what to expect post robotic surgical removal of prostate

Overview

Prostatectomy is surgery to remove function or all of the prostate gland. The prostate gland is situated in the male pelvis, beneath the urinary float. Information technology surrounds the urethra, which carries urine from the bladder to the penis.

The process is used to treat a number of conditions affecting the prostate. It's most usually used equally a treatment for prostate cancer.

Prostatectomy tin be performed in several means, depending on the condition involved. Options include minimally invasive surgery performed with robotic assist and traditional open surgery.

Mayo Clinic urologists utilise advanced endoscopic techniques to address enlarged prostate symptoms without the need for open, laparoscopic, or robotic surgery in almost cases.

Why it'southward done

Virtually often, prostatectomy is done to treat localized prostate cancer. Information technology may exist used lonely, or in conjunction with radiation, chemotherapy and hormone therapy.

Radical prostatectomy is surgery to remove the unabridged prostate gland and surrounding lymph nodes to care for men with localized prostate cancer. A surgeon tin can perform a radical prostatectomy using different techniques, including:

Robot-assisted radical prostatectomy. The surgeon makes five to six small-scale incisions in your lower abdomen to remove the prostate. He or she sits at a console, using instruments attached to a reckoner-assisted mechanical device (robot). The robotic device allows a more than precise response to motion of the surgeon'south hands.
Open radical prostatectomy. The surgeon typically makes an incision in your lower abdomen to remove the prostate.

Less often, unproblematic prostatectomy may be recommended for men with severe urinary symptoms and very enlarged prostate glands. Enlarged prostate glands are known as benign prostatic hyperplasia, or BPH.

Simple prostatectomy is usually performed equally a minimally invasive procedure with robotic assistance. Information technology's not oft done equally an open procedure anymore.

Simple prostatectomy to treat BPH doesn't e'er involve removing the entire prostate, equally in a radical prostatectomy. Instead, this procedure removes just the part of the prostate that'due south blocking the flow of urine. The surgery eases urinary symptoms and complications resulting from blocked urine period, including:

A frequent, urgent need to urinate
Difficulty starting urination
Slow (prolonged) urination
Increased urination frequency at night
Stopping and starting over again while urinating
The feeling that you tin can't completely empty your float
Urinary tract infections
Disability to urinate

Mayo Clinic urologists use advanced endoscopic techniques to address these symptoms without incisions in virtually cases.

Your surgical team will discuss the advantages and disadvantages of each technique, as well as your preferences, to make up one's mind which approach is best for yous.

A doctor consulting with a patient. Explaining prostatectomy options

A Mayo Dispensary urologist explains prostatectomy options.

Risks

Radical prostatectomy risks

In addition to the risks associated with any surgery, risks with radical prostatectomy include:

Bleeding
Urinary tract infection
Urinary incontinence
Erectile dysfunction (impotence)
Narrowing of the urethra or float neck
Germination of cysts containing lymph (lymphocele)

At Mayo Clinic, the urologists who perform prostatectomy procedures have advanced preparation and extensive experience in all aspects of the surgery. Much of this expertise stems from the high numbers of patients treated: More robotic surgery is performed at Mayo Clinic than anywhere else in the world. Additionally, Mayo's multidisciplinary approach ensures the everyman complexity rates and delivers the best outcomes possible for people who accept this surgery.

Simple prostatectomy risks

Although unproblematic prostatectomy works well at relieving urinary symptoms, it has a higher gamble of complications and a longer recovery time than other enlarged prostate procedures such every bit transurethral resection of the prostate (TURP), laser PVP surgery or holmium laser prostate surgery (HoLEP).

Risks of open uncomplicated prostatectomy include:

Bleeding
Urinary tract infection
Urinary incontinence
Dry out orgasm
Erectile dysfunction (impotence)
Narrowing (stricture) of the urethra or bladder cervix

How you prepare

Earlier surgery, your doctor may want to do a test that uses a visual scope to look inside your urethra and bladder (cystoscopy). Cystoscopy lets your doctor cheque the size of your prostate and examine your urinary system. Your doc may also want to perform other tests, such every bit blood tests or tests to specifically measure your prostate and to measure urine flow.

Follow your doctor'south instructions on what to exercise earlier your treatment. Here are some bug to discuss with your doctor:

Nutrient and medications

Your medications. Tell your doc about any prescription or over-the-counter medications or supplements you take. This is especially important if you have blood-thinning medications, such as warfarin (Coumadin) or clopidogrel (Plavix), and nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others). Your surgeon may enquire you to stop taking medications that increase your take a chance of bleeding several days before the surgery.
Medication allergies or reactions. Talk to your care team near any allergies or reactions y'all have had to medications.
Fasting earlier surgery. Your doctor will likely enquire that you non consume or drinkable annihilation later on midnight. On the morning of your process, take simply the medications your doctor tells you to with a small sip of water.
Bowel prep before surgery. You may exist given a kit and instructions for giving yourself an enema to clear your bowels before surgery.

