Usually, men with early-stage disease or cancer are confined to the prostate will undergo surgical removal of the entire prostate gland, plus some surrounding tissue, and then the doctor will reconnect the bladder channel to the urethra.
Advanced surgical procedures may be performed in men with recurrent prostate cancer, such as lymph node removal, which is where the initial landing of prostate cancer metastasis.
Why should the entire prostate be removed?
Because cancer has invaded the seminal vesicles, the nearest part of the vas deferens, along with nearby tissues, and some nearest pelvic lymph nodes.
In addition, the cancer has spread throughout the prostate gland, the prostate should be removed. This is done to ensure that cancer cells do not lag and grow.
Lymph nodes in the pelvis are round or oval round small round the blood vessels. They filter the fluid from the lymph nodes.
Prostate cancer usually spreads first into the soft tissues around the prostate. Then, spread to the seminal vesicles, lymph nodes, bones and other organs. There are many other lymph nodes. So that the body will not be harmed by removing some lymph nodes.
During the procedure of prostatectomy surgery, did not escape the surgery of nerve-sparing prostatectomy. What is a nerve-sparing prostatectomy? In a nerve-sparing prostatectomy, the surgeon cuts to the very edge of the prostate, a functional nerve that runs alongside the prostate.
A neurosurgical-sparing procedure may be performed; It depends on whether the cancer attacks the nerve or not. However, neurosurgical-sparing procedures offer the best opportunity to preserve long-term ssual function.
Treatment of prostate cancer by radical prostatectomy surgery
There are four types of radical prostatectomy surgery, namely:
1. Retropubic radical prostatectomy
This is the most common type of prostate surgery. Your surgeon will make a cut (slice) in the lower abdomen and remove the prostate through this slice.
2. Perineum radical prostatectomy
The removal of the prostate by cutting between the anus and the scrotum.
3. Laparoscopic Radical Prostatectomy
The surgeon will make six incisions about 1 inch in your stomach to remove the prostate gland. This operation has been replaced by the interface of a laparoscopic surgical robot as a tool.
4. Robotic Assisted Laparoscopic Radical Prostatectomy (RALP)
The entire prostate is removed using the help of the robot system. RALP surgery is one of the most common types of prostate surgery today.
However, the success of this operation depends on how experienced your surgeon is. In the hands of experienced clinicians, there is no major difference in outcomes between RALP and retropubic prostatectomy.
Post Surgical Treatment
After the prostate is removed, the urinary tract and bladder are reconstructed again. Then the catheter is inserted through the urethra into the bladder. A new channel between the bladder and the urethra to drain urine (anastomosis).
Most people do not fart for one to two days, and they do not defecate until the third day after surgery. This depends on the amount of anti-pain medication given.
After the surgeon has the latest pathology report, he will make a plan, including regular doctor visit plan and PSA test every 6-12 months. The postoperative PSA level should be undetectable (less than 0.1 ng / mL).
If a pathology report shows cancer in surgical margins or cancer spread to adjacent tissues, seminal vesicles, or lymph nodes, further treatment may be necessary. Therapy can be done with radiation therapy or hormone therapy, or both. It will start 2 to 4 months after surgery.
Reference : http://www.cancer.net/cancer-types/prostate-cancer/treatment-options
