Medical Services for Prostate Disorders/Prostatitis
Male patients often suffer from lower urinary tract symptoms caused by the prostate gland. The prostate is prone to disorders, with symptoms including difficulty urinating, incomplete bladder emptying, and urinary frequency or pain in the groin area. Capital Region Urology offers comprehensive medical services to treat all types of prostate disorders including prostate cancer, enlarged prostate also known as benign prostate hyperplasia (BPH), and prostatitis. Tests may include urinalysis, semen analysis, ultrasound imaging, flexible fiberoptic cystoscopy, and urodynamic bladder testing with uroflowmetry.
Complete Prostate Evaluation
Capital Region Urology physicians do a complete medical history and physical examination to determine the causes of symptoms. The prostate will be checked for enlargement and abnormal nodules, and a serum prostate-specific antigen (PSA) level will often be measured. The serum PSA is a component of prostate cancer screening. In benign prostate enlargement, the serum PSA blood test may help the urologist estimate prostate size.
Prostate Cancer Screening & Treatment
Sometimes a prostate examination reveals a nodule, or an abnormal serum prostate-specific antigen (PSA) level. In these cases the Capital Region Urology physician may discuss the potential benefits of prostate biopsy to rule out the presence of prostate cancer. In those men with prostate cancer, early detection will allow the appropriate therapy. No one therapy is right for all men; the most appropriate treatment will depend upon cancer grade and stage, serum PSA level, and the patient's cancer treatment goals.
Prostate Cancer Treatment Options
Prostate cancer can be treated in a variety of ways; the age and health of the patient are important considerations as well as the degree to which the cancer has spread. Treatment options include watchful waiting, hormone therapy, radiation therapy and surgery. Capital Region Urology physicians will discuss with the patient various options including radical prostatectomy, da Vinci® robotic prostatectomy, shaped beam radiosurgery, prostate brachytherapy (seed implant) or surveillance alone.
Prostatectomy, the surgical removal of the prostate gland and seminal vesicles, is a common treatment for prostate cancer. This procedure may be done conventionally or with the da Vinci surgical system.
Conventional prostatectomy is performed through large, open surgical incisions, which can result in lengthy and uncomfortable patient recovery, substantial blood loss and significant risk of impotence and incontinence. In recent years, some surgeons have begun using less invasive techniques called laparoscopic radical prostatectomy and robotic prostatectomy. Capital Region Urology was the first urology practice in the area to perform laparoscopic prostatectomy (2002) and the first to perform the even more advanced da Vinci robotic prostatectomy (2005).
da Vinci Robotic Prostatectomy
With the da Vinci surgical system, surgery is so precise that instruments recheck their positions by computer 1,500 times per second. Controlling a console near the patient, the surgeon uses a high-powered camera with a headrest to view a high-resolution, 3D color image of the surgical field, magnified 10 times. Using glove-like "endo-wrists," the surgeon manipulates the instruments by flexing his or her thumb, forefinger or wrist in a joystick-like control.
For many patients, a major concern about surgery for prostate cancer is the possibility of life-changing complications. But robotic surgery helps lower the risk of complications. Because there is little bleeding, the surgeon has a crystal clear view inside the patient. This is not always the case in traditional open surgery.
Typical benefits of robotic surgery:
- Faster healing.
- Smaller incisions with less scarring.
- Much less pain after the procedure.
- Faster recovery.
- Less blood loss and need for transfusions.
- A shorter hospital stay.
Shaped Beam Radiosurgery
Shaped beam radiosurgery is another treatment option giving physicians the ability to operate on more remote tumors and lesions with much more accurate and precise doses of high-energy radiation. Using computerized and highly sophisticated software, the Capital Region Urology team develops a customized treatment plan that may involve multiple treatments during the course of several treatment days. Shaped beam surgery continuously shapes the treatment beams to match the size and shape of the tumor from all angles. This ensures that the tumor receives the fully prescribed dose of radiation, while sparing healthy tissue and critical organs near the prostate.
Benefits of shaped beam surgery:
- Tumors or lesions receive an even and exact dosage of the prescribed radiation.
- Extremely precise radiation minimizes damage to normal tissue.
- No scarring or disfigurement and little risk of infection.
- Non-invasive and virtually painless.
- Performed on an outpatient basis.
Prostate Brachytherapy (PSI)
Prostate Brachytherapy (PSI), or "prostate radioactive seed implant," offers physicians another way to treat prostate cancer. It eliminates the need for traditional, invasive surgery. During PSI, radioactive seeds (about the size of a grain of rice) are implanted directly into the diseased prostate. The seeds release gradual doses of concentrated radiation for about a year, destroying cancer cells. Special computer programs calculate the exact dose of radiation needed. The cancer cells are carefully targeted with the help of advanced medical imaging equipment so that very little healthy tissue is affected. The seeds never have to be removed.