Clothing and personal items

Plan alee to avert wearing these items into surgery:

Jewelry
Eyeglasses
Contact lenses
Dentures

Arrangements after surgery

Ask your doctor how long you'll be in the hospital. You'll desire to arrange in advance for a ride home, because y'all won't be able to drive immediately following surgery.

Activity restrictions

You may not be able to work or practice strenuous activities for several weeks after surgery. Inquire your medico how much recovery time you may need.

What you can expect

Before the process

Prostatectomy is unremarkably washed using general anesthesia, which ways you're not awake during the procedure. Your doctor may also give you an antibody right before surgery to aid preclude infection.

During the procedure

Robot-assisted radical prostatectomy. Your surgeon sits at a remote-control console a short altitude from y'all and the operating table and precisely controls the motion of the surgical instruments using two manus-and-finger control devices. The panel displays a magnified, 3D view of the surgical area that enables the surgeon to visualize the procedure in much greater detail than in traditional laparoscopic surgery.

The robotic organization allows smaller and more-precise incisions, which for some men promotes faster recovery than traditional open surgery does. But as with open retropubic surgery, the robotic arroyo enables nerve-sparing techniques that may preserve both sexual potency and continence in the appropriately selected person.
Open up radical prostatectomy. Your surgeon makes an incision in your lower abdomen, from below your bellybutton to just above your pubic bone. After carefully dissecting the prostate gland from surrounding nerves and blood vessels, the surgeon removes the prostate along with nearby tissue. The incision is then closed with sutures.
Unproblematic prostatectomy. At the kickoff of the procedure, your doctor may insert a long, flexible viewing telescopic (cystoscope) through the tip of your penis to see within the urethra, bladder and prostate area. Your medico will and then insert a tube (Foley catheter) into the tip of your penis that extends into your bladder to drain urine during the process. The location of incisions will depend on what technique your physician uses. If you also accept a hernia or bladder trouble, your md may employ the surgery equally an opportunity to repair it.

Once your physician has removed the office of your prostate causing symptoms, one to two temporary drain tubes may be inserted through punctures in your skin most the surgery site. 1 tube goes directly into your bladder (suprapubic tube), and the other tube goes into the area where the prostate was removed (pelvic drain).

After the procedure

After surgery you should expect that:

You'll be given Four pain medications. Your doctor may requite yous prescription pain pills to take after the IV is removed.
Your doctor will have yous walk the mean solar day of or the twenty-four hours after surgery. You'll also do exercises to motion your feet while you're in bed.
Yous'll likely go home the mean solar day afterwards surgery. When your doctor thinks it's rubber for you to go dwelling house, the pelvic bleed is taken out. You may need to return to the md in 1 or two weeks to have staples taken out.
Yous'll return home with a catheter in place. Most men need a urinary catheter for seven to 10 days after surgery. Full recovery of urinary control can accept up to a year after surgery.

Make sure y'all empathize the post-surgery steps you lot demand to take, and any restrictions such as driving or lifting heavy things:

Yous'll need to resume your activity level gradually. You should exist back to your normal routine in about four to six weeks.
Y'all'll need to run across your doctor a few times to make sure everything is OK. Well-nigh men see their doctors after about six weeks and so once again every 3 months for the first yr, and twice in the second year after surgery. If you have whatever problems or concerns, you lot may need to come across your doctor sooner or more often.
You'll probably exist able to resume sexual activeness afterwards recuperating from surgery. After simple prostatectomy, y'all can still have an orgasm during sex activity, simply yous'll ejaculate very little or no semen. After radical prostatectomy, total recovery of erectile role may take as long as 18 months for some men.

Results

Robot-assisted prostatectomy tin can issue in reduced pain and claret loss, reduced tissue trauma, a shorter hospital stay, and a quicker recovery catamenia than a traditional prostatectomy. You usually can render to normal action, with minor restrictions, effectually four weeks after surgery.

Uncomplicated prostatectomy provides long-term relief of urinary symptoms due to an enlarged prostate. Although it's the most invasive procedure to treat an enlarged prostate, serious complications are rare. Virtually men who accept the process generally don't demand any follow-upwardly handling for their BPH.

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Sept. 01, 2020

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Source: https://www.mayoclinic.org/tests-procedures/prostatectomy/about/pac-20385198