Frequently Asked Questions

General Prostate Cancer FAQs

For the first few weeks, one needs to wear a protective pad. The return of continence is fast and normally within two weeks.

For the first few weeks, one needs to wear a protective pad. The return of continence is fast and, within a few weeks, over 95 percent of the patients have full control of their urination. An occasional patient exhibits mild stress urinary incontinence after surgery which is usually resolved by performing Kegel exercises.

Every effort is made to spare the nerves. One of the main advantages of this procedure is the fact that the nerves and vessels are all magnified and it is much easier to save them. Return of potency could take up to six months and, in some individual cases, Viagra has helped the patients.

The average blood loss for this procedure is about 150cc, significantly reducing the risk of blood transfusion.

The average blood loss for this procedure is about 150cc, significantly reducing the risk of blood transfusion.

For open surgery, the catheter is removed after two to three weeks. With a laparoscopic prostatectomy, the catheter is removed 7 days after the operation.

For open surgery, the catheter is removed after two to three weeks. However, with a laparoscopic prostatectomy, the catheter is removed seven days after the operation. This is done in our office guided by X-ray to ensure the urethra is properly connected to the bladder.

The majority of patients are discharged the day after surgery. However, the time of discharge is decided on a case-by-case basis.

The majority of patients are discharged the day after surgery. However, the time of discharge is decided on a case-by-case basis. By the second night, over 90 percent of patients are comfortable enough to go home.

The results of cancer control in both laparoscopic and open radical prostatectomy patients is essentially identical.

The results of cancer control in both laparoscopic and open radical prostatectomy patients is essentially identical. This is confirmed in major institutions across the country where this procedure is being performed on a routine basis.

Advantages include shortened hospital stay, significantly less bleeding, early removal of catheter and minimal use of pain medications after the surgery

  • Shortened hospital stay (read patient testimonials)
  • Significantly less bleeding
  • Early removal of catheter
  • Minimal requirement for pain medications after the surgery
  • 10X to 15X visual magnification
  • Resumption of normal activity within one to two weeks after operation
  • Cosmetically more acceptable

Radical retropubic prostatectomy is the surgical removal of prostate, seminal vesicles and vas deferens through a lower abdominal incision. The incision measures 8 to 10 inches in length.

Laparoscopic radical prostatectomy can have the same success rate as open radical prostatectomy, given that the surgeon is highly skilled.

Laparoscopic radical prostatectomy can have the same success rate as open radical prostatectomy, given that the surgeon is highly skilled and trained in the procedure. When considering this type of surgery, it’s instrumental to choose a doctor that has successfully practiced LRP on hundreds of cases before.

However, a recent study from Journal of Investigative and Clinical Urology elaborates on  the fact that Robot Assisted Radical Prostatectomy has fewer complications and an improved biochemical recurrence (BCR) rate, potency rate, and continence rate than LRP.

Laparoscopic radical prostatectomy is a minimally invasive surgical treatment for prostate cancer. Involves keyhole incisions to remove the entire prostate.

Laparoscopic radical prostatectomy is a minimally invasive surgical treatment for prostate cancer. It involves a few keyhole incisions in order to remove the entire prostate.

Typically it takes 2½ to 3 hours depending on the size of the prostate, the patient’s anatomy and constitution, and the extent of surgery.

Typically it takes 2½ to 3 hours depending on the size of the prostate, the patient’s anatomy and constitution, and the extent of surgery. This is comparable to the average time of open surgery.

The catheter is removed seven days after the surgery.

Only once in the past 3 years has that happened to Dr. Rahman. He complete the case laparoscopically without needing to open the patient’s abdomen.

Only once in the past three years has that happened to Dr. Rahman. He was able to complete the case laparoscopically without needing to open the patient’s abdomen. For this reason, it is important to be skilled in open, laparoscopic and robotic surgery.

Absolutely not! The robot is completely under the control of the surgeon. The robotic arms enable the surgeon to operate in small spaces in the abdomen.

Men who are diagnosed with a localized prostate cancer are candidates for this procedure.

Men who are diagnosed with a localized prostate cancer are candidates for this procedure. Most patients who are candidates for open surgery would have an excellent outcome with this procedure. The indications for this surgery are very similar to open surgery.

Robotic prostatectomy is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology.

This procedure is also called da Vinci robotic prostatectomy. It is a minimally invasive surgical removal of the prostate involving the latest advancements in robotics and computer technology.

It is a computer-enhanced minimally invasive surgical system consisting of three components:

  • Surgeon Console
  • Patient-side Cart
  • Insite Vision System

The Surgeon Console consists of the master controls  the surgeon uses in order to manipulate the Patient-side Cart and the EndoWrist instruments. The surgeon’s hand movements are translated to the EndoWrists through the surgeon console. The instruments only move if the surgeon decides to move them. The robot is not in control of the instruments — the surgeon is.

