Any surgical intervention requires preparation which may vary depending on each individual. It is essential that you follow the recommendations given to you by your urologist and your anesthesiologist. If these recommendations are not followed, the intervention could be postponed. In view of the intervention, certain examinations may be prescribed (ultrasound, smear, urodynamic assessment, MRI, etc.) An anesthesia consultation must take place a few days before the intervention. You will be asked to perform a urine analysis a few days before the procedure (ECBU). In the event of infection, intervention is deferred until the urine is sterilized.
The procedure is carried out under general anesthesia. It can be performed laparoscopically with or without robotic assistance. In the operating room, you are placed flat on your back. A urinary catheter is placed at the start of the procedure.
The time for removal of the urinary catheter is defined by your surgeon. Resumption of intestinal transit (gas) usually occurs within the first 48 hours. However, constipation can bother you for a few days and continue if you are prone to this problem. You may then be prescribed a laxative treatment. The length of hospitalization is usually a few days. A convalescence is expected. Its duration is adapted to the work you do. You should refrain from exercise, sports, carrying heavy loads, taking baths and having penetrative sex for approximately 1 month. A follow-up consultation with your urologist is planned a few weeks after the procedure.
This decides on the possibility of resuming all your activities, particularly sporting activities. You must avoid violent efforts in the 3 months following the procedure. Sexuality By replacing the descended organs in the correct position, the intervention most often allows you to improve your sexuality. On the other hand, the quality of intercourse can rarely be altered by pain and vaginal lubrication problems. You may be prescribed treatment to improve these local phenomena.
Healing Laparoscopic surgery involves one or more incisions of varying size. These incisions are not only areas of weakness, but also possible entry points for infection. It is therefore necessary to ensure good local hygiene. If the scar becomes red, hot or if it is raised, it is important to show this scar to your surgeon without urgency: it may be a hematoma or an abscess. The skin heals over several days. During this period, a little bleeding may occur which can be stopped by compressing it with a compress or a clean cloth. The removal of the wires or staples is carried out by a nurse at home following the medical discharge prescription.
Disunion of the skin can sometimes occur. If this opening is superficial, you simply have to wait for it to close; the closing time can reach several weeks (especially in diabetic patients or those on corticosteroid treatment). On the other hand, in the event of a feeling of deep cracking or deep disunity, it is necessary to consult your surgeon quickly. You will be able to resume normal activity but violent efforts and carrying heavy loads (greater than 5 kg) are prohibited for 3 months. Your usual sporting activities will need to be interrupted for 1 to 3 months depending on the type of sport and its intensity. Cycling and motorcycling is also not recommended for 1 month.
You must absolutely avoid constipation so as not to have to strain to have a bowel movement. Transit-facilitating treatment is often necessary for several weeks. You will need to avoid baths, penetrative sex and periodic tampons for six weeks following the procedure. When showering, you can wash the skin incisions with your usual soap. Be sure to dry them by dabbing or hairdrying to avoid any maceration. Tobacco and malnutrition slow down healing. Post-operative fever The occurrence of a fever after the treatment of genital prolapse
The prostate is a gland located below the bladder and in front of the rectum. It is crossed by the urethra canal which extends to the end of the penis and allows the evacuation of urine. It is close to the sphincter system which ensures urinary continence and the nerves of erection. The seminal vesicles are the reservoir for sperm and open directly into the prostate.
The essential function of the prostate is to secrete a component of spermatic fluid which, together with sperm produced in the testicles, constitutes semen. It contributes to the emission of sperm.
The prostate is dependent on the male hormone called testosterone.
Total prostatectomy (removal of the prostate) is indicated in cases of cancer. This prostate cancer is the leading cancer in men and is responsible for 8,000 deaths per year in France. In the case of cancer localized to the prostate, one of the possible treatments is radical surgical treatment.
There are other treatments for localized prostate cancer such as external beam radiotherapy, brachytherapy, active surveillance or in some cases focal treatment.
The advantages and disadvantages of the surgical strategy were clarified by the urologist.
The choice of surgery takes into account age, general condition and characteristics of the cancer.
Prostate biopsies revealed cancer. The aim of the procedure is to remove the entire prostate (because prostate cancer is multifocal, meaning that there are several cancers within the prostate) as well as the seminal vesicles. The absence of treatment exposes you to the progressive risks of cancer, locally and remotely in the form of metastases and death.
Any surgical procedure requires preparation which may vary depending on each individual. It is essential that you follow the recommendations given to you by your urologist and your anesthesiologist.
If these recommendations are not followed, the intervention could be postponed.
A pre-anesthesia consultation is mandatory a few days before the procedure.
The assessment before the intervention must include:
Taking anti-platelet agents or anticoagulants must be stopped for several days.
An antibiotic will be systematically given during the procedure according to current protocols.
Usually, there is no digestive preparation to carry out. A rectal enema is suggested in certain cases.
Total prostatectomy is carried out under general anesthesia.
Several approaches are possible depending on the surgeon’s habits. This intervention can be carried out by an incision under the umbilicus (open approach) or by small incisions allowing the installation of trocars through which the instruments necessary for the intervention are introduced (laparoscopic approach sometimes assisted by a robot).
The entire prostate is removed, as well as the seminal vesicles. Continuity between the bladder and the urethra is restored by a suture under cover of a urinary catheter. A drain allowing the evacuation of serosities from the operating area is sometimes placed at the end of the procedure.
A lymph node dissection, that is to say the removal of the lymph nodes draining the prostate, can be associated with prostatectomy in order to look for microscopic dissemination of the cancer which could modify the treatment strategy.
The prostate is analyzed under a microscope by the pathologist. It specifies whether the cancer is limited to the prostate or whether it extends beyond the limits of the prostate, as well as any possible damage to the lymph nodes removed.
The result is sent to your surgeon after several days.
After the procedure, pain treatment is prescribed if necessary.
The duration of hospitalization is generally short and remains at the discretion of the surgeon.
The removal of the drain is generally carried out a few hours to a few days after the procedure.
The urinary catheter is usually well tolerated, but it can sometimes cause discomfort. The time the urinary catheter is kept in place and the length of hospitalization are specified by the surgeon. Removal of the probe can be carried out during hospitalization or after discharge.
Urinary leakage may occur initially