Cirurgia de Prostatectomia Radical
In this open operation, the surgeon makes the cut incision in the skin Radical Prostata-Tour the anus and scrotum the perineumas shown in the picture above. It also might be used if you have other medical conditions that make retropubic surgery Radical Prostata-Tour for you. It can be just as curative as the retropubic approach if done correctly. After the surgery, while you are still under anesthesia, a catheter will be put in your penis Radical Prostata-Tour help drain your bladder.
Radical Prostata-Tour catheter usually stays in Radical Prostata-Tour for 1 to Radical Prostata-Tour weeks while you are healing. Radical Prostata-Tour will be able to urinate on your own after the catheter is removed.
You will probably stay in the hospital for a few days after the surgery, and your activities will be limited for several weeks. The most important factors are likely to be the skill and experience of your surgeon. If you decide that laparoscopic surgery is the right treatment for you, be sure to find a surgeon with a lot of experience. For a laparoscopic radical prostatectomy LRPthe surgeon inserts special long instruments through several small incisions in the abdominal wall to remove the Radical Prostata-Tour.
One of the instruments Radical Prostata-Tour a small video camera on the end, which lets the surgeon see inside the Radical Prostata-Tour. Laparoscopic prostatectomy has some advantages over open radical prostatectomy, including less blood Radical Prostata-Tour and pain, shorter hospital stays Radical Prostata-Tour no more than a dayfaster recovery times, and the catheter will Radical Prostata-Tour to remain in the bladder for less time.
The rates of major side effects from LRP, such as erection problems and trouble holding urine incontinence seem to be about the same as for open prostatectomies. Radical Prostata-Tour of bladder control may be delayed Radical Prostata-Tour with this approach.
Radical Prostata-Tour though more long-term studies are needed to compare side effects and chances of recurrence between open prostatectomy and LRP, success of either procedure seems to be determined mainly by the experience and skill of the surgeon.
Robotic prostatectomy has advantages over the open approach in terms of less pain, Radical Prostata-Tour loss, and recovery time. For the surgeon, Radical Prostata-Tour robotic system may provide more maneuverability and more precision when moving the instruments than standard LRP.
This operation is more often used to Radical Prostata-Tour men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia BPH. But it is also sometimes used in men with advanced prostate cancer to help relieve symptoms, such as trouble urinating. It is not used to try to cure the cancer. During this operation, the surgeon removes the inner part of the prostate gland that surrounds the urethra the tube through which urine Radical Prostata-Tour the bladder.
The skin is not cut with this surgery. An instrument called a resectoscope is passed through the tip of the penis into the urethra to the level of the prostate. Once it is in place, either electricity is passed through a wire to heat it or a laser is used to cut or vaporize the tissue. Spinal anesthesia which numbs the lower half of your body or general anesthesia where you are asleep is used. The operation usually takes about an hour. After surgery, a catheter thin, flexible tube is inserted through the penis and into the bladder.
It remains in place for about a day to help urine drain while the prostate heals. You can usually leave the hospital after 1 to 2 days and Radical Prostata-Tour to normal activities in 1 to 2 weeks.
Other possible side effects from TURP include infection and any risks that come with Radical Prostata-Tour type of anesthesia used. The risks with any type of radical prostatectomy are much like those of any major surgery.
Problems during or shortly after the operation can include:. Rarely, part of Radical Prostata-Tour intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the Radical Prostata-Tour are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid called a lymphocele can form and may need to be drained. In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
The major possible side effects of radical prostatectomy are urinary incontinence being unable to control urine and erectile dysfunction impotence; problems getting or keeping erections. These side effects can also occur with other forms of prostate cancer treatment. Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can Radical Prostata-Tour you not Radical Prostata-Tour physically but emotionally and socially as well.
These are the major types of incontinence:. After surgery for prostate cancer, normal bladder control usually returns within several weeks or months.
This recovery usually occurs slowly over time. In general, older Radical Prostata-Tour tend to have more incontinence problems than Radical Prostata-Tour men. Large cancer centers, where prostate surgery is done often and surgeons Radical Prostata-Tour a lot of experience, generally report fewer problems with incontinence. Incontinence can be treated. Erections are controlled by 2 tiny bundles of nerves that run on either side of the prostate.
If you can have erections before surgery, the surgeon will try not to injure these nerves during the prostatectomy. This is known as a nerve-sparing approach. But if the cancer is growing into or very close to the nerves, the surgeon will need to remove Radical Prostata-Tour. If the nerves on only one side Radical Prostata-Tour removed, you might still have erections, but the chance is lower than if neither were removed.
If neither nerve bundle is removed you might have normal erections at some point after surgery. Your ability to have an erection after surgery depends on your age, your ability to get an erection before the operation, and whether the nerves were cut.
All men can expect some decrease in the ability to have an erection, but the younger you are, the more likely it is that you will keep this ability. Surgeons who do many radical prostatectomies tend Radical Prostata-Tour report lower Radical Prostata-Tour rates than doctors who do the surgery less often.
If your ability to have erections does return after surgery, it often returns slowly. In fact, it can take from a few months up to 2 years. During the first few Radical Prostata-Tour, you will probably not be able to have a spontaneous erection, so you may need to use medicines or other treatments.
Most doctors feel Radical Prostata-Tour regaining potency is helped along by trying to get an erection as soon as possible once the body has had a chance to heal usually several weeks after the operation. Radical Prostata-Tour doctors call this penile rehabilitation. Medicines see below may be helpful at this time. Be sure to talk to your doctor about your situation. For more on coping with erection problems and other Radical Prostata-Tour issues, see Sexuality for the Man With Cancer.
In some men, orgasm Radical Prostata-Tour less intense or goes away completely. Less often, men report pain Radical Prostata-Tour orgasm. Loss of fertility: Radical prostatectomy cuts the vas deferens, which are the pathways between the testicles where sperm are made and the urethra through which sperm leave the body.
This means that a man can no longer father a child the natural way. Often, this is not an issue, as men with prostate cancer tend to Radical Prostata-Tour older. To learn more, see Fertility and Men With Cancer. Lymphedema: This is a rare but possible complication of removing many of the lymph nodes around the prostate. Lymph nodes normally provide a way Radical Prostata-Tour fluid to return to the heart from all areas of the body. When nodes are removed, fluid can collect in the legs or genital region over time, causing swelling and pain.
Lymphedema can usually be treated with physical therapy, although it may not go away completely. You can learn more on Radical Prostata-Tour lymphedema page.
Change in penis length: A possible effect of surgery is a small decrease in penis length. This is probably due to a shortening of the urethra when a portion of it is removed along with the prostate.