Doctors for Prostatectomy in Kolkata

A prostatectomy is a surgical technique used to partially or completely remove the prostate gland, a tiny gland located in the male pelvis beneath the urinary bladder. The prostate gland surrounds the urethra, which serves as the passage for urine and semen to exit the body. By removing the affected portion of the prostate, a urologist aims to address various conditions that can impact this gland. During a prostatectomy, a skilled surgeon carefully removes the prostate gland, ensuring the preservation of surrounding tissues and structures. These surgical procedures are used to treat diseases like prostatitis, benign prostatic hyperplasia (BPH), and prostate cancer. The prostate gland, being a vital component of the male reproductive system, contributes additional fluid to the ejaculate. It plays a role in the ejaculation process, as the semen from the prostate enters the urethra during orgasm, and the surrounding muscles contract to propel the semen out of the urethra.

There are two primary types of prostatectomy procedures employed in the field of urology.

• Simple Prostatectomy: In a simple prostatectomy, the surgeon focuses on removing the inner portion of the prostate gland while leaving the outer part intact, much like the process of eating an orange. This surgical approach involves making a vertical incision in the lower abdomen, through which the inner portion of the prostate is carefully removed. Alternatively, the surgeon may opt for a laparoscopic method, which involves making a few small incisions in the abdomen and using specialized tools and a camera to remove the inner portion of the prostate gland. Laparoscopic surgery is considered less invasive compared to traditional open surgery.
• Radical Prostatectomy: A radical prostatectomy involves the complete removal of the prostate gland, along with any surrounding fat, tissues, seminal vesicles, and occasionally lymph nodes.The procedure aims to eliminate the cancerous or problematic tissue entirely. Both open surgery and laparoscopic procedures can be used to accomplish a radical prostatectomy;
1. In an open radical prostatectomy , a vertical incision is made between the belly button and pubic bone to access and remove the prostate.
2. In a laparoscopic radical prostatectomy , laparoscope and surgical tools are placed through tiny incisions.
3. In certain cases, a robotic-assisted approach, known asrobotic laparoscopic radical prostatectomy , may be employed, where the surgeon controls a robot's arms to perform the procedure with enhanced precision and maneuverability.
• Single Port Robotic Radical Prostatectomy: Furthermore, a newer technique called single-port radical prostatectomy has emerged, primarily using robotic assistance. This procedure involves instruments entering through a single small incision in the lower abdomen, resulting in reduced invasiveness, faster recovery, and minimal scarring. The availability of this procedure, however, may differ between hospitals due to its new introduction, so it's vital to keep that in mind.

As part of the preparation for a prostatectomy in Kolkata, a series of diagnostic tests and assessments are routinely performed to comprehensively evaluate your health condition and ensure optimal readiness for the surgical procedure. These tests are carefully designed to gather essential information about various aspects of your well-being, including your overall health, kidney function, cardiovascular system, and respiratory function. The specific tests employed may vary based on individual patient factors and the preferences of the attending medical team. Here are several commonly performed tests that contribute to a comprehensive assessment;

• Blood Tests: Blood tests are commonly carried out to assess your general health and provide valuable information about various aspects of your body's functioning. These tests may include a complete blood count (CBC) to evaluate red and white blood cell counts, kidney function tests to assess renal health, and liver function tests to assess liver enzyme levels and overall liver function. Additionally, blood clotting tests may be conducted to ensure your blood is clotting normally.
• Electrocardiogram (ECG): An electrocardiogram is a non-invasive test that assesses the electrical activity of your heart. By measuring the electrical impulses, an ECG provides information about the rhythm and function of your heart. This test is crucial to ensure that your heart is healthy and can withstand the stress associated with surgery.
• Lung Function Tests: Lung function tests, also known as breathing tests, are conducted to assess the health and efficiency of your respiratory system. These examinations gauge a number of factors, including lung capacity, airflow, and the capability to exchange oxygen and carbon dioxide. Lung function tests help identify any underlying respiratory conditions and provide valuable information for anesthesia management during the surgical procedure.
• Echocardiogram: A painless examination called an echocardiography uses sound waves (ultrasound) to produce images of your heart. It provides detailed information about the structure and function of your heart, including the chambers, valves, and blood flow patterns. This test allows the medical team to evaluate the overall health of your heart and detect any abnormalities or pre-existing conditions that may impact the surgery or anesthesia.

