What are the precautions for surgical treatment of prostate cancer

At present, there are many treatments for prostate cancer, and surgical treatment is the best way to cure prostate cancer, and it is also the best choice for controlling prostate cancer in the later stage.

5 major surgical treatments for prostate cancer

1. Bilateral orchiectomy: Removal of the testicle removes the source of testosterone production, so that androgen-dependent prostate cancer grows slowly or regresses. The procedure is simple, safe and has few side effects. Castration levels can be achieved within 12 hours after surgical resection (serum testosterone concentration less than 1.75 mmol/L). However, after orchiectomy, it can cause secondary adrenal cortical reticular zone proliferation, which leads to hypersecretion of androgens in the adrenal glands. Therefore, surgery is often performed in combination with other therapies to achieve better results. Testicular removal for prostate cancer remains an effective treatment.

2. Radical prostatectomy: The scope of radical prostatectomy surgery includes the prostate body and prostate capsule to eliminate all tumor tissues in the body. The surgical route is a perineal or retropubic incision, and now a retropubic incision is mostly used. The degree of tumor infiltration and the presence of lymph node metastases in the pelvic area can be explored at the same time as the posterior part of the bladder floor and near the seminal vesicles. Generally, patients who are suitable for radical prostatectomy only account for 5%~10% of all cases.

3. Pelvic lymph node dissection: the incidence of pelvic lymph node metastasis of prostate cancer is high, so the pelvic lymph node metastasis should be fully checked during the operation. If metastases are found, pelvic lymph node dissection should be performed at the same time.

4. Extended radical prostatectomy: the use of high-frequency electrosurgical knife to extensively remove the local tumor in situ, especially to remove the base of the bladder, seminal vesicles and the remnants of the vas deferens, the fascia behind the bladder and the urogenital diaphragm around the urethra around the membranous urethra.It is mainly suitable for stage C prostate cancer and should be used in combination with interstitial radiation therapy, but such extensive expansion of surgery has not achieved satisfactory results.

5. Transurethral resection of the prostate (TURp): It is suitable for the elderly and frail patients who have complications such as urination obstruction, and for those whose local lesions have reached stage C, TURp can only relieve the symptoms and have no possibility of cure. TURp is preventableuremiaIn order to improve the quality of life of patients, many patients can be treated with repeated transurethral resection to alleviate bladder orifice obstruction. If it can be supplemented with non-surgical treatment, it can improve the value of surgical treatment, unlike ordinary TURp surgery, due to the invasion of cancer masses, the boundary markers (such as the sperm mons) are no longer very clear, and care should be taken not to damage the external sphincter during surgery.

Precautions for surgical treatment of prostate cancer

1. After the operation, the patient's penile function will be damaged to a certain extent, which will bring mental torture to the patient. After surgeryErectile dysfunctionIt is very common that surgery can damage bilateral vascular bundles of the penisErectile dysfunction。 Patients with loss of sexual ability, distress, and low self-esteem should be given effective psychological counseling.

2. After surgical treatment, the patient may not be able to control his urine independently, which also requires active care.Postoperative urinary incontinence is due to injury or traction of the urethral sphincter and can manifest as permanent or temporary incontinence. Due to the inability to control urination, the quality of daily life is seriously affected, and the patient has long-term urinary incontinence, which is prone to secondary skin infections of the urinary tract and vulva. Patients with temporary urinary incontinence after catheter removal should be well prepared. In order to cooperate with the continuation of treatment after surgery, patients are guided to overcome postoperative tension and anxiety and build confidence in treatment. Patients should be instructed to perform pelvic floor muscle exercises, i.e., lying flat in bed to reduce abdominal pressure and increase urethral closure pressure, while constricting the anus.