovery period- one to two weeks. The first week he will not be allowed to drive, and for up to three weeks, he cannot exercise, run or play golf, and can return to work on light duty after three weeks. We may both be nuts by the end of the recovery period, lol. Most men have trouble with urinary control for up to 6 months following surgery, however, everyone is different and some gain normal control after one week. Again, this depends on general fitness levels and age, in addition, the doctor will provide you with exercises to strengthen the muscles needed to regain control.

Medications and other methods may be needed for up to six months following surgery to achieve sexual function.

Typically, you will follow up with the doctor one week after surgery, then 3 months later for the first PSA check. For the first year, your PSA will be checked every 3 months. It should remain at zero following surgery. If it is any higher than that, further treatment may be necessary.

I hope I have shed some light on what can be a scary subject for most men, if you have any questions, let me know in the comments and I’ll answer them to the best of my ability. In the meantime, keep the prayers coming if you don’t mind, we need all we can get! Thank you in advance and I’ll see you all tomorrow for Throwback Thursday. Keep smiling and have a great day! 🙂




7 Replies to “Day 171-Wednesday's Medical Minute-Radical Prostatectomy”

  1. You did an excellent job of explaining the procedures involved. My hubby, his three brothers and his father all had this surgery. men should get checked out each year for this cancer. It is completely curable if found early. A simple blood draw for the PSA and a followup exam if the PSA is off. easy peasy yet so many men put it off.

    1. True, I’m so glad my husband and his doctor were so persistent! The benefits outweigh the negatives and hopefully more men will follow the advice, it could possible save their life!

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