What is radical prostatectomy: preparation, operation, levels of PSA before and after the intervention
Indications for prostatectomy and its types
Consider some of the cases when assigned to the removal of the prostate gland. Key among these are:
- The complex shape of the adenoma, are not amenable to traditional treatment. That happens quite rarely.
- Prostate cancer in stage I and II, if the disease has not gone beyond the body, and does not have metastases in the lymph nodes.
- Prostate cancer in stage III, when it is necessary to eliminate the obstruction, that is to stop the flow of urine.
As prostatectomy is performed under General anesthesia, it determines the range of contraindications. So, do not perform surgery in patients over 70 years of inflammation, regardless of etiology, as well as diseases of the cardiovascular system. A contraindication is considered to be taking certain medications (Aspirin, Heparin, Fragmin) or presence of abnormalities in hemostasis.
The main goal, which is prescribed removal of the prostate gland, is a complete cure from cancer. Sometimes it is required to remove not only the body, but the part located nearby tissues.
The course and operative technique
Radical prostatectomy can be different depending on the type of surgery.
Most often done with open surgery. In this case, in the lower part of the belly make a cut to 10-12 cm, through which remove the prostate. Then the surgeon makes pasadenabuy approach, i.e. inserting a urethra into the bladder. In some cases, removing lymph nodes, further testing them for cancer.
Recovery after an open prostatectomy potadromous may take a few days. At this time, the catheter is placed into the bladder. Leave it for up to 3 weeks, until the urine is completely restored.
Radical perineal prostatectomy is now indicated rarely. The surgeon performs an incision of the perineum with a length of 4 cm and using it removes the prostate. This type of surgery does not allow you to save the nerve bundles. In addition to the removal of lymph nodes required for research on cancer, will have to make another cut. If they are not damaged, then remove the lymph nodes is not necessary.
After an operation this way, it is necessarythe recovery, but it will take less time than recovery from potadromous prostatectomy.
In General, open surgery is performed rarely, as invented by minimally invasive methods of removal of the prostate.
Laparoscopic prostatectomy involves the performance of small incisions in the abdomen. In one of them insert a laparoscope that allows you to monitor the progress of the operation. With the help of special instruments through the other hole of the removed prostate and lymph nodes.
Laparoscopic radical prostatectomy currently may be performed not only manually, but also using the Da Vinci robot is a device that holds the most minimally invasive surgeries. The doctor uses manipulators equipped with special medical instruments. PSA levels after radical prostatectomy checked regularly, every three months. With the growth of the number of antigens is diagnosed with biochemical recurrence of cancer.