Friday, November 28, 2014

Facing Prostate Surgery

Below the Moustache blog series

Dr. Arthur Grabowski, Urologist

Patients with prostate cancer facing surgery are naturally apprehensive. Not only are they usually concerned with how the procedure will go, the extent of pain involved and the time it will take for them to recover, they also worry about long-term side effects. 

In this blog, I hope to alleviate some of these concerns by providing a detailed account of what patients can expect to experience.

Let’s begin with the actual surgery itself.

If a radical prostatectomy is required, it is because a surgeon believes he or she can remove the localized tumour completely. This type of surgery is generally recommended for patients who are younger, in good health and have prostate cancer that requires treatment. The surgeon accesses the area either through a single incision or a few small incisions in the abdomen. Using delicate surgical instruments, the surgeon then removes the prostate gland and some of the surrounding tissue. This is an added measure to ensure the whole area is free of cancer cells.

The procedure takes approximately two to four hours, depending on the extent and type of surgery. When a patient wakes up following the surgery, he will have a catheter to empty his bladder and a small tube in his abdomen to help drain any fluid that may accumulate. He can expect to stay in hospital after surgery for two to three days. He is discharged home with the catheter, which stays in for 10 to 14 days to allow healing of the connection between the bladder and the urinary passage.

Now let’s look at what happens during recovery and any possible side effects.

For the next couple of weeks he may notice some blood in his urine. This is normal and will ease off on its own as the surgical site heals. There will be some pain, as with most surgeries, but it can be managed well with medications both in the hospital and once the patient is home. Each patient and his surgery is different. For example, some may need follow-up radiation if the cancer has spread beyond the confines of the prostate.

Long-term side effects also vary with each patient. Incontinence, the involuntary loss of urine, occurs in about two to seven percent of patients and can vary in degree from mild to bothersome. Erectile dysfunction occurs in about 40 to 50 per cent of patients depending on a patient's age, type of surgery and pre-operative erectile status. Again, these have varying levels of severity and can often improve with time.

Here at Rouge Valley Health System, we understand the anxiousness that patients may be feeling. That’s why we have a patient-centric model that guides how we care for patients before, during and after surgery. We want patients to have the best experience possible throughout their prostate cancer care journey. Our surgeons work with a number of other sub-specialists and healthcare providers to ensure we address all the health needs of patients. Often this means a team approach, which can bring together oncologists, counsellors and even home care professionals.

Rouge Valley urologists are ‘hands on’ in patients’ care well beyond the surgical suite. This is how we provide the best outcomes for patients in Durham and Scarborough.

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