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Prostate cancer is a malignant tumor, which develops from the epithelial cells of the prostate gland. The main treatment method for prostate cancer is surgery. The operation is called radical prostatectomy.
- Indications for prostatectomy
- Types of prostatectomy
- Postoperative period
- Complications after prostatectomy
- How to avoid negative consequences after surgery?
- Cost of prostatectomy in different countries
- Selection of the hospital for radical prostatectomy
- How can I undergo treatment abroad?
Indications for prostatectomy
Radical prostatectomy is called the "gold standard" in prostate cancer treatment. Prostatectomy at the early stages of the disease allows the patient to achieve complete recovery. However, surgical treatment is not indicated for all patients.
The following conditions are necessary for radical prostatectomy:
- Localized prostate cancer – the tumor does not spread beyond the prostate. In other words, cancer is at the stage I-II. However, in some cases, the operation is carried out at the stage III.
- Young age. Other treatment methods for prostate cancer are applied in elderly men, since surgery may be too dangerous for them.
- Satisfactory general state of health. The operation cannot be performed in the case of severe heart and respiratory failure, impaired blood clotting system.
Types of prostatectomy
Radical prostatectomy is an operation that involves the removal of the entire prostate gland along with the portion of the urethra passing through it, seminal vesicles, and in some cases also regional lymph nodes. Currently, there are several ways to perform prostatectomy.
In open prostatectomy, the surgeon makes a long incision in the abdomen from the navel to the pubic region. The prostate with a part of the urethra, as well as the seminal vesicles, are removed through the incision. At the end of the operation, your doctor will connect the transected urethra to the neck of urinary bladder. A temporary catheter is inserted into the bladder to drain urine.
Currently, open prostatectomy is performed less frequently due to the significant injury rate of the procedure. In particular, when performing an open prostatectomy, there is a risk of damage to the nerves that are responsible for urination and erection.
Laparoscopic prostatectomy is a minimally invasive surgical procedure. Your doctor will make several small punctures in the abdomen. A laparoscope with a camera and a light source, is placed in one of the incisions. The image from the laparoscope is displayed on a large screen, so the doctor can monitor the progress of the operation. The doctors insert microsurgical instruments in other incisions for removal of the prostate gland.
Advantages of laparoscopic prostatectomy as compared to open surgery are as follows:
- Less blood loss
- Less severe pain syndrome after surgery
- Lower risk of complications
- Faster recovery
Robot-assisted prostatectomy is an advanced laparoscopic surgery. In this case, the operation is performed through several punctures on the abdomen. However, all surgical manipulations are performed by the "hands" of the robot.
The doctor controls the manipulators of the robot with the help of a special control panel. All surgical manipulations are carried out with maximum precision, since the factor of hand trembling is excluded completely. Removal of the prostate gland is carried out in the image-guided manner – the image of the surgical field is displayed on the monitor at multiple magnification.
The risk of damage to the nerves responsible for erection and urination is minimized thanks to high movement accuracy and better imaging of the anatomical structures of the small pelvis.
After the operation, the patient is moved to the room, where he stays for several days. The medications for pain management and prevention of inflammatory process are prescribed. The care for postoperative wound is also performed. It includes the treatment of wound using antiseptics and regular change of dressings.
The urinary catheter is removed in 1-2 weeks. After removal of the catheter, the patient may feel some discomfort and burning sensation in the urethra, but these unpleasant phenomena will pass soon. During the first weeks, urine leakage may occur, so it becomes necessary to wear urological pads.
After discharge from the hospital, the patient should follow these recommendations:
- Exclude lifting weights
- Exclude active sports
- Follow a diet and drinking regimen
- Exercise to strengthen the pelvic floor muscles, which will help regain control over urination and erection
- With a certain frequency, undergo diagnostics and follow-up examinations by an oncourologist
In most cases, patients can return to work 2-4 weeks after surgery. However, if the work involves significant physical activity, then more time on recovery may be required.
Complications after prostatectomy
Any surgical procedure involves some risks and in this regard, radical prostatectomy is not an exception.
The following negative consequences are possible after the radical prostatectomy:
- Urinary incontinence
- Erectile dysfunction
- Stricture (scarry stricture) of the urethra
- Lymphedema (excessive accumulation of lymph in the legs or genital area)
How to avoid negative consequences after surgery?
