Prostatectomy: Difference between revisions
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==Overview== | ==Overview== | ||
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A '''prostatectomy''' is the [[surgical]] removal of all or part of the [[prostate gland]]. Abnormalities of the prostate, such as a [[tumour]], or if the gland itself becomes enlarged for any reason, can restrict the normal flow of [[urine]] along the [[urethra]]. | A '''prostatectomy''' is the [[surgical]] removal of all or part of the [[prostate gland]]. Abnormalities of the prostate, such as a [[tumour]], or if the gland itself becomes enlarged for any reason, can restrict the normal flow of [[urine]] along the [[urethra]]. | ||
==Prostatectomy== | |||
There are several forms of the operation: | There are several forms of the operation: | ||
* '''[[Transurethral resection of the prostate]]''' (TURP): a [[cystoscope]] is passed up the urethra to the prostate, where the surrounding prostate tissue is excised. This is a common operation for [[benign prostatic hyperplasia]] (BPH) and outcomes are excellent for a high percentage of these patients (80-90%). A more refined and safer operation is by means of a holmium high powered "red" laser. This technique has been well documented as being the only laser operation that is of higher standard than the "old" TURP operation. | * '''[[Transurethral resection of the prostate]]''' (TURP): a [[cystoscope]] is passed up the urethra to the prostate, where the surrounding prostate tissue is excised. This is a common operation for [[benign prostatic hyperplasia]] (BPH) and outcomes are excellent for a high percentage of these patients (80-90%). A more refined and safer operation is by means of a holmium high powered "red" laser. This technique has been well documented as being the only laser operation that is of higher standard than the "old" TURP operation. | ||
* ''' | * '''[[Open prostatectomy]]''': A surgical procedure involving a skin incision and enucleation of the prostatic adenoma, through the prostatic capsule (RPP-retropubic prostatectomy) or through the [[bladder]] (SPP-suprapubic prostatectomy). Reserved for extremely large prostates. | ||
* '''[[Laparoscopic]]''': a laparoscopic or four small incisions are made in the abdomen, and the entire prostate is removed sparing nerves more easily damaged by a retropubic or suprapubic approach. Laparoscopic prostatectomy has more advantages than the radical perineal or retropubic operation and is more economical than the robot assisted technique. | * '''[[Laparoscopic]]''': a laparoscopic or four small incisions are made in the [[abdomen]], and the entire prostate is removed sparing nerves more easily damaged by a retropubic or suprapubic approach. Laparoscopic prostatectomy has more advantages than the radical perineal or retropubic operation and is more economical than the robot assisted technique. | ||
* '''Robotic-assisted prostatectomy''': Laparoscopic robotic arms are controlled by a surgeon. The robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy: much smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.<ref name="sciencedaily"> Center for the Advancement of Health; August 29, 2005; Robot-assisted Prostate Surgery Has Possible Benefits, High Cost | * '''[[Robotic-assisted prostatectomy]]''': Laparoscopic robotic arms are controlled by a surgeon. The robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy: much smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.<ref name="sciencedaily"> Center for the Advancement of Health; August 29, 2005; Robot-assisted Prostate Surgery Has Possible Benefits, High Cost | ||
[http://www.sciencedaily.com/releases/2005/08/050829073446.htm]</ref>. While the cost of such procedures is high, costs are declining rapidly <ref name="liebertonline"> Cost Analysis of Radical Retropubic, Perineal, and Robotic Prostatectomy; Scott V. Burgess, Fatih Atug, Erik P. Castle, Rodney Davis, Raju Thomas; Journal of Endourology 2006 20:10, 827-830 [http://www.liebertonline.com/doi/abs/10.1089/end.2006.20.827?cookieSet=1&journalCode=end]</ref>. | [http://www.sciencedaily.com/releases/2005/08/050829073446.htm]</ref>. While the cost of such procedures is high, costs are declining rapidly <ref name="liebertonline"> Cost Analysis of Radical Retropubic, Perineal, and Robotic Prostatectomy; Scott V. Burgess, Fatih Atug, Erik P. Castle, Rodney Davis, Raju Thomas; Journal of Endourology 2006 20:10, 827-830 [http://www.liebertonline.com/doi/abs/10.1089/end.2006.20.827?cookieSet=1&journalCode=end]</ref>. | ||
