PROSTATE CANCER TREATMENT:THE ANATOMICAL RETROPUBIC APPROACH. BEFORE THE OPERATION

Are you in shape for surgery? Your doctor will want to check you out thoroughly beforehand. Surgery may be delayed if you’ve recently had other prostate surgery for BPH (see below), and it’s generally scheduled for six to eight weeks after a needle biopsy of the prostate. These delays give the body a chance to recover from the earlier procedures. Also, imagine a surgeon’s difficulty in trying to operate on inflamed, irritated tissue, where a needle has penetrated the rectal wall six times, and it hasn’t yet healed properly! A few weeks’ wait, though it may seem agonizing to a man who’s anxious to have the cancer removed as soon as possible, can be critical in helping the surgeon preserve the delicate neurovascular bundles and avoid injury to the patient’s rectum during the procedure.

Before surgery, when you give the doctor your medical history, be sure to say so if you’ve had any unusual problems with bleeding in the past (from dental work, for example). Also, aspirin can cause excessive bleeding; if you are taking aspirin regularly, make sure you stop at least ten days before the operation. Another point to discuss with your doctor: Many men who undergo radical prostatectomy need a blood transfusion during the procedure. The best blood for you to get, obviously, is your own; if your hospital allows this, it’s a good idea to donate several units of your blood ahead of time. This is another good reason for the six-to-eight-week delay; it gives you plenty of time to make up your own blood bank. The night before surgery, you’ll be given an enema and perhaps some laxatives, as well. Or, if you’re scheduled to be admitted the day of your surgery, you may be asked to give yourself an enema or take laxatives the night before. You’ll probably be told not to eat anything the night before surgery, as well.

This is how some men find out they have prostate cancer—when the prostate tissue removed in a TUR procedure or open prostatectomy is evaluated by a pathologist. It’s more difficult for surgeons to perform a radical prostatectomy after an open prostatectomy, but that doesn’t mean it can’t be done. It often is, and with greater success. You may be told to wait, however, about twelve weeks after a TUR procedure, until the inflammation from this operation has gone down.

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