Prostate removal: alternatives
L'prostate removalor prostatectomyis a surgical operation mainly for treating prostate cancer. It may also be indicated in certain cases of severe benign prostatic hyperplasia (bPH)When drug therapy or minimally invasive treatments are no longer sufficient. If this operation improves affected patients a localized cancerHowever, it can also have side effectsincluding erectile dysfunctiona urinary incontinenceor changes in the way seminal vesicles.
Why resort to prostate ablation?
L'total or partial removal of the prostate is generally recommended in the following situations:
- Localized prostate cancer : When the tumor is confined to the prostate, its removal completely eliminates the cancer cells and prevents them from spreading to the rest of the body. lymph nodesthe rectumthe bladder or the testicles.
- Severe prostate adenoma When theprostate adenoma leads to urinary disorders such as bladder retention or an inability to urinateand alternative treatments are no longer sufficient.
The choice of this intervention is based on a specialized urology careincluding a complete check-up with screening, biopsiesand evaluation of gleason score to determine the aggressiveness of prostate cancer.
How is surgery performed?
L'prostate removal can be achieved using several techniques:
- Total prostatectomy : Complete removal of the prostate glandoften indicated in cases of aggressive prostate cancer. It can be performed by open surgery, by endoscopic technique (laparoscopy) or with the help of a surgical robot.
- Partial prostatectomy : Removal of part of the prostate glandmainly in the case ofprostate adenoma voluminous.
- Transurethral resection of the prostate (TURP) A procedure endoscopic which consists of removing part of the prostate via theurethramainly to treatprostate adenoma and improve urination.
The operation takes place under general anesthesiawith installation a urinary catheter after the operation to help evacuate urine.
Life expectancy after prostatectomy
L'life expectancy after prostatectomy depends on a number of criteria, including patient's agethe cancer stageand the possible presence of metastases.
In case of prostate cancer
- Localized cancer : When detected early, removal of the prostate gland enables 10-year survival rate greater than 90 %.
- Advanced cancer If the tumor has grown beyond the prostate glandthe prognosis depends on complementary treatments as the radiotherapythe brachytherapy or thehormone therapy.
The gleason scorewhich assesses the aggressiveness of cancer cells, and the PSA levelwhich measures the presence of a prostate cancerare key indicators for adapting care.
In case of prostate adenoma
Removal of the prostate in cases ofbenign hypertrophy does not reduce life expectancy, but considerably improves the quality of life by reducing urinary disordersthe bladder retention and difficulty urinating.
Side effects and complications
Although the removal of the prostate allows treating cancerit can lead to side effects variable depending on the patient:
- Urinary incontinence Some people have bladder weakness after the operation, particularly in the first few months. Perineal rehabilitation is often necessary.
- Erectile dysfunction : The procedure may damage the nerves involved in erection, resulting in a loss of erection. impotence more or less reversible. Treatments such as testosterone or intracavernous injections are possible.
- Retrograde ejaculation Ejaculation may be absent or occur in the bladder, affecting fertility.
- Decreased seminal volume : Removal of seminal vesicles reduces seminal fluid production.
- Risk of infection The insertion of a urinary catheter can promote urinary tract infectionswhich require medical supervision.
Prostate embolization: an alternative to ablation
For affected patients d'prostate adenomathere is an alternative less invasive : embolization of prostatic arteries. This technique, performed by a interventional radiologistallows you to gradually reduce prostate volume by blocking certain arteries, without the need for asurgical operation.
Why embolization?
Without surgery : No general anaesthetic, no incision.
Fast, lasting results Immediate reduction in urinary disorders.
No catheterization after surgery.
Preserving sexual function No impact on erection or ejaculation.
Fast recovery Return home the same day and resume activities within 48 hours.
L'prostate artery embolization is therefore an effective, less invasive solution, particularly suitable for patients with prostate adenoma who wish to avoid a total prostatectomy.
Conclusion
L'prostate removal is an effective option for prostate cancer treatment and severe adenomasbut it can also lead to side effects significant. L'life expectancy after prostatectomy is generally excellent if the disease is detected early, but complications such asurinary incontinence or the erectile dysfunction can occur.
For affected patients d'prostate adenoma, l'embolization is a modern, efficient alternative to the traditional surgical operation while offering rapid and lasting improvements in urination and quality of life. A early detectiona active monitoringand regular follow-up in urology optimize the chances of success for cancer treatment.
