Bladder capacity is usually reduced somewhat by the surgery, but the main cause is that, after surgery; the bladder wall is swollen and thickened and irritable. Normally, the bladder wall is thin and elastic and maintains a low pressure until it has stored 8 to 10 ounces of urine. After surgery, the swollen bladder does not store much urine at a low pressure. As soon as it starts to fill, the pressure goes up and you feel the need to urinate.

A radical robotic prostatectomy incorporates the advantages offered with laparoscopy together with the delicate maneuvers and techniques previously only available with open surgery. Standard laparoscopic instruments can be cumbersome and do not avail themselves to delicate surgical procedures. Minimally invasive robotic radical prostatectomy allows the surgeon to perform sensationally an "open" radical prostatectomy without the need for the large incision.

bull;Greater surgical precision, which, in turn, potentially means more accurate removal of cancer and reduced risk of impotence and incontinence

While the da Vinci technology allows for the precise translation of the surgeon's movements while eliminating any tremor present in all surgeons’ hands it does not provide tactile feedback. As surgeons however, we rely on tactile sensation only when we do not have an accurate or clear view of the operative field. The camera system utilized with the da Vinci system is a clear 3 dimensional field with ten times the magnification of even the surgeon with 20-20 vision.

It is not possible to say for certain where the recurrent cancer is located, but there is about a 70% chance that it is in the “bed of the prostate” (where the prostate used to be). Accordingly, radiotherapy has a good chance of controlling it. After the prostate gland has been completely removed, any PSA in the blood is produced by prostate cancer cells that have left the prostate gland and spread to other areas of the body.

With any cancer, not only prostate cancer, there’s always a possibility that the cancer can come back and that’s why patients need to have follow up visits. I recommend a PSA test every six months for 15 years after the operation.

The two treatment options are postoperative radiotherapy, which should begin before the PSA rises above 1.0ng/ml, and intermittent or continuous hormonal therapy, which can be initiated immediately or delayed until the PSA rises to 4.0.

This swelling could be related to lymph node dissection, which sometimes causes swelling in the groin, penis, scrotum, and pubic area. In such circumstances, I recommend a visit to the surgeon and perhaps a CT scan of the abdomen and pelvic region.

Diagnosis of prostate cancer can, understandably, be an emotional and difficult experience for many patients. Your fears, concerns, questions, and opinions are welcomed and valued as part of your treatment. Communication with Dr. Gholami and the office staff is recommended to maintain rapid recovery. Support groups may also prove helpful in dealing with frustrations and other feelings associated with cancer.

Usually, the patient is in the hospital for 2 to 3 days. The catheter remains for 10 days. The patient can drive once the catheter is out. No vigorous exercise should be performed for 6 weeks. The patient can return to work after 3 or 4 weeks, but he usually tires easily because of anemia for the first 6-8 weeks.

IMRT (Intensity-Modulated Radiation Therapy) is one of the best forms of radiation therapy. It is computer-controlled radiation that delivers precise doses to malignant tumors or specific areas within a tumor with minimal effect on other tissue. The technology allows for higher and more effective doses to be delivered without damaging surrounding tissue. But there is a statistical issue about how the results are reported that make them appear 10% to 20% better than they really are.

Yes, nerve sparing radical prostatectomy was started in the early 1980's. I have been performing this operation since 1984 with very rewarding results.

The short answer is “yes.” I believe that it will pay dividends to strengthen the muscles before surgery.

Erections usually begin to return as partial erections 3 to 6 months after surgery and then continue to improve for about 36 months after surgery, as the nerves recover from the trauma of surgery. Despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is uncommon. Even when the nerve-sparing surgery is performed with meticulous technique, patients do not recover erectile function as quickly as they do urinary continence.

Radical prostatectomy is the usual surgical option for early prostate cancer. It involves having a general anaestetic and staying in hospital for approximately 6 days. You will be infertile afterwards and may have temporary incontinence and impotence, which is often treatable. The operation may be followed up with radiotherapy or hormone therapy to deal with any remaining cancer cells.

In the most recent tabulation of my surgical patients, now including more than 4,400 men, the 10-year prostate cancer-specific survival rate is 96%. This statistic means that whether or not there has been a recurrence of the prostate cancer, only 4% of men died of prostate cancer before 10 years after surgery. These statistics are for my patients. General statistics could be different.

Yes, it can. To the extent that enlargement of the prostate is contained, pressure on the bladder is minimized, thereby decreasing the urgency for urination.

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It is not unusual for the male to experience some burning (dysuria) during urination following ejaculation. This is the result of friction developed along the urethra (the lining of the penis) during the act of sexual intercourse or masturbation. Urine moving along the urethra creates a burning sensation. It should not be considered a sign of any active disease or indicative of injury to the penis but rather a natural event.

The hospital stay for prostatectomy averages about five days and depends mostly on the nature of the surgery and the health status of the patient. In addition, a high level of patient support from others, including family, relatives, and friends, can promote the healing process and shorten the hospital stay.