Рак предстательной железы: диагностика и лечение в Москве
Постоянная усталость, необъяснимая потеря веса, боли в области промежности или учащенное ночное мочеиспускание — повод не откладывать визит к урологу. Рак предстательной железы — злокачественное новообразование, характеризующееся неконтролируемым делением опухолевых клеток, их распространением в соседние ткани и образованием метастазов. Это самое частое онкологическое заболевание у мужчин старше 60 лет, при этом на ранних стадиях оно протекает практически бессимптомно — именно поэтому ежегодный скрининг является наиболее эффективным способом защиты.
В урологическом отделении «К+31» диагностика и лечение рака простаты проводятся консилиумом с участием профессоров, докторов и кандидатов медицинских наук в полном соответствии с международными протоколами доказательной медицины. Клиника располагает собственным центром робот-ассистированной хирургии da Vinci, что позволяет выполнять радикальную простатэктомию с максимальной точностью и минимальной травматичностью.
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treatment
When surgery becomes necessary
Benign hyperplasia (prostate adenoma)
Adenoma is the most common urological indication for surgery in mature and elderly men. This is not an oncological disease, but a natural process of enlargement of glandular tissue against the background of age-related hormonal changes. An enlarged prostate puts pressure on the urethra, causing:
- Difficulty urinating, requiring straining
- Frequent urges in small portions, including at night
- Imperative (sudden, urgent) urges
- Feeling of incomplete emptying of the bladder
- Episodes of urinary incontinence
In the early stages, drug therapy and physical therapy are effective, but with progressive enlargement of the gland and the risk of complications (chronic urinary retention, urinary tract infections) surgery remains the only radical solution.
Calculous prostatitis
Chronic inflammation of the prostate itself does not require surgery, but when calculi (stones) form in the ducts of the gland - the so-called calculous prostatitis - persistent pain syndrome, hemospermia and erectile dysfunction develop. The operation is indicated when the process is complicated by purulent foci against the background of an adenoma.
Prostate cancer
Prostate cancer is asymptomatic for a long time, so early detection and timely prostatectomy are critical for a favorable prognosis. At K+31, radical removal of the gland for cancer is performed, among other things, using the da Vinci robotic system - with the most accurate preservation neurovascular bundles responsible for erectile function and urinary continence.
Methods of surgical treatment of the prostate in K+31
| Method | The essence of the operation | When to use |
|---|---|---|
| Transvesical adenomectomy | Removal of adenoma through an incision in the bladder wall | Large prostate volume, concomitant pathology of the bladder |
| Retropubic adenomectomy | Access to the gland without opening the bladder | Reduced risk of bleeding compared to transvesical approach |
| Perineal adenomectomy | Perineal access | Rarely, with pathology of the anterior abdominal wall |
| Radical prostatectomy | Complete removal of the gland with capsule and part of the urethra | Prostate cancer |
| Laparoscopic prostatectomy | Removal through punctures under video camera control | Reduced trauma, quick recovery |
| Robot-assisted prostatectomy (da Vinci) | Maximum precise removal while preserving nerve bundles | Prostate cancer, function preservation priority |
| Prostate TOUR | Transurethral resection through the urethra | Adenoma volume up to 80 cm³, without oncology |
Laparoscopic and robotic techniques can significantly reduce blood loss, the intensity of postoperative pain and shorten the length of hospitalization compared to open interventions.
Preparation for surgery: diagnostic standard K+31
Before intervention on the prostate, the patient undergoes a comprehensive examination that complies with international protocols:
- General and biochemical blood test, coagulogram
- General urine test
- ECG and examination by a therapist, if necessary - a cardiologist, endocrinologist
- Determination of PSA (prostate-specific antigen) level
- Ultrasound of the prostate (transabdominal and transrectal)
- Urethroscopy and cystoscopy when indicated
- Rectal digital examination
- Consultation with an anesthesiologist
A few days before the operation, it is necessary to exclude alcohol and drugs that affect blood clotting, and 8 hours before the intervention - intake of food and liquid. All details of preparation are individually agreed upon with the attending physician and anesthesiologist.
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Recovery after prostate surgery
In the first days, the patient is in the hospital under the supervision of a urologist: the outflow of urine through the catheter is controlled, painkillers are prescribed, anti-inflammatory drugs and antibiotics. After removal of the catheter, rehabilitation continues at home for 1–2 months:
- Eliminate blood thinners
- Do not visit the bathhouse or sauna, avoid overheating
- Avoid constipation and straining
- Avoid heavy physical labor
- Refrain from intimate life for the period recommended by your doctor
To prevent and correct urinary incontinence, K+31 specialists develop an individual Kegel exercise program, strengthening the pelvic floor muscles. Sexual function after adenomectomy is usually preserved, since the nerve structures responsible for erection are not affected.
Frequently asked questions (FAQ)
Is it painful to have prostate surgery?
The intervention is performed under general anesthesia or spinal/epidural anesthesia, so the patient does not feel pain during the operation. In the postoperative period, discomfort is controlled with modern painkillers, and with endoscopic and robotic techniques, the pain intensity is minimal.
Will erectile function be maintained after prostate removal?
During adenomectomy, the nerve bundles, as a rule, are not affected, so sexual function is preserved. During radical prostatectomy for cancer in “K+31” Nerve-saving techniques are used, including the da Vinci robotic system, which significantly increases the chances of maintaining an erection.
Which surgical method is right for me personally?
The choice depends on the diagnosis, the volume of the gland, concomitant diseases and the general condition of the patient. Final decision is accepted by a urologist after a full examination - an exact recommendation can only be obtained during a consultation.
How long does it take to recover from surgery?
With endoscopic and robotic techniques, hospitalization is usually 2–5 days, full recovery is from 1 to 2 months. Open surgeries require longer rehabilitation.
How much does prostate surgery cost in K+31?
The cost depends on the chosen method: from TUR of the prostate to robot-assisted nerve-sparing prostatectomy. The exact price is determined by the doctor after diagnosis, taking into account the volume of intervention.
Do I need to go to the hospital early?
Yes, hospitalization occurs as planned after completion of the preoperative examination - tests, ECG, consultation with an anesthesiologist. The timing of preoperative preparation is specified by the attending physician.
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Preparation for surgery: diagnostic standard K+31
Before intervention on the prostate, the patient undergoes a comprehensive examination that complies with international protocols:
A few days before the operation, it is necessary to exclude alcohol and drugs that affect blood clotting, and 8 hours before the intervention - intake of food and liquid. All details of preparation are individually agreed upon with the attending physician and anesthesiologist.