Life after prostate removal: what patients should know before surgery

At 64, Suresh (name changed), had a comfortable and active life. Apart from a small urinary problem that he linked to a slightly enlarged prostate, he had no serious health problems. At his annual health checkup, which included a standard prostate-specific antigen (PSA) test, it was found that Suresh’s PSA levels were raised. This led additional testing, including an MRI that revealed a concerning prostate lesion and a biopsy that verified early-stage prostate cancer. To find out whether the cancer had spread beyond the prostate gland, a PSMA PET scan was requested and fortunately, the results indicated that the cancer was still confined to the prostate. A surgical team decided to perform a robot-assisted radical prostatectomy, a minimally invasive surgical procedure that removes both the prostate gland and the surrounding lymph nodes, because of his general good health and the fact that the disease was still in its early stages. After surgery, Suresh recovered well and was discharged from the hospital within a few days.

What happens after surgery

Even though robotic surgery improves accuracy, leads to quicker recovery and better outcomes, there are certain factors with regard to post-surgical realities that all patients who are undergoing a prostatectomy (removal of the prostate gland), should be informed about. These include:

Transient urine leakage: Urinary incontinence, or a small flow of urine that occurs during a cough, sneeze, or exertion, is a common occurrence in men. This can last anywhere from a few weeks to several months, though it is usually transient. Kegel or pelvic floor exercises improve bladder control and speed of recovery both before and after surgery.

Erectile function: The manipulation of the nerve during robotic prostate surgery could result in temporary erectile dysfunction after the procedure, even when using nerve-sparing techniques. Many people slowly regain function over time as the outcome of taking medication, exercising, and adopting better lifestyle practices.

Further treatments: A small percentage of patients might be advised to receive radiation treatment if there is concern about potential microscopic disease or if their PSA levels are elevated once again, even though most early-stage prostate cancer cases are treated by surgery alone. Every patient is unique, and through follow-up assessments, their treatment is adjusted as necessary.

Regular follow-ups, a must

Regular monitoring is essential after surgery. To be sure that the cancer has not reappeared, PSA testing is carried out at predetermined intervals.

Suresh began walking and took up light duties just a few weeks after surgery. He maintained his follow-ups, a healthy diet, and regular exercise. His energy levels eventually restored to normal, and his ability to regulate his urination increased.

Also Read: What is stereotactic radiation therapy for prostate cancer? How does it compare to other treatments?

When detected early, prostate cancer is a very treatable condition. These days, patients can get back to everyday activities with few difficulties because of procedures such as robot-assisted radical prostatectomy. If the procedure is done early on, a robotic prostate removal not only offers superior cancer management but also quicker recovery with minimal or no pain, while preserving function.

A return to normal life can be aided by being aware about early screenings, post-prostatectomy expectations, and by ensuring a well-organised recovery plan is in place.

(Dr. Rahul Wagh is a consultant in surgical oncology, Manipal Hospital, Baner, Pune Rahul.wagh@manipalhospitals.com)