Prostatectomy is performed after thorough consultations with healthcare providers who determine the most suitable approach for each patient. There are two main types: robotic prostatectomy and open prostatectomy. The typical duration of the procedure is 2-4 hours. A robotic prostatectomy often requires a hospital stay of 1-2 days, while an open prostatectomy may require 3-4 days. The decision of anesthesia is made by the surgical team and the patient. Before the surgery, general health assessments and discussions take place, enabling the healthcare provider to evaluate the patient's overall condition.

• Preparation for Prostatectomy: Prior to a prostatectomy, patients undergo a thorough preoperative preparation to ensure their readiness for the procedure. This involves a comprehensive evaluation of their general health status. To determine general health, vital indicators including temperature, pulse, and blood pressure are taken. It is crucial for patients to disclose all prescription and over-the-counter medications they are taking, including herbal supplements, as certain medications can increase the risk of bleeding. Temporary discontinuation of specific medications may be required before surgery, and it is essential to consult with a healthcare provider regarding the management of medications.
• Anesthesia and Incision: During a prostatectomy, a specialized team of healthcare providers, including urologists, anesthesiologists, and nurses, collaborate to ensure a safe and successful procedure. The patient is administered general anesthesia by the anesthesiologist, which induces a state of unconsciousness, ensuring a pain-free experience throughout the surgery. A urinary catheter is implanted to drain the patient's bladder of urine into a collection bag after the patient has been given general anesthesia.
• In an open prostatectomy, the urologist makes a vertical incision (suprapubic) between the navel and pubic bone, or sporadically in the skin between the anus and scrotum (perineum). This incision allows clear visibility of the prostate and surrounding tissues. The incision typically ranges from 6 to 12 inches. Following the removal of the prostate gland, the incision is closed using sutures or small metal staples. In some cases, a small silicone tube known as a surgical drain may be inserted to remove excess blood or fluid, which is usually removed a few days after surgery.
• A laparoscopic prostatectomy is carried out by a urologist utilizing minimally invasive methods. In this method, a laparoscope and specialized surgical tools are inserted through tiny incisions, usually less than 3/4 of an inch. With the assistance of the laparoscopic tools, the surgeon carefully removes the prostate gland and seminal vesicles, reconnects the urethra to the bladder using sutures, and may conduct lymph node evaluation as necessary. In comparison to open surgery, laparoscopic prostatectomy has the advantages of smaller incisions, less scarring, and perhaps a quicker recovery.
• In a robotic prostatectomy, the urologist uses a scalpel to create one small incision (single port prostatectomy) or multiple extremely small incisions (multi-port prostatectomy). These incisions, no larger than 3/4 of an inch, serve as entry points for the laparoscope and robotic surgical equipment. With the assistance of the robotic system, the surgeon meticulously removes the prostate gland and seminal vesicles, reconnects the urethra to the bladder using sutures, and may perform lymph node evaluation.
• Post-Surgery and Recovery: Following the completion of the prostatectomy, the incision sites are covered with bandages or skin glue. The effects of anesthesia gradually wear off, and the patient regains consciousness in the recovery room, where healthcare providers monitor their overall well-being and administer pain management techniques as necessary. With the right medication, nausea, a frequent side effect of anesthesia, can be managed.

Patients are placed on a liquid diet for one to two days to allow for a smooth recovery process. As healing progresses, solid foods are gradually reintroduced. The day following surgery, patients are encouraged to get out of bed and move, as early mobilization is advised. Walking boosts blood flow, speeds up recovery, and lowers the chance of problems like blood clots and pneumonia. After a prostatectomy, urinary catheters are routinely needed, albeit the length of time depends on the surgical technique and the particular patient.

Prostatectomy offers several significant benefits for patients facing prostate-related conditions. Here are the various benefits of prostatectomy, ranging from improved disease management to enhanced quality of life;

• Disease Control and Cure: Prostatectomy is an effective treatment option for prostate cancer, providing the potential for complete removal of cancerous tissue. By eliminating the prostate gland, including any tumors or malignant cells, the procedure aims to eradicate the disease and prevent its spread. This can significantly enhance the chances of long-term disease control and potentially achieve a cure.
• Symptom Relief: For individuals experiencing bothersome urinary symptoms due to benign prostatic hyperplasia (BPH), prostatectomy offers relief and improved quality of life. The surgery reduces symptoms like frequent urination, poor urine flow, urgency, and incomplete bladder emptying by eliminating the obstructive prostate tissue that causes urinary issues. Restoring normal urinary function can greatly enhance comfort and well-being.
• Prevention of Complications: Prostatectomy can help prevent potential complications associated with prostate conditions. For example, in cases of chronic prostatitis or recurrent urinary tract infections (UTIs) that are unresponsive to conservative treatments, surgical removal of the prostate may be considered. By eliminating the source of infection or inflammation, the procedure can reduce the likelihood of recurrent complications and promote better long-term health.
• Improved Long-Term Survival: In cases of localized prostate cancer, where the disease is confined to the prostate gland, prostatectomy has been associated with improved long-term survival rates. By removing cancerous tissue at an early stage, the procedure can effectively eliminate or control the disease, increasing the chances of prolonged survival and reducing the risk of cancer progression.
• Enhanced Quality of Life: Overall quality of life may be significantly improved with prostate removal. By addressing prostate-related conditions, the procedure can alleviate symptoms, improve urinary function, and restore sexual health and potency in appropriate cases. This restoration of normal function can lead to increased confidence, psychological well-being, and a better overall quality of life for patients.