The Insite Vision System provides a 3-D view of the surgical field – a vast improvement over the 2-D view of laparoscopic surgery. This translates to a much better visual field and better depth perception. The high definition video cameras give a 10X to 15X magnification – a view the surgeon could never get with traditional surgery. This is particularly important in visualization of the prostate capsule, sparing the neurovascular bundles responsible for erectile function and reconnecting the urethra to the bladder.

There are three surgical options to remove the entire prostate gland. These options are for patients with early diagnosed organ-confined prostate cancer.

There are three surgical options to remove the entire prostate gland. These options are for patients with early diagnosed organ-confined prostate cancer.

  • Robotic Radical Prostatectomy
  • Laparoscopic Radical Prostatectomy
  • Traditional Open Radical Prostatectomy

Prostate cancer is characterized by the uncontrolled growth and potential spread of abnormal cells. About 40,000 men die of prostate cancer each year.

The prostate is a walnut-sized gland located in front of the rectum, below the bladder and surrounding the urethra. Its main purpose is to produce fluid that transports sperm during the male orgasm. According to recent estimates, there are 180,000 to 200,000 newly diagnosed cases of prostate cancer detected annually. Prostate cancer is the second leading cause of cancer death in men after lung cancer. In the U.S., approximately 40,000 men die as the result of prostate cancer each year. Prostate cancer is characterized by the uncontrolled growth and potential spread of abnormal cells.

 

Active Surveillance

The challenge is that today’s diagnostics do not allow us to say with any certainty what the speed or severity of your prostate cancer will ultimately be.

Prostate cancer is called a silent killer for a reason. It can advance very quickly and without warning. On the other hand, some prostate cancer never advances and those men may eventually succumb to any number of other medical or age-related conditions before their prostate cancer is ever a problem. Older men may have more pressing medical conditions that require treatment before addressing the prostate cancer.

The challenge is that today’s diagnostics do not allow us to say with any certainty what the speed or severity of your prostate cancer will ultimately be. Keep in mind that delaying prostate cancer treatment can also take an emotional toll on men and their families, as they can be filled with worry about the disease’s status.

Both options are essentially the decision not to treat prostate cancer. They involved frequent screening regimens to monitor the disease’s status.

Though slightly nuanced, both options are essentially the decision not to treat prostate cancer. They involved frequent screening regimens to monitor the disease’s status and progression in the body. Some men choose to simply postpone treatment until tests indicate that it may be advancing, while others choose not to treat it at all.

Cancer treatment is a very complex and personal decision that should be based on individual beliefs, family support, and expert physician guidance.

Some men opt for Active Surveillance or Watchful Waiting instead of taking action to treat their prostate cancer. Cancer treatment is a very complex and personal decision that should be based on individual beliefs, family support, and expert physician guidance. Your age and overall medical status should be a factor in your decision, as well.

 

Robotic Prostatectomy

Prostate surgery recovery time is substantially improved in comparison to open prostatectomy. Dr. Rahman’s prostate surgery takes just 1.5-2 hours.

Prostate surgery recovery time is substantially improved in comparison to open prostatectomy. As mentioned earlier, the much larger incision required in open surgery means pain is greater and recovery takes longer. Dr. Rahman’s prostate surgery takes just 1.5-2 hours and almost all of his patients return home the day after having a robotic prostatectomy. Around 80% of open prostatectomy patients leave the hospital within the first week.

Eradicating prostate cancer is the true measure of prostate surgery success, be it open, laparoscopic or robotic. Nowhere is the evolutionary progression more pronounced than with this marker. The positive surgical margin is the measurement used to determine whether any cancer remains or is likely to recur. A physician always seeks low positive margins.

Dr. Rahman’s unique nerve-sparing technique for prostate removal surgery is crucial to preserving sexual function.

Following proper prostatectomy recovery guidelines, patients that were able to achieve sexual function before prostate surgery.

Dr. Rahman’s unique nerve-sparing technique for prostate removal surgery is crucial to preserving sexual function. These tiny nerves surrounding the prostate course laterally along the prostate and rectum and provide nerve connections to the proximal penis deep in the pelvis. If they are damaged during prostatectomy, so is erectile function. Put simply, preserving the cavernous nerves preserves sexual potency after prostate surgery. There are treatments for erectile dysfunction resulting from prostatectomy surgery, but with the right surgeon and prostate surgery technique, they are often unnecessary.

More commonly, traditional prostatectomy inadvertently results in damage to one or both of the cavernous nerves.

Following proper prostatectomy recovery guidelines, patients who experienced normal continence prior to surgery should regain function within 12-13 months.

Following proper prostatectomy recovery guidelines, patients who experienced normal continence prior to surgery should regain function within 12-13 months.

Loss of bladder control, or urinary incontinence, is a potential side effect of prostate removal surgery. Because the prostate sits just below the bladder and encircles the urethra, the urinary tract can be damaged during a radical prostatectomy. In the hands of an experienced robotic surgeon like Dr. Rahman, preservation of the urinary sphincter and competent rebuilding of the urinary tract can eliminate the risk of long-term incontinence. Uniquely, Dr. Rahman does not sever the endopelvic fascia and cuts the bladder neck very narrowly during robotic prostatectomy.

