Prostatectomy
From Wikipedia, the free encyclopedia
| Intervention: Prostatectomy |
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| ICD-10 code: | ||
| ICD-9 code: | 60.2 - 60.6 | |
| MeSH | D011468 | |
| Other codes: | ||
A prostatectomy is the surgical removal of all or part of the prostate gland. Abnormalities of the prostate, such as a tumour, or if the gland itself becomes enlarged for any reason, can restrict the normal flow of urine along the urethra.
There are several forms of the operation:
- Transurethral resection of the prostate (TURP): a cystoscope[A Resectoscope Rather, which has 30 degree of viewing angle, along with Resectoscopy Sheath & Working Element] is passed up the urethra to the prostate, where the surrounding prostate tissue is excised. This is a common operation for benign prostatic hyperplasia (BPH) and outcomes are excellent for a high percentage of these patients (80-90%). A more refined and safer operation is by means of a holmium(Nd:YAG) high powered "red" laser. A related laser procedure for relief of prostatic obstruction utilizes a potassium titanyl phosphate(KTP) laser to vaporize the adenoma. More recently the KTP laser has been supplanted by a higher power laser source based on a lithium triborate crystal, though it is still commonly referred to as a "Greenlight" or KTP procedure. The specific advantages of utilizing laser energy rather than a traditional electrosurgical TURP is a decrease in the relative bloodloss, elimination of the risk of TUR-syndrome, the ability to treat larger glands, as well as treating patients who are actively being treated with anti-coagulation therapy for unrelated diagnoses.3,4
- Open Prostatectomy: A surgical procedure involving a skin incision and enucleation of the prostatic adenoma, through the prostatic capsule (RPP-retropubic prostatectomy) or through the bladder (SPP-suprapubic prostatectomy). Reserved for extremely large prostates.
- Laparoscopic Radical Prostatectomy: a laparoscopic or four small incisions are made in the abdomen, and the entire prostate for prostate cancer.
- Robotic-assisted Laparoscopic Radical Prostatectomy: Laparoscopic robotic arms are controlled by a surgeon. The robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy: much smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.[1]. While the cost of such procedures is high, costs are declining rapidly [2].
- Radical perineal prostatectomy: an incision is made in the perineum, midway between rectum and scrotum, and the prostate is removed. Radical prostatectomy is one of the key treatments for prostate cancer.
- Radical retropubic prostatectomy: an incision is made in the lower abdomen, and the prostate removed, by going behind the pubic bone (retropubic). Radical prostatectomy is one of the key treatments for prostate cancer.
- Transurethral plasmakinetic vaporization prostatectomy (TUPVP).
[edit] External links
[edit] References
- ^ Center for the Advancement of Health; August 29, 2005; Robot-assisted Prostate Surgery Has Possible Benefits, High Cost [1]
- ^ Cost Analysis of Radical Retropubic, Perineal, and Robotic Prostatectomy; Scott V. Burgess, Fatih Atug, Erik P. Castle, Rodney Davis, Raju Thomas; Journal of Endourology 2006 20:10, 827-830 [2]
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3. Malex, RS. et al. Photoselective vaporization of the prostate for the treatment of benign prostatic hyperplasia:12-month results from the first United State multicenter prospective trial. J Urology: Vol. 172(4). Pages 1404-1408.