Prostatectomy is an effective intervention for various prostate-related conditions. While it offers several benefits, it also has some potential side effects that may arise as a result of the procedure;

Urinary Incontinence: One of the common side effects following prostatectomy is urinary incontinence, which refers to the loss of bladder control. The extent and duration of incontinence may vary among individuals. While most patients experience temporary incontinence that gradually improves over time, a small percentage may require long-term management strategies, such as pelvic floor exercises or the use of absorbent pads.

• Erectile Dysfunction: Another possible side effect of prostatectomy is erectile dysfunction, which refers to the inability to obtain or sustain an erection strong enough for sexual engagement. The likelihood and severity of erectile dysfunction depend on various factors, including the patient's age, pre-existing sexual function, and the extent of nerve-sparing techniques used during surgery. However, advancements in surgical techniques and the availability of post-operative treatments, such as medications or penile rehabilitation programs, have improved the chances of recovery.
• Infertility: Prostatectomy typically results in infertility, as it involves the removal of the prostate gland, which contributes to the production of seminal fluid. Individuals who desire to father children after surgery may consider options such as sperm banking or assisted reproductive techniques before undergoing the procedure.
• Changes in Orgasm: Some individuals may experience changes in orgasm following prostatectomy. These changes can include decreased intensity, altered sensation, or absence of ejaculation. The impact on orgasmic function can vary among patients, and it is important to note that these changes do not affect sexual pleasure or the ability to experience sexual satisfaction.
• Bowel Dysfunction: In rare cases, prostatectomy can result in bowel dysfunction, such as bowel urgency or changes in bowel movements. These symptoms are typically temporary and resolve within a few weeks to months after surgery. However, patients should consult their healthcare providers if they experience persistent or severe bowel dysfunction.

The recovery process following a prostatectomy, a surgical procedure to remove the prostate gland, requires time and proper care to ensure optimal healing. Patients can usually anticipate a few week recovery period. After spending a few days in the hospital, it is important to allow oneself ample time to recuperate at home. Most patients can return to their regular activities 6 to 8 weeks after surgery. Here are the recommended steps for a successful recovery after prostatectomy, including estimated recovery time and essential considerations;

• Immediate Postoperative Care: Right after the procedure, you will be transferred to your room, where you will have small bandages over the incision sites, a drain attached to a vacuum container, and a urine catheter (Foley) connected to a urine bag. Intravenous (IV) fluids will be administered initially, but this will be discontinued the day after surgery. As required, painkillers will be given to help with any discomfort.
• Early Ambulation and Activity: Early mobilization is crucial for a speedy recovery. Once you are ready, it is recommended to sit up and take short walks within the hospital premises. Walking encourages bowel movement, enhances blood flow to the legs, and lowers the chance of blood clot development. We encourage patients to aim for a total of one mile or approximately 25 laps around the hospital wing, gradually increasing the distance as tolerated.
• Dietary Progression: Initially, a liquid diet will be provided the morning after surgery, followed by a gradual transition to solid foods once intestinal gas is passed, and a bowel movement is achieved. It is common for patients to experience a delay in passing intestinal gas and having a bowel movement, which may take several days. Adhering to the prescribed dietary guidelines and monitoring bowel function is essential during this phase.
• Breathing Exercises and Lung Expansion: To prevent respiratory complications and infections, you will be provided with a breathing device called a spirometer. It is important to use the spirometer every hour, taking ten consecutive deep breaths with the device in your mouth. This helps expand the lungs, clear secretions, and maintain optimal lung function throughout the recovery period.
• Discharge and Home Recovery: The majority of patients can go home the day after a robotic prostatectomy. You will be given comprehensive instructions on wound care, medication administration, and activity limitations prior to release. It is essential to strictly adhere to these instructions and show up for any scheduled follow-up meetings in order to track your development.