Author: Stéphane Pierre

Robotic prostatectomy in detail

Robotic prostatectomy in detail

Before discovering the signs of complications, discover the symptoms to watch out for in our guide : What are the symptoms of prostate cancer?

Robotic-assisted radical prostatectomy is a state-of-the-art surgical procedure to treat localized prostate cancer. A major concern for many men is the preservation of erectile function after this procedure. This article explores the conditions under which erectile nerve preservation is possible and the factors that influence this crucial decision.

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Understanding Robotic Prostatectomy and Erectile Nerves

Robotic prostatectomy involves removal of the prostate and, potentially, surrounding tissue. The nerves responsible for erection are located close to the prostate. Preservation of these nerves is a priority to maintain erectile function post-operatively.

Key Factors for Nerve Preservation

Cancer stage and location:

  • If the cancer is localized and far from the nerves, preservation is more likely.
  • Advanced cancer or cancer close to the nerves may require more extensive removal.

Patient age and health:

  • Younger patients with good pre-operative erectile function have a better chance of recovery.
  • Pre-existing medical conditions may influence recovery.

Surgeon’s experience:

  • The precision of the robotic technique and the surgeon’s expertise are crucial to successful nerve preservation.

Preoperative magnetic resonance imaging (MRI):

  • MRI helps to localize the tumor before surgery.

The Importance of Preoperative Assessment

A thorough evaluation is essential to determine the feasibility of nerve preservation. This includes:

  • Complete physical examination.
  • Erectile function tests.
  • MRI of the prostate to assess the extent of the cancer.
  • PSA assay

Nerve Preservation Techniques

Robotic prostatectomy offers enhanced precision, enabling meticulous nerve dissection. Techniques include:

  • Interfascial dissection: preserves nerves located between the prostate fascia.
  • Intrafascial dissection: preserves nerves located very close to the prostate.

Expectations and Post-Operative Recovery

It’s important to note that nerve preservation does not guarantee immediate recovery of erectile function. Recovery may take several months or even years. Factors influencing recovery include:

  • Extent of nerve preservation.
  • Patient’s age and health.
  • Post-operative rehabilitation.

Treatment Options for Post-Operative Erectile Dysfunction

Several options are available to treat erectile dysfunction after prostatectomy:

  • Oral medications (PDE5 inhibitors).
  • Intracavernosal injections.
  • Vacuum devices.
  • Penile prostheses.

Conclusion

Preserving the erectile nerves during prostatectomy for cancer is an important goal for improving patients’ quality of life. Thorough preoperative evaluation and precise surgical technique are essential to maximize the chances of success.

Need a diagnosis or follow-up? Make an appointment at the Colmar Urology Center for personalized care.

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When can erectile nerves be preserved during robotic prostatectomy?

When can erectile nerves be preserved during robotic prostatectomy?

Before discovering the signs of complications, find out what symptoms to look out for in our guide:: What are the symptoms of prostate cancer?

Robotic-assisted radical prostatectomy is a commonly performed surgical procedure for the treatment of localized prostate cancer. However, this procedure can have an impact on quality of life, particularly on erectile function. Erectile nerve preservation, also known as nerve conservation, is a technique that can reduce these side effects, but is not always possible. Here’s a comprehensive guide to when this approach might be considered.

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What is nerve preservation?

The erectile nerves are located in neurovascular bundles that run along each side of the pprostate. They are not visible to the naked eye.
During a prostatectomy, the surgeon may attempt to preserve them, provided this does not compromise the removal of the cancer. This is a delicate technique, as the bundles are very close to the prostate and sometimes in direct contact with the cancer cells.

Criteria for nerve preservation

Tumor location and extension

Tumor location is a key factor. If the tumor is located at a distance from the neurovascular bundles, it is possible to preserve them. However, if the tumor is close to or invades these areas, complete nerve preservation may increase the risk of cancer recurrence.

How does the surgeon assess this location?

Pre-operative imaging, such as multiparametric MRI, enables visualization of the tumor and its relationship with the neurovascular bundles. This assessment is essential for deciding on the surgical strategy.

Gleason score and cancer aggressiveness

What is the Gleason score?

