Your prostate is one of the most important organs of your body as it plays a crucial role in reproductive functionality. This walnut-size gland located between bladder and penis secretes a prostate fluid that protects and nourishes semen. The muscle of the gland helps propel the fluid comprising sperm into the urethra during ejaculation. It is vas deferens that brings sperm from testes to the seminal vesicle, where the fluid is added during ejaculation. It is a highly complex structure requiring special care as it is very prone to infection.
With age prostrate normally grows in size. But if it grows too large it requires special attention as it might be the signal of some fatal diseases. If you notice symptoms like a sudden increase in urine frequency, blood in urine or semen, pain and burning sensation, painful ejaculation or pain in the lower part of the body then it is time to consult your doctor. You doctor will suggest some tests to know about the issue in detail. Based on the outcome of the tests conducted, your doctor will either recommend medication to treat symptoms or refer you to urologists for advance treatment. It is very natural that your mind will fill with surgery-related worries like is it required, when and how, what would be the impact among others. Let us explore these issues step by step, starting from tests so that you could know about it in detail.
Depending on symptoms your doctor will ask for examinations and tests to know about the exact reason and possible treatments. Here are some of the tests that are normally conducted for prostate.
- Digital rectal examination (DRE)
It is a physical examination of your rectum using a lubricated gloved finger. This helps your doctor in knowing the size of the prostate, lumps or nodules of prostate cancer. It is just a primary check-up to judge the size of your prostate.
- Prostate-specific antigen (PSA)
If your doctor feels the need to go deeper in analysis, he may recommend a PSA test to judge the level of PSA in blood. The high level of PSA is an indicator of the likely chance of cancer. However, it has been noticed that the PSA level also rises in cases of an enlarged prostate.
- Prostate ultrasound
It is done to know about the exact size and status of the prostate. It is done through the rectum using sophisticated ultrasound tools. It is normally conducted along with a biopsy to judge the presence of maligned cells.
- Prostate biopsy
Your oncologist will insert a needle into the prostate to take tissue samples and conduct an advance test to know about the cell growth and malign cell status.
Based on inputs from the tests conducted, your doctor will suggest remedies or treatments. One of the several measures is surgery. However, it all depends on the condition of your prostate. Let us know about the prostate conditions.
Some of the known prostate ailments that affect the majority of people are;
- Prostatitis:It is simply an inflammation of your prostate caused by bacteria that enters into the gland through the urinary tract or through lymphatic spread from the rectum. Depending on the acuteness of the infection and swelling, it can be treated with antibiotics.
- Enlarged prostate:Technically it is called Benign Prostatic Hypertrophy (BPH). It is very common among people of over 50 years of age, however the size of enlargement that makes all the difference in terms of symptoms and difficulty. Depending on the size and symptoms your doctor will recommend medication or surgery.
- Prostate cancer:This is one of the most common types of maligned cell growth in men. Depending on the outcome of the biopsy and other tests, your urologist and oncologist will recommend either surgery to remove maligned tissues or user radiation, chemotherapy or hormone therapy to treat the prostate cancer.
Now you know about the condition of your prostate and doctor’s opinion is with you. Before taking the final you need to ask your doctor whether the surgery will cure the condition, impact on urination normalcy and erection, side effects and precautions. Any of the three conditions mentioned above may require surgery for the partial or total removal of the prostate gland. The process of removal is called prostatectomy. Thanks to technological advancement made in medical treatments, you have the option of minimally invasive procedures requiring tiny cuts or tube-based inserting instruments. These procedures help you recover fast and it is less painful with low risk as compared to invasive surgery which requires larger cuts and takes longer time to recover.
Types of prostate surgery
Depending on the condition of your prostate, your doctor will define goals of surgery whether it will remove maligned tissues in cases of cancer or it will remove prostate tissues in BPH surgery to restore urine normalcy. Here are some of the major procedures used by surgeons to remove tissues;
It is a traditional approach of surgery in which your surgeon will make an incision through the skin to either total removal of the prostate or extra tissues. This is called open prostatectomy. Normally surgeons use either of the two approaches mentioned below in the open procedure;
- Radical Retropubic:This is the most traditional approach in which a doctor removes your prostate and additional tissues by making an incision from the belly button to pubic bone. Your doctor will check the spread of the cancer tissues and accordingly take the call to remove nearby tissues. If the spread in deep, then your doctor might not proceed further.
- Radical Perineal approach:In this approach, a cut is made between scrotum and rectum. This is preferred when you have other medical condition making it difficult for retropubic approach. Although it is a less time-consuming procedure, there is a limitation as the surgeon will not be able to remove lymph nodes. The risk of erectile dysfunction is a little higher in the surgery.
This is a minimally invasive approach of surgery to remove tissues from the prostate. This also has two major approaches in terms of a number of mini cuts and the use of robotic technology in surgery.
- Laparoscopic Radical Prostatectomy (LRP):Your surgeon will make some micro-cuts in your skin to insert the laparoscopic tube to conduct tissue removal surgery. Multiple cuts are required as the procedure needs camera and tissue collection to operate simultaneously.
- Robotic-assisted Laparoscopic Radical Prostatectomy (RLRP): From cuts and goal point of view the procedure is same as LRP with a difference of using the robotic arm to conduct the procedure with more precession. Your doctor will be controlling the arm of the robot and feeding commands to execute the procedure.
So, which procedure is better? It depends on the goal set by the doctor. However, it has been found that LRP and RLRP procedure is a little more effective in terms of blood loss, pain, duration, hospital stay, and recovery.
Prostate Surgery for Urine Flow
It is very common to have enlarged prostate resulting in urine flow complications. Depending on the diagnosis, your doctor may recommend surgery to improve the urine flow and may use any of the below mentioned surgical procedure.
- Prostate Laser Surgery
This procedure is used mainly to treat BPH without any incision in your body. Laser surgery involves the insertion of fiber-optic scope cable through the penis into your urethra. Your surgeon will remove blocking tissues from prostate making your urine flow normally. It is normally a temporary measure to normalize your urine flow as re-growth of tissue might again block the urinary tract.
- Endoscopic Surgery
The procedure is almost similar to the laser surgery as in this also there is no incision required. Your surgeon will insert a long tube with light and lens via penis tip to remove tissues from the prostate.
This Transurethral resection of the prostate is also used for BPH. Your surgeon uses the wire loop to cut tissues of your enlarged prostate. The cut tissues go to bladder and flush out at the end of the whole procedure.
In transurethral incision of the prostate, your surgeon will make some small cuts in bladder neck and prostate to widen the urethra so that urine could flow easily.
By now you are fully aware of the symptoms, tests and surgical procedure involved in prostate-related conditions. Depending on your condition your doctor will recommend suitable surgery for you. Your surgeon will give a dose of anesthesia to begin the procedure, so you need to be ready for that in advance. You will have to stay in the hospital for a few days with a catheter inserted in the penis to drain urine. You will have to carry it for one or two weeks. Once your urine flow normalizes, the doctor will remove the catheter. Following surgery, you may experience blood in urine, little irritation in the urinary tract and difficulty in holding urine. These are normal, you need not panic as this normalizes in a few weeks. Maintain a healthy diet and hygiene and follow medication and advise of your for a speedy recovery