Prostate cancer is the 3rd most common cancer among Singaporean men. Prostate specific tumor antigen (PSA) blood testing can be done in men with symptoms suggestive of prostate cancer or in men at high risk of developing prostate cancer Show
Prostate cancer is a disease in which malignant (cancer) cells form in the tissues of the prostate. The prostate is a gland in the male reproductive system located below the bladder and in front of the rectum. It is about the size of a walnut and surrounds the urethra (the tube that empties urine from the bladder). The prostate gland produces fluid that is one of the components of semen. With greater public awareness, early detection is on the rise and mortality rates are declining. Additionally, new advances in medical technology are enabling cancer patients to live active and productive lives after their treatment. Treatment options may include active surveillance, surgery or radiation. However, surgery is the only treatment that removes the cancerous prostate from the body. All prostate cancer treatments can affect urinary continence, as well as sexual potency and function. Patients should always consult with their doctor for advice on the options available to treat their condition and what to expect before, during and after treatment. The Prostate Cancer Treatment: Radical ProstatectomyThe da Vinci Surgical System provides surgeons with enhanced capabilities, including the latest high-definition 3D vision and a magnified view. Your doctor controls the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body. Though it is often called a “robot”, da Vinci cannot act on its own. Instead, the surgery is performed entirely by your doctor. Together, da Vinci technology allows your doctor to perform complex procedures through just a few tiny openings. As a result, you may be able to get back to your normal activities faster – without the long recovery that usually follows open surgery. The da Vinci System has been used successfully worldwide in hundreds of thousands of procedures to date. Robotic Surgery: The Potential Benefits of The Da Vinci ® Prostatectomy For qualified candidates, da Vinci Prostatectomy offers numerous potential benefits over traditional open prostatectomy, including:
General Risks of Having An Operation After Prostate SurgeryCatheter Care
ActivityYou should be physically active and try to do a little more each day, to build up your stamina. You may walk and climb stairs with no limitations. You may not lift more than 7kg or do any vigorous physical activity for 4 weeks (running, swimming, going to the gym, golf, tennis, etc.). Doing this kind of activity too soon may cause internal bleeding or hernia formation. Even after 4 weeks, you may not be comfortable doing strenuous exercise in a seated position (bicycling, motorcycling, etc.). DrivingYou should not drive for at least one week. After one week, if you are not taking pain killers, not having pain and are just as mobile as before surgery, you should be fine to drive. Surgical WoundsKeep your wounds clean and dry to prevent infection. If needed, the doctor may refer you to a polyclinic or general practitioner for wound dressing. For robotic surgery, there are about 6 small incisions. They are closed with absorbable sutures or non-absorbable ones. You may shower beginning the 3rd day after surgery. Please do not swim or take baths in bathtubs until the catheter is removed. Swelling or bruising is normal around the incisions, penis or scrotum which will resolve in 10-20 days. Firmness or hardness under the incisions is normal and takes several months to resolve. Common Side Effects of Prostate Cancer SurgeryIncontinence is when you leak or pass urine when you do not want to. It is normal not to be able to control your urine after the removal of your catheter, which can continue for weeks or months. However, this control improves as time goes by. There are some products that are helpful to prevent soiled clothes. Continue pelvic floor exercises to improve urine control. Consult your doctor or incontinence nurse if you have problems with your urine control. Impotence is the inability to achieve or sustain an erection for sexual intercourse. It can last up to a year or longer for some men. Erectile dysfunction occurs because the nerves that are present near the prostate may need to be removed during prostate surgery. There are medications and medical devices available to help. Consult your doctor if you and your partner have a concern with impotence. EmergencySeek medical aid if you encounter any of the following:
Potential Disadvantages of Da Vinci ® ProstatectomyWhile clinical studies support the use of the da Vinci Surgical System as an effective tool for minimally invasive surgery, individual results may vary. da Vinci Prostatectomy remains a surgical procedure, and as such carries inherent risks. Though clinical data support high rates of cancer control, maintaining sexual function and return to urinary continence, there is no guarantee of these benefits to every patient. Some individuals may not be candidates for a full nerve-sparing procedure due to the extent of their cancer. Results are surgeon-dependent and improve significantly with surgeon experienced in this surgical modality. Specific Risks of Having An OperationMore common complications are outlined on the following page. Some are far less common than others, so please speak to your Urologist about them.
