Prostate Cancer
Surgery
Surgery is one of the options available in the fight against prostate cancer. Comprehensive Urology has surgeons specially trained in each surgical approach including:
Radical retropubic prostatectomy
Traditionally, the prostate is removed in this fashion which involves a 5 inch long incision below the navel. Most urologists are trained in this method, and it remains the standard-of-care for the radical surgical treatment of prostate cancer. Despite being a highly effective operation, it is falling out of favor with the advent of more minimally-invasive treatment options. Like with any radical prostate surgery, patients can expect a period of catheterization after surgery. The major risks include loss of erections (impotence) and urinary control (incontinence).
Radical perineal prostatectomy
Radical perineal prostatectomy continues its resurgence as a minimally invasive treatment for prostate cancer. It involves removing the prostate through a tiny hidden incision between the scrotum and rectum. Outcomes are comparable to robotic prostatectomy including short hospital stay, low blood loss, preservation of erections, excellent fecal and urinary continence and quick return to work, often within 14 days. It can be done with spinal anesthesia avoiding the need for a breathing tube during surgery.
An article published in the Journal of Urology in 2002 suggested similar success rates at Beaumont Hospital in cancer removal with either the perineal or retropubic approach. Also fecal continence was similar for perineal and retropubic approaches. A recent abstract by Beaumont urologists suggested that the perineal approach is a cost- effective way to remove a prostate so that it helps save valuable healthcare dollars. Finally, a study at Beaumont also showed that perineal patients use less pain medication than robotic or conventional open prostatectomy patients.
We believe that the perineal prostatectomy will stand the test of time as an important, minimally invasive treatment for prostate cancer and has efficacy equal to robotic and open prostatectomy
Robotic-assisted laparoscopic radical prostatectomy
For over five years now, Comprehensive Urology surgeons have been performing radical prostatectomy utilizing the Da Vinci robot (Intuitive Surgical) with excellent outcomes. The number of robotic prostatectomies across the nation has grown by leaps and bounds since then. Adding the robot to laparoscopic prostatectomy improves surgical precision while still operating through small key-hole sized incisions on the abdomen. Advantages include less bleeding, less pain, shorter catheterization period and quicker return to normal activities.