Diagnosis
Prostate cancer. Bladder stones. Chronic ischemic heart disease.
Patient:
Male, 73 years old, Kazakhstan
Physician:
Prof. Christian Thomas, Chief Physician, Department of Urology, University Hospital Dresden
Response from Professor Christian Thomas
'The MRI images of the pelvic organs show signs of diffuse nodular hyperplasia of the prostate gland. A histological examination of the tumour biopsy material, conducted at the patient's place of residence, revealed prostate adenocarcinoma. The Gleason score is 3+4=7. A calculus measuring approximately 19 mm has been detected in the bladder cavity. There is also a cyst in the left kidney.
In this case, surgery is necessary: a radical prostatectomy. We most often use the da Vinci robot to perform such operations. According to the preliminary assessment, the patient is suitable for a da Vinci prostatectomy, but we will only be able to make a final decision on the surgical method after an examination at our clinic.
Patient questions
- Is it possible to remove a bladder stone?
- Would this require a separate procedure or surgery?
- What impact will the removal of the bladder stone have on the cost of the surgery?
The doctor's response
- The bladder stone will be removed during the operation.
- No additional surgery is required.
- The total cost of the procedure will not change as a result.
Estimated cost of treatment: €19,800.
Treatment performed
Robot-assisted bilateral pelvic lymphadenectomy; Da Vinci radical prostatectomy with preservation of lateral fibres; therapeutic urethroscopy with a flexible urethroscope; and removal of a stone from the bladder.
The postoperative period was uneventful. A cystogram performed on the sixth postoperative day revealed no significant paravascularisation in the area of the vesicourethral anastomosis. A follow-up ultrasound examination revealed no urinary outflow disorders.
The patient was discharged from the clinic on the seventh day after the operation.
The actual cost of treatment: €18,000