What is Open Prostate Cancer Surgery?
Prostate cancer is the second most common type of cancer diagnosed in men and accounts for 15% of all cancers. Today, thanks to the increase in screening for prostate cancer and technological developments, it has become more possible to diagnose at an early stage.
After the diagnosis of prostate cancer, bone scintigraphy, MR and PET-CT can be performed to see local and systemic spread. Depending on the patient's performance score, general condition and risk group, it is decided which treatment to be given together with the patient.
How is Open Prostate Cancer Surgery Performed?
Prostate cancer surgery is the gold standard treatment of prostate cancer and is taken by connecting the entire prostate gland, along with the seminal sacs and semen ducts. In an open operation, the prostate gland and its appendages are removed with an 8 cm incision made under the umbilicus. Considering the degree of disease and local spread in the preoperative and intraoperative evaluation, the prostate can be removed by unilateral or bilateral nerve-sparing method in suitable patients. If it is appropriate to remove lymph node stations in the preoperative evaluation, bilateral pelvic lymph node removal and sending for pathological examination is performed.
After the removal of the prostate and its appendages, the reconstruction part of the surgery begins. In this part, the continuity of the urinary canal is ensured by suturing the mouth of the urine bag and the urethra (urinary canal) to the mouth-to-mouth. A urinary catheter is inserted to be left in the patient for 7-10 days after the surgery. Our patients, who are usually followed up in the service for 3-4 days, are invited to the polyclinic for catheterization.
How to Follow Prostate Cancer Surgery?
After the surgical treatment of prostate cancer, it is aimed to achieve well-being in conditions that affect the patient's survival and social life. The first of these is oncological survival, and according to the pathological result after surgery, additional treatment is given if necessary, and controls are made every 3 months. The second goal is for the patient to hold their urine. Although the first few months experience mild difficulties in this regard, our patients recover quickly with the necessary exercise and drug treatments. Our third goal is to ensure adequate erection for sexual intercourse, although the expectation rate varies from patient to patient.
Our team, who is experienced in the operation technique, nerve protection, and protection of the sphincter (voluntary urine retention clamp) in the continuation of urinary retention and erection, can also be used for second treatments (medication, exercises, sling surgery, injection treatments, prosthesis) operations) is experienced and competent.
If the treatment of prostate cancer detected at an early stage is suitable for the operation in the light of parameters such as additional diseases, age, and performance score, surgical treatment is performed. Treatment with medication is carried out only if the disease has spread to the bones and other organs.
It should be done in the way that the surgical team is experienced in the technique.
In terms of results, open surgery, laparoscopic and robotic surgery were not superior to each other. It is known that open surgery has slightly longer hospital stays than other techniques.
RT (radiation therapy) and HT (hormone therapy) can be performed according to the pathology result and the PSA test to be performed at the 6th week.
Yeah. You can have a child by freezing sperm before the operation with assisted reproductive techniques, or by taking sperm from the testis in the post-operative period, as natural ways are obtained by operation.
In our clinic, penile rehabilitation treatment (such as medication, injection, shock wave therapy) is applied to every possible patient. Penile prosthesis (happiness stick) procedure is performed for our patients who do not benefit from these methods.
We perform follow-up PSA tests with our patients, usually every 3 months after surgery.
You can usually start light activities within 1-2 weeks. After the first month after the operation, you will start normal activities and exercises.