Urinary incontinence is far more common after open prostatectomy, as is risk of infection.

A robotic prostatectomy requires 5 small incisions, each about one-quarter of an inch in the lower abdomen, through which instruments are inserted. A sophisticated video camera is one of the instruments, which gives Dr. Rahman a three-dimensional, 10x magnified field of vision. The keyhole incisions drastically reduce blood loss and the camera provides unprecedented visual clarity. The result is a clear surgical field during the prostatectomy with nothing to obstruct Dr. Rahman’s view of the prostate and surrounding tissue.

Cameras are also used in laparoscopic prostatectomy, but they provide only a two-dimensional image and no magnification.

The survival rate is higher after prostatectomy:

Recently, following a study published by the European Association of Urology in 2015, radical prostatectomy has been shown to have a survival rate higher than that of patients who choose to undergo radiotherapy.

Currently, the therapeutic option in prostate cancer is strongly influenced by the patient and personal preferences and experience of the treating physician.

But here are survival rates of the patients that had implemented a prostatectomy and other types of treatments:

  • prostatectomy (surgery) 83%
  • radiotherapy 75%
  • hormonal therapy 41%
  • other therapies 71%

Today, surgeons use robotic or laparoscopic prostatectomy to remove a cancerous prostate, but early methods involved traditional or open surgery.

Prostatectomy and robotic prostate surgery are both terms for prostate removal surgery. Today, surgeons use robotic or laparoscopic prostatectomy to remove a cancerous prostate, but early methods involved traditional or open surgery.

David B. Rahman, MD, is at the forefront of prostatectomy and prostate removal surgery and has performed more than 7,000+ successful procedures to date. His innovative SMART technique uses robotic prostate surgery enhancements to improve vision and precision. In Dr. Rahman’s skilled hands, patients are assured superior quality of life results in both sex after prostate surgery and urinary control after prostate surgery.

 

Laparoscopic Prostatectomy

Certainly, any patient who is a candidate for open surgery, would have an excellent outcome with a laparoscopic prostatectomy.

Men who are diagnosed with a localized prostate cancer are candidates for this procedure. Certainly, any patient who is a candidate for open surgery, would have an excellent outcome with a laparoscopic prostatectomy.

For the first few weeks, it’s recommended to wear a protective pad. The return of continence is fast and, within few weeks, over 95 percent of patients have full control of their urination. Occasionally I see patients with mild stress urinary incontinence after surgery which usually resolves by performing Kegel exercises.

One of the main advantages of laparoscopic prostatectomy is that the nerves and vessels are magnified and it is much easier to save them.

Every effort is made to spare the nerves. One of the main advantages of laparoscopic prostatectomy is that the nerves and vessels are magnified and it is much easier to save them. Return of potency could take up to six months and in some individual cases, Viagra has significantly helped.

The average blood loss for a laparoscopic prostatectomy is about 150cc. Therefore, the risk of blood transfusion is extremely low.

The average blood loss for a laparoscopic prostatectomy is about 150cc. Therefore, the risk of blood transfusion is extremely low.

For open surgery, the catheter is removed after 2-3 weeks. With laparoscopic prostatectomy, the catheter is removed seven days after the operation.

For open surgery, the catheter is removed after two to three weeks. However, with laparoscopic prostatectomy, the catheter is removed seven days after the operation. This is done with the assistance of an X-ray in order to check the status of the site where the urethra has been connected to the bladder.

However, the time of discharge is decided on a case-by-case basis. By the second night, over 90 percent of patients are comfortable enough to go home.

A majority of patients are discharged one day after a laparoscopic prostatectomy. However, the time of discharge is decided on a case-by-case basis. By the second night, over 90 percent of patients are comfortable enough to go home.

It is usually about 2½ -3½ hours. Each case differs due to prostate size and individual anatomy. This is comparable to the average time of open surgery.

It is usually about 2½ -3½ hours. Each case differs due to prostate size and individual anatomy. This is comparable to the average time of open surgery.

The results of cancer control in both laparoscopic and open radical prostatectomy patients is essentially identical. This is confirmed in major institutions across the country where this procedure is being performed on a routine basis.

Some advantages include shortened hospital stay, significantly less bleeding, early removal of catheter and minimal requirement for pain medications.

  • Shortened hospital stay
  • Significantly less bleeding
  • Early removal of catheter
  • Minimal requirement for pain medications after the surgery
  • 10-15 times visual magnification
  • Resumption of normal activity within one to two weeks after operation
  • Improved cosmetic results

It is a minimally invasive surgical treatment for prostate cancer. It involves a few key hole incisions in order to remove the whole prostate.

It is a minimally invasive surgical treatment for prostate cancer. It involves a few key hole incisions in order to remove the whole prostate.