The Gleason score is a scale that measures the aggressiveness of cancer cells. The higher the score, the more aggressive the cancer. For example, a score of 6 indicates a less aggressive cancer, while a score of 8 or more suggests an advanced cancer.

Impact on nerve preservation

For less aggressive cancers (score 6 or 7), nerve preservation is often possible. For higher scores, on the other hand, the chances diminish, as the priority is to completely eliminate the cancer.

Advanced techniques

Robotic-assisted techniques enable 3D visualization and precise movements, improving the chances of nerve preservation. The use of appropriate energies, such as bipolar forceps, also reduces collateral damage.

Patient factors

Age and general health

Younger (under 65), healthier patients are more likely to recover erectile function after surgery. Co-morbidities, such as diabetes or cardiovascular disease, can also influence recovery.

Importance of preoperative discussion

An open discussion between patient and surgeon is essential. The patient’s expectations in terms of sexual quality of life and cancer treatment priorities must be taken into account to define an appropriate strategy.
This makes it possible to stratify priorities, taking into account the disease, its stage, the patient’s history and, above all, his or her expectations.

Conclusion

Preservation of erectile nerves during prostatectomy for cancer is an important objective for improving patients’ quality of life. However, it is not always possible, and depends on many factors, including the location and aggressiveness of the cancer. Accurate assessment and personalized discussion help optimize the outcome for each patient.

Need a diagnosis or follow-up? Make an appointment at the Colmar Urology Center for personalized care.

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Excellence in urology: Colmar Civil Hospitals' Urology Department shines in Le Point newspaper's 2024 ranking

Excellence in urology: Colmar Civil Hospitals’ Urology Department shines in Le Point newspaper’s 2024 ranking

The Urology Department of the Colmar Civil Hospitals is proud to announce its outstanding performance in the 2024 ranking of hospitals and clinics published by Le Point. This annual ranking, renowned for its rigorous standards, highlights establishments that excel in patient care. The department ranks among the best nationwide in several key areas of urology.

Ranking image

Summary

Prostate Cancer Ranking

Prostate Cancer

  • 10th position out of 138 establishments performing at least twelve prostate cancer surgical procedures in 2022.
  • Score awarded: 18.42/20.

Prostate adenoma

  • 3rd place out of 246 establishments performing at least twelve prostate adenoma procedures in 2022.
  • Score awarded: 19.16/20.

Urinary calculi

  • 8th position out of 269 facilities treating at least twelve patients for urinary calculi in 2022.
  • Score awarded: 18.30/20.

Well-deserved recognition

These results testify to the day-to-day commitment of the Urology Department’s medical and paramedical teams, who work tirelessly to provide optimum quality care. Whether treating cancers, adenomas or urinary calculi, the urology teams combine expertise, cutting-edge technologies and a personalized approach to meet patients’ needs.

Why choose the Colmar Urology Department?

  • Une équipe multidisciplinaire experte : Chirurgiens, anesthésistes, infirmiers et personnels de soutien travaillent de concert pour assurer un parcours de soins complet et efficace.
  • Des équipements à la pointe de la technologie : Robotique chirurgicale, techniques mini-invasives et outils diagnostiques avancés sont utilisés pour garantir des interventions sûres et précises.
  • Une prise en charge individualisée : Les patients bénéficient d’un accompagnement sur mesure, adapté à leur situation clinique et à leurs besoins personnels.

Towards continuous improvement

Although very encouraging, this ranking is not an end in itself. The Urology Department of the Colmar Civil Hospitals is continuing its efforts to constantly improve the quality of its services. Investing in team training, developing new techniques and enhancing the patient experience remain priorities.

We would like to thank all our patients for their trust, and all our healthcare professionals for their dedication.

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What are the first signs of complications associated with untreated, progressive prostate cancer?

What are the first signs of complications associated with untreated, progressive prostate cancer?

Before discovering the signs of complications, check out the symptoms to look out for in our guide : What are the symptoms of prostate cancer?

If prostate cancer is not detected or treated in time, it can progress and lead to serious complications. These complications can occur at an advanced stage of the disease, affecting not only the prostate but also other parts of the body. Recognising these early signs is crucial to acting quickly. Here’s everything you need to know.

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Why do complications arise?