The outcome of the operation depends largely on the skills of the surgeon and the chosen prostatectomy technique. So, the surgeons from leading foreign hospitals perform radical prostatectomy mainly with a minimally invasive technique – using a laparoscope or the da Vinci surgical system. Such minimally invasive operations eventually allow the doctors to achieve an excellent therapeutic result with a low risk of complications.
Medical centers in Germany consistently demonstrate the best results in the treatment of prostate cancer.
- University Hospital Tuebingen. According to the authoritative Focus magazine, this German hospital ranks among five best medical facilities in the country. The certified Prostate Cancer Center was opened at the hospital in 2009. The University Hospital Tuebingen has everything for effective treatment of prostate cancer: experienced surgeons, modern equipment, advanced treatment methods.
- University Hospital of Ludwig Maximilian University of Munich. Department of Adult and Pediatric Urology under the guidance of Prof. Dr. med. Christian G. Stief ranks among the TOP German healthcare facilities specializing in comprehensive prostate cancer treatment. In addition, the department is certified by the German Cancer Society as the Prostate Cancer Center. It is equipped with the innovative da Vinci Si HD robotic system and focuses on the tumor surgeries.
- Helios Hospital Berlin-Buch. Department of Urology under the guidance of Prof. Dr. med. Mark Schrader focuses on the minimally invasive and endourological procedures that are often combined with the systemic drug treatments. In addition, doctors of Helios Hospital Berlin-Buch collaborate closely, so patients with advanced prostate cancer can undergo palliative radionuclide therapy in the Department of Nuclear Medicine.
- HELIOS Clinic Krefeld. Department of Adult and Pediatric Urology under the guidance of Prof. Dr. med. Martin Friedrich offers men with prostate cancer precise diagnostics (MRI-guided biopsy, high-precision imaging studies), the full range of therapeutic interventions and chance to participate in clinical trials. In addition, doctors from HELIOS Clinic Krefeld are actively involved in the scientific and research activities.
- Marien Hospital Marl. Department of Adult and Pediatric Urology under the guidance of Dr. med. Hans-Jörg Sommerfeld is certified in according to the international quality standard DIN EN ISO 9001. This confirms high efficacy and safety of prostate cancer treatment, as well as vast practical experience and skills of doctors. All the surgical procedures in the department are performed with da Vinci robotic system.
Prostate cancer is treated at a high level in Israel. Israeli oncourologists successfully apply surgical and conservative treatment methods in this disease. As of today, the treatment in Turkey is becoming more and more popular. Patients are attracted by the opportunity to undergo high-quality medical care at affordable prices.
Cost of prostatectomy in different countries
Selection of the hospital for radical prostatectomy
Leaders in the treatment of prostate cancer are the countries of Central and Western Europe, particularly – Germany. When choosing a medical facility, it is necessary to take into account its specialization (for example, hospital may specialize in systemic therapy of prostate cancer, rather than in surgical treatment), the level of qualifications of doctors, the availability of equipment for minimally invasive interventions, the quality of postoperative care and rehabilitation, and other factors.
In the case of radical prostatectomy in German hospitals, the best treatment success rates are demonstrated in the following medical facilities:
- Helios Hospital Berlin-Buch, Department of Urology. The cost of radical prostatectomy starts from 17,700 EUR.
- University Hospital of Ludwig Maximilian University of Munich, Department of Adult and Pediatric Urology. The cost of the procedure starts from 19,900 EUR.
- Charite University Hospital Berlin, Department of Adult and Pediatric Urology. The cost of the procedure starts from 26,600 EUR.
As a rule, children and adults undergo treatment in the same department at the large university hospitals. This reaffirms the high qualifications of operating urologists and oncologists, who consider peculiarities of interventions in patients of different age groups.
How can I undergo treatment abroad?
Foreign hospitals admit not only local residents, but also foreign patients. However, the process of treatment organization abroad requires knowledge of specific questions. For a person who does not have such experience, it is better to delegate this task to a medical tourism agency.
Booking Health is a certified medical tourism operator. The company directly cooperates with leading foreign hospitals and can arrange a treatment there.
In addition, Booking Health provides the following services:
- Help in selection of the most competent clinic
- Communication with the clinic
- Translation of medical documents
- Provision of medical insurance
- Booking airline tickets and hotels, transfer from the airport and back, translation services and other questions
If you want to undergo treatment abroad, please leave a request on our website. The medical coordinator will contact you within the next few hours.
Choose treatment abroad and you will for sure get the best results!
Author: Dr. Nadezhda Ivanisova