Prostatectomy

Recently Answered

• QIs robotic prostatectomy better for nerve sparing than an open surgery?

  1 Answer

  A

  

  A Jayram Krishnan, DO , answered on behalf of Sunrise Hospital & Medical Center

  

  Both robotic and open prostatectomy have similar outcomes regarding nerve sparing, says Jayram Krishnan, DO, a urologist at Sunrise Hospital. In this video, he advises that you seek a doctor with the most experience in the type of procedure.

  

  Find out more about this DVD:

  Is Robotic Prostatectomy Better for Nerve Sparing Than an Open Surgery?
  Buy DVD
• QHow will a prostatectomy affect my ability to get an erection?

  1 Answer

  A

  

  A Jayram Krishnan, DO , answered on behalf of Sunrise Hospital & Medical Center

  

  Prostatectomy does decrease erections by about 30%, says Jayram Krishnan, DO, a urologist at Sunrise Hospital. In this video, he explains that your urologist can help you with any erection issues.

  

  Find out more about this DVD:

  How Will a Prostatectomy Affect My Ability to Get an Erection?
  Buy DVD
• QCan urinary leakage occur after a radical prostatectomy?

  1 Answer

  A

  

  A Dr. Joseph E. Busby, MD , Urology, answered on behalf of Greenville Health System

  Yes, it is common for men to leak for 6 weeks to 6 months after surgery. This will progressively improve as men perform their kegel exercises, where they will wear pull-ups (like Depends) for the first few weeks after the catheter is removed, then graduate to pads (similar to panty-liners). Approximately 5-7% of men will have a risk for long-term leakage beyond 1 year, and only 1-2% of men may need a procedure to help correct this leakage.
  The contents of this website are for informational purposes only and are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Nor does the contents of this website constitute the establishment of a physician patient or therapeutic relationship. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
• QWho will be on my surgical team for my prostatectomy?

  1 Answer

  A

  

  A Intermountain Healthcare answered

  Your surgical team will consist of: your surgeon, an assistant surgeon, anesthesiologist operating room nurse and operating room technician. Once your surgery is complete you will have a nurse in the post anesthesia care unit that will care for you on a one on one basis unit you are awake and ready to be transferred to the ward. On the ward you will have a team on nurses, respiratory therapists, occupational therapists, nutritionists and pharmacist who will all care for you until discharge. As you can see the team is much more than just your surgeon.
• QDoes radical prostatectomy lead to incontinence?

  1 Answer

  A

  

  A Dr. Neil H. Grafstein, MD , Urology, answered on behalf of The Mount Sinai Health System

  Although urinary incontinence is extremely common in the aftermath of prostate surgery, for most patients, it’s a temporary problem. The majority of men improve in the first six months to a year.

  After the one year mark, it is very unlikely the incontinence will go away  untreated --- and many men are reluctant to seek treatment because they’re hoping it will go away on its own.

  Fortunately, post surgery incontinence is a condition that we can treat very effectively using minimally invasive methods.
• QHow long will the pelvic drain be in after radical prostatectomy?

  2 Answers

  A

  

  A The Mount Sinai Health System answered

  At the conclusion of the prostatectomy a drain is placed around the new connection between the bladder and urethra.  The drain helps remove residual blood and fluid as well as any urine that might leak from the new connection.  The drain is typically on the first day following surgery. However if there is significant fluid draining, than your physician may decide to keep it in place for longer. 

  See All 2 Answers
• QIs erectile dysfunction (ED) common after radical prostatectomy?

  1 Answer

  A

  

  A Dr. Mehmet Oz, MD , Cardiology (Cardiovascular Disease), answered

  It's hard to get a handle on what percentage of men will experience erectile dysfunction after having their prostates removed, the procedure known as a radical prostatectomy. However, it's fair to say that problems with erections are a very real possibility if you have a radical prostatectomy, which is performed to treat prostate cancer. Your outcome will depend on several factors, including:

  • Your age. Younger men are less likely to have erectile dysfunction after this procedure.
  • Your pre-surgery health. If you are capable of having a healthy erection before a radical prostatectomy, your odds of developing erectile dysfunction aren't as great.
  • Your surgeon. Let's face it, some surgeons are more skilled than others. Shop around for a good one.
  • Your procedure. Some surgeons are trained to perform a variation on this procedure known as a nerve-sparing radical prostatectomy, which seems to do a better job of preserving sexual functioning.

  Here's another thing to keep in mind: Many men who have erectile dysfunction following a radical prostatectomy gradually regain the ability to have an erection suitable for sex. For those who don't, there are several treatment options, including medications.

• QIs radiation therapy required after robotic prostatectomy?

  1 Answer

  A

  

  A The Mount Sinai Health System answered

  Radiation therapy is sometimes suggested in place of surgery if the cancer is localized or if it has spread to the surrounding tissue. Radiation has its own set of side effects such as bowel dysfunction. In some cases, if surgery is unsuccessful, the physician may suggest radiation as a potential treatment choice. In the vast majority of robotic prostatectomies, however, the cancer is removed, the patient remains disease-free and radiation, with its harmful side effects, is avoided.
• QWhat is a radical prostatectomy?

  1 Answer

  A

  

  A Dr. Marc B. Garnick, MD , Hematology & Oncology, answered

  The goal of radical prostatectomy is to cure early prostate cancer that is confined to the prostate by removing the entire gland. Because the prostate is wedged tightly between the bladder and the rectum, the procedure is a delicate task that should be performed by a skilled urologic surgeon. The nerves that are responsible for erections are often damaged during the operation, so impotence is a common complication. A variation on this procedure, the nerve-sparing prostatectomy, attempts to preserve potency by removing the prostate without disrupting the nerves. Surgeons always try to strike a balance between removing all of the cancer and sparing the nerves and the urinary sphincter. Most err on the side of doing as complete an operation as possible to minimize the chance of leaving cancer cells behind.
  
  Not surprisingly, almost everyone undergoing prostatectomy wants the nerve-sparing procedure, and it's available across the country. However, success is not guaranteed. If the tumor is too close to a nerve bundle, the nerves can't be saved -- and saving one nerve bundle is not as likely to preserve erectile function as saving both of them. Even if the procedure is successful, it can take a year or more for the tiny nerve fibers -- which often stop transmitting impulses when they've been traumatized by the surgery -- to heal sufficiently to restore sexual function. Estimates of the number of men undergoing radical prostatectomy who actually regain their ability to have erections range widely, from 25% to 80%.
  
  It's important to choose an experienced surgeon. The likelihood of a successful outcome -- in terms of preserving potency, preventing incontinence, and, most important, curing the cancer -- generally correlates with experience. The number of procedures a surgeon performs does not necessarily make him better than one who does fewer; however, a minimum of 15 to 20 prostatectomies per year is necessary to be sufficiently skilled at the operation.
  
  Recovery of sexual function also depends on the patient's age and the location of the tumor. Medication may be prescribed to help this process.
• QWhat is open prostatectomy surgery for BPH?

  1 Answer

  A

  

  A Dr. Marc B. Garnick, MD , Hematology & Oncology, answered

  In open prostatectomy for the treatment of benign prostatic hyperplasia (BPH), the surgeon removes tissue blocking the urethra through an incision in the lower abdomen, leaving the rest of the prostate gland in place.