* '''[[Radical perineal prostatectomy]]''': an [[incision]] is made in the [[perineum]], midway between [[rectum]] and [[scrotum]], and the prostate is removed. Radical prostatectomy is one of the key treatments for [[prostate cancer]]. | * '''[[Radical perineal prostatectomy]]''': an [[incision]] is made in the [[perineum]], midway between [[rectum]] and [[scrotum]], and the prostate is removed. Radical prostatectomy is one of the key treatments for [[prostate cancer]]. | ||
* '''[[Radical retropubic prostatectomy]]''': an incision is made in the lower [[abdomen]], and the prostate removed, by going behind the [[pubic bone]] (retropubic). Radical prostatectomy is one of the key treatments for [[prostate cancer]]. | * '''[[Radical retropubic prostatectomy]]''': an incision is made in the lower [[abdomen]], and the prostate removed, by going behind the [[pubic bone]] (retropubic). Radical prostatectomy is one of the key treatments for [[prostate cancer]]. | ||
* ''' [[Transurethral plasmakinetic vaporization prostatectomy]]''' (TUPVP). | |||
* ''' Transurethral plasmakinetic vaporization prostatectomy (TUPVP). | |||
==External links== | ==External links== | ||
* [http://www.prostate-answers.com/surgery-prostate.html Prostate Cancer Treatment Guide] | * [http://www.prostate-answers.com/surgery-prostate.html Prostate Cancer Treatment Guide] | ||
[[Category:Urology]] | [[Category:Urology]] | ||
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<references/> | <references/> | ||
{{Urogenital surgical procedures}} | {{Urogenital surgical procedures}} | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 15:19, 18 August 2015
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Steven C. Campbell, M.D., Ph.D.
Overview
A prostatectomy is the surgical removal of all or part of the prostate gland. Abnormalities of the prostate, such as a tumour, or if the gland itself becomes enlarged for any reason, can restrict the normal flow of urine along the urethra.
Prostatectomy
There are several forms of the operation:
- Transurethral resection of the prostate (TURP): a cystoscope is passed up the urethra to the prostate, where the surrounding prostate tissue is excised. This is a common operation for benign prostatic hyperplasia (BPH) and outcomes are excellent for a high percentage of these patients (80-90%). A more refined and safer operation is by means of a holmium high powered "red" laser. This technique has been well documented as being the only laser operation that is of higher standard than the "old" TURP operation.
- Open prostatectomy: A surgical procedure involving a skin incision and enucleation of the prostatic adenoma, through the prostatic capsule (RPP-retropubic prostatectomy) or through the bladder (SPP-suprapubic prostatectomy). Reserved for extremely large prostates.
- Laparoscopic: a laparoscopic or four small incisions are made in the abdomen, and the entire prostate is removed sparing nerves more easily damaged by a retropubic or suprapubic approach. Laparoscopic prostatectomy has more advantages than the radical perineal or retropubic operation and is more economical than the robot assisted technique.
- Robotic-assisted prostatectomy: Laparoscopic robotic arms are controlled by a surgeon. The robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy: much smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.[1]. While the cost of such procedures is high, costs are declining rapidly [2].
- Radical perineal prostatectomy: an incision is made in the perineum, midway between rectum and scrotum, and the prostate is removed. Radical prostatectomy is one of the key treatments for prostate cancer.
- Radical retropubic prostatectomy: an incision is made in the lower abdomen, and the prostate removed, by going behind the pubic bone (retropubic). Radical prostatectomy is one of the key treatments for prostate cancer.
- Transurethral plasmakinetic vaporization prostatectomy (TUPVP).
External links
References
- ↑ Center for the Advancement of Health; August 29, 2005; Robot-assisted Prostate Surgery Has Possible Benefits, High Cost [1]
- ↑ Cost Analysis of Radical Retropubic, Perineal, and Robotic Prostatectomy; Scott V. Burgess, Fatih Atug, Erik P. Castle, Rodney Davis, Raju Thomas; Journal of Endourology 2006 20:10, 827-830 [2]