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A prostatectomy is the
surgicalremoval 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 urinealong the urethra.
There are several forms of the operation:
Transurethral resection of the prostate:Also called a TURP, this is a cystoscope[A Resectoscope Rather, which has 30 degree of viewing angle, along with Resectoscopy Sheath & Working Element] 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(Nd:YAG) high powered "red" laser. A related laser procedure for relief of prostatic obstruction utilizes a potassium titanyl phosphate(KTP) laser to vaporize the adenoma. More recently the KTP laser has been supplanted by a higher power laser source based on a lithium triborate crystal, though it is still commonly referred to as a "Greenlight" or KTP procedure. The specific advantages of utilizing laser energy rather than a traditional electrosurgical TURP is a decrease in the relative bloodloss, elimination of the risk of TUR-syndrome, the ability to treat larger glands, as well as treating patients who are actively being treated with anti-coagulation therapy for unrelated diagnoses.3,4
*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 Radical Prostatectomy:a laparoscopic or four small incisions are made in the abdomen, and the entire prostate for prostate cancer.
*Robotic-assisted Laparoscopic Radical 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. 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] ] . While the cost of such procedures is high, costs are declining rapidly 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] ] .
Radical perineal prostatectomy:an incisionis made in the perineum, midway between rectumand 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 :This is also caleed a TUPVP.
* [http://www.prostate-answers.com/surgery-prostate.html Prostate Cancer Treatment Guide]
* [http://prostatecancer.info/prostatectomy-basics The Basics of the Prostatectomy Procedure Explained]
* [http://www.fightprostatecancer.org/site/PageServer?id=wp National Prostate Cancer Coalition]
3. Malex, RS. et al. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia:12-month results from the first United State multicenter prospective trial. J Urology: Vol. 172(4). Pages 1404-1408.
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