Scientific trials in support of prostatectomy

Radical prostatectomy refers to the surgical removal of the entire prostate. It may also require the removal of the surrounding tissues, a portion of the urethra, and the seminal vesicles. It is a very delicate process that can be performed only by a highly-skilled and experienced urologist or a high-precision robot because one wrong move and the patient will have urination and erection problems for the rest of his life.

In a normal setting, no man would ever want to have his prostate gland removed. It is, after all, related to his sexual organ and there alternative treatments available that they can try first. Only in the following cases would urologists strongly advise their patients to have their prostate gland removed:

1. A severe case of benign prostatic hyperplasia (BPH) — Prostate enlargement is as natural as the graying of hair in men. However, urologists advise their patients to get prostate removal if the prostate is greatly enlarged and, as a result, caused considerable damage to the wall bladder. Patients who are suffering from obesity are more likely to be advised to have their prostate removed than normal, healthy patients.

2. Cancer is limited to the prostate gland — If your urologist has determined that your cancer is confined to your prostate gland and has not spread to the nearby areas, then radical prostatectomy is the most effective form of treatment currently available. Your urologist will use the TNM (Tumor, Node, Metastasis) staging system to determine whether you are a suitable candidate for this operation along with other exams in his arsenal. Before you agree to it, get informed and find out the pros and cons of radical prostatectomy.

What complications can be caused by a Da Vinci prostatectomy?

Since it first hit the market in 2000, the da Vinci Surgical System has been reported to cause a number of complications when used during prostatectomies, a procedure that involves the surgical removal of all or part of the prostate gland. Because the prostate is centered around many blood vessels, intraoperative and postoperative blood loss is the most commonly reported da Vinci prostatectomy complication. Other complications may include deep vein thrombosis (a blood clot that originates in the legs or pelvic region), and herniation of the bowel at the site where the robot enters the abdominal cavity.

Due to the prostate’s location and function, other possible da Vinci prostatectomy complications may include incontinence and erectile dysfunction (ED). After the procedure is completed, most patients will experience some degree of incontinence during the recovery period. This is because control of urinary function resides with a number of muscles, one of which is located in the prostate.

The greatest concern in patients is the possibility of losing the ability to erect due to damage to the nerves because of operation. However, recent studies have shown that more than 80% of men restore sexual function completely, another 10 get an erection of sufficient strength for full sexual intercourse.

Radical prostatectomy and  clinical research trials: prostatectomy of the future

Radical prostatectomy and clinical research trials include combining several treatments to those that medically qualify. The National Cancer Institute has a database of ongoing clinical trials around the world. With over 150 ongoing prostate cancer trials progress is being made in the cancer treatment options. Some trials are new treatment options, other trials are new treatments to correct side effects of cancer or side effects of the treatments themselves. Since every patient has their unique physiology and level of prostate cancer, the doctors will plan your treatment for the best outcome, by using all available means.

Emerging technology is now bringing the cost of a person’s complete genome within reach for everyone by 2021. Already personal exomes are available for the consumer. These personal genomes are giving the ability to find out the susceptibility to prostate cancer, and which medications we may be allergic to, even what medications would work or not work on each individual.

Radical prostatectomy and clinical research trials are changing the surgical models by attacking each cancer cell and not harming healthy cells. Clinical trials have begun to use nanoparticles to find and destroy cancer cells and as they become available Urology Specialists will offer them to the patients. Nanoparticles include nanoshells, quantum dots, and dendrimers. Nanoshells are a gold or iron molecular sphere that surrounds molecules of silica. Attaching an antibody to the nanoshell helps send it to the prostate cancer cells. Once injected into the bloodstream, millions of nanoshells will attach themselves to a cancer cell. Then an imaging device will show the doctor that the nanoshells are at the prostate cancer cells. Once the nanoshells are at the cancer site infrared light will be aimed at the prostate which then heats up the nanoshells and destroys the cancer cells while the healthy prostate cells remain unaffected.

Dendrimers and quantum dots are other nanoparticles that are being tested to find their way into cancer cells, light them up under imaging devices, and then kill the cancer cells without damaging the healthy cells right next to them. Microscopic strips of RNA are being used to stop cancer cells by canceling out important proteins that create new cancer cells, stopping cancer from growing. That method is called RNA interference (iRNA). Gene therapy to boost the immune system so that it kills cancer is another tact that the emerging future of human genetic engineering is trying to accomplish. Stem cell technology for tissue regeneration is paving the way to repair the damage created from cancer and aging.


The article is written by licensed urologists: Dr. David M. Kaufman and David M. Weiner, MD. If you have any questions after reading the article, you can contact us by asking a question in the feedback form

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