Alternative Prostate Cancer Treatment OptionsWhen prostate cancer is believed to be still localised within the prostate gland, there are essentially three treatment options available to a patient:
Patients should discuss the advantages and disadvantages of each treatment approach with their doctor. For localised prostate cancer, radical prostatectomy (surgical removal of the prostate and surrounding cancerous tissues) has historically been considered the definitive way to remove cancer. Drugs Before Prostate SurgeryIt is important to tell your doctor of any prescription, herbal, or over-the-counter drugs you are taking. Some can cause thinning of the blood, and this can increase the risk of bleeding. These drugs should not be taken before surgery for a period as specified by your doctor. If these drugs have not been stopped in advance, it may be safer to postpone the operation to avoid an increased risk of bleeding. Before Your OperationAfter consultation with your surgeon, you will be given a date for the operation and a prescription for the bowel preparation to be administered the night before your surgery. You will also be given an appointment with the Nurse Clinician to do a pre-operative Pelvic Floor Exercise and an assessment with the Pre-Admission Clinical Evaluation (PACE) clinic to determine your fitness for operation. During your PACE appointment, you will be asked questions about your health. A general body checkup will also be conducted. Blood tests, chest Xray and electrocardiogram (ECG) may be done if needed. The purpose of these tests is to ensure that you are healthy and fit enough to proceed with the operation. A Day Before Your Prostate SurgeryOn the night before your surgery, you have to administer the bowel preparation prescribed to you to clear your bowel. And you have to start fasting from midnight. Day Of Your Prostate SurgeryOn the day of your operation, head down to the Day Surgery Centre located on Medical Centre block level 3. Following registration, you will be led to the centre’s waiting area, where a nurse will verify your identity and go through a preoperative checklist with you. When the theatre is ready, you will be assisted onto a bed and pushed to the operating theatre, accompanied by a nurse. At the operating theatre, you will meet your anaesthetist, and he or she may ask you some questions and examine you. During Prostate SurgeryOnce in the operating theatre, a nurse will again verify your identity and the procedure you have agreed to. A blood pressure cuff will be applied to your arm and three discs will be placed on your chest to monitor your heart rate. A small clip will also be placed on your finger to measure the amount of oxygen in your blood. You will then be given your anaesthesia, and the operation will proceed. Recovering from your OperationFollowing your operation, you will be moved to the post anaesthesia care unit (PACU), where a PACU nurse will monitor you closely until you have recovered from the anaesthetic. If you feel nauseous or in pain, please inform the nurse so medication can be given to relieve your discomfort. You will then go to the ward to recover until you are well enough to go home. Your stay in hospital will likely be about 2 to 3 days. DietWhen you return from the operating theatre, you will have a drip in your arm. This will be removed once you can eat and drink normally. Eat lightly for the first 2 to 3 days. Avoid carbonated beverages (sodas) for the first week – as they can cause gas pains. If you are not hungry, don’t overeat, but if you are hungry, it is fine to eat what you like. Bladder and UrineThe urine may often be bloody for a few days after the operation. A flexible plastic tube called the urinary catheter will be inserted into the bladder to drain urine. This tube is kept in place for 7 to 10 days, only to be removed during the next follow-up appointment with your doctor in the clinic. BowelsMost men will not move their bowels for the first time until 4 to 5 days after the surgery. Keep taking the stool softeners until your bowels become regular. Pain medications and inactivity typically slow down bowel function. Medication After Prostate SurgeryIt is normal to have a moderate amount of pain for the first 2-3 days. After that, the discomfort should lessen rapidly. Take pain medication when you first start feeling pain. You will not be addicted to the painkiller when it is taken over a short period of time. Controlling your pain allows you to rest well and sleep through the night. After surgery, you should immediately resume any regular medications that you take. If you regularly take aspirin or anti-inflammatory medicines, please follow the doctors’ instructions strictly. Download the HealthHub app on Google Play or Apple Store to access more health and wellness advice at your fingertips. Can a person live without a prostate?So if we remove the prostate, what is starting stopping urinary flow? The answer is nothing! If there is urine in the bladder (and there always is), it will flow right through to the outside. Men without a prostate need another way to gain control over urination.
What is life like without a prostate?The two prominent quality-of-life issues associated with living without a prostate are the loss of urinary control and the loss of erectile function. When you read or hear that success rates in these two areas are in the 90% range, it's highly probable you're reading hype.
What are the negative effects of having your prostate removed?Radical prostatectomy risks
Urinary tract infection. Urinary incontinence. Erectile dysfunction (impotence) Narrowing of the urethra or bladder neck.
Can you still get an erection if prostate is removed?Erectile dysfunction following radical prostatectomy for clinically localized prostate cancer is a known potential complication of the surgery. With the advent of the nerve-sparing radical prostatectomy technique, many men can expect to recover erectile function in the current era.
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