Diagnosis
Prostate adenocarcinoma. Coronary artery disease. Diabetes mellitus.
Patient:
Male, 67 years old, Kazakhstan
Physician:
Professor Michael Truss, Chief Physician at the Urology Clinic in Dortmund
Response from Professor Michael Truss:
During a local urological examination conducted due to severe benign prostatic hyperplasia, prostate gland formation was detected. The PSA level was 12.5 ng/mL. The histological analysis result is consistent with prostate cancer.
If the tumour has not spread beyond the prostate capsule, radical prostatectomy and/or radiation therapy are recommended. To decide on the most appropriate treatment, additional testing is required, as well as a review of the biopsy material.
Due to coronary heart disease, the patient’s cardiac status must be assessed before surgery.
Questions from the patient:
- How will the surgery be performed?
- What are the risks associated with this surgery?
- How long will I need to stay in hospital?
Doctor's response:
- Provided there are no contraindications, we will perform prostate removal surgery using the da Vinci robotic system. Possible side effects of radical prostatectomy include erectile dysfunction and urinary incontinence. However, depending on the size of the tumour, it may be possible to preserve the nerves responsible for potency and continence using the da Vinci Robotic Surgical System.
- The estimated length of stay at the clinic is 10 days.
The estimated cost of treatment: €16,000
Treatment performed:
A minimally invasive, robotic-assisted, transperitoneal radical prostatectomy (Da Vinci surgery) was performed, alongside a bilateral pelvic lymphadenectomy, bladder neck reconstruction, Robinson catheter insertion and placement of a permanent catheter.
The postoperative period proceeded without complications. A cystogram performed on the sixth postoperative day revealed no significant leakage in the vesicourethral anastomosis area, enabling the transurethral catheter to be removed.
The patient urinated spontaneously with minor urinary incontinence. An ultrasound examination revealed no urinary tract obstruction and no residual urine after urination.
Recommendations: outpatient follow-up with a urologist. Monitoring of PSA (prostate-specific antigen) levels.
The actual cost of the treatment: €15,800