Cover Story
A common treatment for prostate cancer is surgery to remove the prostate gland . This is a radical prostatectomy . And many men still do not understand that prostate cancer , may lead to infertility .
The Da Vinci Surgical System
said Dr . Colin Teo .
It is widely recognised that robotic surgery offers several advantages over traditional open surgery . For one it reduces recovery time : Patients can often return to normal activities in two to three weeks , compared to six to eight weeks for open surgery . Robotic surgery uses small keyhole incisions , resulting in less pain , less bleeding and smaller scars .
The robot ’ s arms can reach places that a surgeon ’ s hands can ’ t , and they ’ re free from hand tremors , offering greater precision and better dexterity .
Robotic surgery is similar to another minimally invasive procedure called laparoscopic surgery , but robotic surgery uses a more advanced camera and instruments . Not to be mistaken as zero or non invasive , a robot surgery does have some amount of invasiveness as any keyhole surgery ,
“ Prostate-specific antigen ( PSA ) is a protein produced by the prostate gland that is used as a tumor marker to screen for prostate cancer . It gives a urologist an indication from the blood test , that measures the amount of PSA in a man ’ s blood , to diagnose and treat prostate conditions . But to me and most urologists out there , MRI is still the way to go ” Dr Teo said .
HIFU and NBI Dr Teo further explained that minimally invasive techniques like cryoablation , radio-frequency ablation and high-intensity focused ultrasound ( HIFU ), which is an ongoing stage of refining , allowing better oncological outcomes and expanding their indications . HIFU is a minimally invasive treatment that uses sound waves to treat a variety of conditions , including prostate cancer , pain from cancer in general and skin tightening . HIFU works by focusing sound waves onto a targeted area of tissue , generating heat that destroys or modifies the tissue . The treatment is noninvasive , doesn ’ t require incisions , and can be repeated as needed .
Narrow band imaging ( NBI ) is a technological advance whose impact in the management of bladder cancer will be visible in the next few years . It is safe , can be performed for diagnosis or resection , has limited initial cost and does not require additional materials . NBI has a greater ability to detect cancerous tissue compared with the currently prevalent white-light cystoscopy , with research finding that the use of NBI in transurethral resection of bladder tumours reduced tumour recurrence . Whilst this imaging may benefit those with nonmuscle invasive bladder cancer , it may have further ramifications for other urological cancers .
Miniaturization , optical technology and robotics constitute the future of surgery . The use of state of the art imaging that avoids radiation exposure has the potential to revolutionize diagnostics . There is even a real possibility of tiny nano-bots and nano-biotics coursing through the bloodstream to their targets
Dr Colin ’ s Patient Story A then 50 + year old male patient of mine , an affluent , well-read and well- informed gentleman came for treatment alternatives opinion for his diagnosis . There ’ s a lot of back and forth with this gentleman and I couldn ’ t understand why , at his age and maturity , to be sceptical and indecisive about what he should do next . Until I realised the hesitation .
A common treatment for prostate cancer is surgery to remove the prostate gland . This is a radical prostatectomy . And many men still do not understand that prostate cancer , may lead to infertility .
Afrer a prostatectomy , you will not be able to have children by sexual intercourse .
He has a 30-year old girlfriend and is insistent about having more children even after his surgery . And that ’ s not going to happen .
My only advise to the male patients out there , you might consider storing sperm if you think you might want to have children in the future . You need to store sperm before starting your prostate treatment .
It might be possible to take sperm directly from your testicles if you have had a radical prostatectomy . The sperm can be used to fertilise your partner directly or with the test tube baby technique ( in vitro fertilization or IVF ). n
Dr Colin Teo is a Senior Consultant Urologist , currently practising at Gleneagles Hospital , Singapore . With over 20-years of experience , his subspecialties are in endourology , laparoscopic / robotic surgery , andrology and male subfertility .
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