The Post-operative Period and the Consequences of the Surgery to Remove the Prostate
Surgery is the main form of treatment to eliminate the cancer of the prostate therefore, in most cases, it is possible to remove the entire malignant tumor, and definitely the cancer, especially when the disease is still little advanced and has not reached other organs.
This surgery, known as radical prostatectomy, is usually done in men 75 years of age, sexually active diagnosed with prostate cancer still do not have metastases. Although this treatment is essential, it may also be necessary to carry out chemotherapy and radiation therapy after surgery to eliminate all malignant cells, complementing the treatment.
The prostate tumor is slow growing and therefore it is not necessary to perform the surgery immediately after discovering the adenocarcinoma, being able to wait a few days, without this increase the risk of complications.
How is the recovery from prostatectomy
The recovery is relatively quick and is only recommended staying home, avoiding effort, by approximately 10 to 15 days. After this time, you can return to activities of day-to-day, such as driving or working, however, the permission for efforts occurs only after 90 days from the date of the surgery. Already the intimate contact can be resumed after 40 days.
In the post-op prostatectomy it is necessary to place a small tube into the bladder, known as probe in the bladder lining, to be able to urinate because the urinary tract are very inflamed, preventing the passage of urine. This small tube should be used within 1 to 2 weeks, and must be removed only after the indication of the doctor.
In addition, surgery may be needed to do chemotherapy and radiation therapy to kill the malignant cells that were not removed in the surgery or that have spread to other organs, avoiding that continue to multiply.
In addition to the general risks, such as infection at the site of the scar or bleeding, the surgery for prostate cancer can have other consequences such as:
1. Urinary incontinence
After the surgery, the man may present some difficulty to control the output of urine, resulting in urinary incontinence. This incontinence can be mild or total, and generally lasts between a few weeks or months after surgery.
This problem is more common in the elderly, but can happen at any age depending on the degree of development of the cancer and type of surgery. The treatment usually starts with sessions of physical therapy with pelvic floor exercises and small instruments, such as biofeedback, and therapeutic exercise. In the most extreme cases one may perform a surgery to fix this dysfunction.
2. Sexual impotence
Sexual impotence is one of the most frequent complications and concern for men, because they fail to fail to start or to keep an erection. This is because with the prostate there are important nerves that control erection. Thus, the impotence is more common in cases of cancer developed in that it is necessary to remove many of the affected areas, it may be necessary to remove the nerves.
In other cases, the erection can be affected only due to inflammation of the tissues around the prostate that presses on the nerves. Generally, these cases improve over the months or years to the extent that the fabrics will be on the mend.
To help in the first months, the urologist may recommend some drugs, such as Vardenafil or Sildenafil, which help you have an erection satisfactory.
3. Retrograde ejaculation
This is one of the most common complications of surgery for prostate cancer and happens when the man does not eliminate the sperm after intimate contact, or masturbation. In these cases, the sperm is removed to the bladder, and then eliminated in the urine.
Although this complication does not cause any health problem, you can decrease the fertility of the man and, therefore, it may be necessary to make treatment, especially if the man you want to have children.
The price of the surgery
The value of surgery for treatment of prostate cancer is approximately 15 thousand reais, but it can be made free of charge by the SUS for indication of the urologist.
How is the surgery
The surgery is done in most cases with general anesthesia, however it can also be done with spinal anaesthesia, which is applied on the back or just through a medication into the vein to sleep deeply. The surgery takes on average 40 minutes to 1 hour and, usually, it is necessary to be hospitalized for about 3 days.
Prostatectomy consists of the removal of the prostate, including the urethra, prostate, seminal vesicles and ampoules of pipelines, different, associated or not to the achievement of lymphadenectomy bilateral.
The main techniques to perform the surgery
To remove the prostate, the surgery can be done laparoscopically, meaning through small holes in the belly through which they pass instruments to remove the prostate, or by laparotomy where it is made a larger cut in the skin. Thus, some techniques may be:
- Radical prostatectomy retropúbica: in this technique, the doctor makes a small cut in the skin next to the navel to remove the prostate tumor;
- Radical prostatectomy perineal: it is made a cut between the anus and the scrotum and removed the tumor. However, this technique is used with less frequency than the previous one, because the nerves responsible for erection are almost always affected, which can cause impotence;
- Robotic radical prostatectomy: in this technique the doctor control a machine with robotic arms and, therefore, the technique is more precise and there is less risk of sequelae. However, it is a technique very rare and more expensive;
- Resseção transurethral of the prostate:is usually performed in the treatment of benign prostatic hyperplasia, however, in the case of cancer also helps to relieve some of the symptoms, such as difficulty passing urine.
In most cases, the technique most recommended is the one made by laparoscopy, because it causes less pain, causes less blood loss and recovery time is faster.
Examinations and consultations after the surgery
After completing the treatment of prostate cancer is necessary to perform a PSA test every 6 months for 5 years. Bone densitometry and other imaging tests may also be conducted annually to ensure that all is well, or diagnose any changes as soon as possible.
The system emotional and sexuality can be very shaken by this may be indicated to be followed by a psychologist during the treatment and in the first months following. The support of family and close friends is also an important aid to continue in peace.
The cancer can come back?
Yes, men diagnosed with prostate cancer have a greater risk of developing other types of cancer, such as rectal, leukemia, bowel, or bladder, for example. This way is advised to maintain healthy habits, and not smoking, in addition to performing diagnostic tests periodically, and whenever requested by the doctor, because the sooner it is diagnosed, the higher are your chances of a cure.