Yeditepe University Koşuyolu Hospital Chief Physician and Urologist Prof. Dr. Faruk Yencilek gave information about the prostate cancer surgery process.

• How Many Types of Surgery Are There?

There are generally 2 types of surgery. Endoscopic surgeries and open operations. Open surgery is rarely performed anymore. There are different types of closed surgery such as classical TUR, bipolar TUR, plasma kinetic TUR, and laser. 

• How is Prostate Surgery Performed?

In prostate surgery; closed surgeries are performed by entering through the penis. The inner part of the prostate is removed in pieces like peeling with a knife up to the shell part. In laser operations, the inner tissue of the prostate is vaporized. 

• Is One Technique Superior to the Other?

No, there is not. If you are competent in your work as a surgeon, you will get the same result in all of them. It is necessary to look at the experience of the surgeon, not the fashion methods. In the past, the greenlight laser wind blew, and it was performed on both suitable and unsuitable patients. Then, urinary canal stenosis appeared in many patients.

• How Long Does Prostate Surgery Take?

Closed prostate surgery is completed in 1 hour. Then the patient is taken to the room and a catheter is inserted. Depending on the surgical technique and the patient's condition, the catheter is inserted for 1 to 3 days. The duration of hospitalization is the same as the duration of the catheter. After the catheter is removed, the patient is discharged when he urinates comfortably. 

• How Does the Process Work After Returning Home?

Even though it is a closed surgery, it is an operation. In the postoperative period, the patient can walk around and do his work. There is no restriction. We only make some small recommendations. For example, "Do not have sexual intercourse immediately". Although the time to return to sexual life varies from patient to patient, it is on average 1 week later. A patient who has undergone surgery for benign prostate enlargement should be checked by a urologist every year even if he has no complaints. He should have an examination and PSA test against prostate cancer. 

• Are There Side Effects of Surgery?

All closed surgery techniques have similar side effects. The most important side effect is that the semen escapes inward instead of forward during sexual intercourse. This is not a medical or sexual problem. By the way, there are operations performed by protecting the bladder neck in cases where the prostate grows too large towards the bladder. The risk of retrograde ejaculation is lower in such surgeries. Finally, none of the surgeries performed for enlarged prostate have a negative effect on erection.

• Is Prostate Cancer Common?

It is the most common type of cancer after lung cancer in men in our country. There are 3 scientifically proven risk factors.

• Advancing Age; It is found in one man out of 10 thousand men at the age of 40, but its frequency increases with age.
• Ethnic Origin: It is more common in Black men.
• Genetics: The incidence increases in first-degree relatives with prostate cancer.

• Does Diet Have an Effect?

It is known that a diet high in red meat, high in calories, and rich in fat has a negative effect. Whether saturated or unsaturated, a fat-poor diet is necessary to reduce the risk. Obesity is also an important risk factor. When the fat layer in the body is high, a substance called insulin-like growth factor (IGF) and leptin is secreted from the fat tissue. These also have an adverse effect on prostate health.

• What Are the Symptoms?

There are no specific symptoms. For example, a bladder tumor should be considered when blood is seen in the urine. But there is no such warning symptom in prostate cancer. The urinary problems we see in benign prostate enlargement may be completely related to prostate cancer. The number of people who say, "Doctor, I have no problems, I am healthy as a horse," but when we look at the tests, prostate cancer is considerable. Therefore, having nothing does not rule out prostate cancer. After the age of 50, every man must undergo prostate cancer screening.
The First Symptom of Prostate Cancer May Be Bone Metastasis
Since it metastasizes to the backbone very often, low back pain can be the first complaint. But we used to see such cases frequently in the 1980s because there were no scans then. Until the early 1990s, 30 percent of patients were caught when they were metastatic. Now PSA has become widespread and people are more aware. Today, in 60 percent of cases, the cancer is caught while it is in the prostate and has not spread to another organ.