As prostate cancer progresses, it can invade neighbouring tissues or spread to other organs, leading to what are known as metastases. These complications are often caused by uncontrolled tumour growth or delayed treatment.

Signs of prostate cancer complications

Urinary complications

  • Acute urinary retention: A sudden inability to urinate, often accompanied by intense pain.
  • Blood in the urine (haematuria) : A sign that the tumour is affecting the urinary tract.
  • Common urinary tract infections: Resulting from partial or total blockage of the urethra.
  • Kidney failure: If the tumour blocks the flow of urine over a long period.

Bone pain

When cancer spreads to the bones (bone metastases), it can cause :

  • Intense pain in the back, hips or ribs.
  • Increased fragility of bones, leading to fractures.

Neurological disorders

  • Weakness or numbness in the legs: Possible indication of spinal cord compression.
  • Difficulty walking : Linked to pain or nerve complications.

Hormonal and sexual disorders

  • Severe erectile dysfunction: Caused by nerve or vascular damage due to the tumour.
  • Hot flushes or intense fatigue: Often linked to advanced hormone treatments.

Fatigue and unexplained weight loss

These signs may indicate that the cancer has spread or that the body as a whole has been affected.

Quand consulter en urgence ?

Some symptoms require immediate consultation :

  • Persistent or severe bone pain.
  • Sudden inability to urinate.
  • Weakness or paralysis of the lower limbs.
  • Blood in urine or semen.
  • Rapid weight loss associated with extreme fatigue.

Don’t ignore these signs: prompt treatment can prevent serious complications and improve quality of life.

What can be done to limit complications?

  • Early detection: The best way to avoid complications is to diagnose cancer in its early stages. Consult a urologist as soon as any unusual symptoms appear.
  • Rigorous medical follow-up: If you’ve already been diagnosed, stick to the recommended appointments and treatments.
  • Healthy lifestyle: A balanced diet and regular exercise can support your overall health.

Conclusion

Complications associated with prostate cancer are often the result of uncontrolled disease progression. Recognizing early signs, such as bone pain, urinary problems or unexplained fatigue, is key to acting quickly. If you notice any of these symptoms, consult a specialist immediately.

Need a diagnosis or follow-up? Make an appointment at the Colmar Urology Center for personalized care.

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How is prostate cancer diagnosed?

How is prostate cancer diagnosed?

Before diving into the diagnostic stages, find out what symptoms to look out for in our guide : What are the symptoms of prostate cancer?

Prostate cancer is one of the most common cancers in men, particularly after the age of 50. If you are experiencing symptoms such as urinary problems, or simply wish to undergo preventive screening, it is essential to understand the key steps involved in making an accurate diagnosis. Here’s a complete guide to the prostate cancer diagnosis process.

An abnormal psa level should lead to a consultation with a urologist.

Contents

The importance of early diagnosis

Prostate cancer is often asymptomatic in its early stages. Early diagnosis enables :

  • Rapid care.
  • Reduced risk of complications.
  • A wider choice of effective treatments.

If you experience symptoms such as difficulty in urinating, frequent urination at night or pelvic pain, it is vital to consult a specialist.

Steps in diagnosing prostate cancer

Initial consultation with a urologist

  • Analysis of symptoms: The urologist will ask questions about your family history, your lifestyle and your symptoms.
  • Assessment of risk factors: Age, heredity, ethnic origin and pre-existing medical conditions.

Clinical examination: rectal examination

  • This quick, painless examination allows the doctor to palpate the prostate via the rectum to detect any abnormalities (induration), enlargement).
  • Although uncomfortable for some, it remains a key screening tool.

Biological tests: PSA assay

  • PSA (Prostate Specific Antigen) is a protein produced by the prostate gland.
  • A high level may indicate a problem: inflammation, benign hypertrophy or cancer.
  • This test is often used in addition to the digital rectal examination (DRE).

Medical imaging to confirm anomalies

  • Multiparametric MRI:
    • Advanced imaging to visualise the prostate and identify suspicious areas.
    • It is particularly useful for guiding biopsies.
  • Transrectal ultrasound :
    • Used to measure the size of the prostate and detect abnormalities.

Prostate biopsy: the definitive examination

  • If any abnormalities are detected, a biopsy is performed.
  • This involves taking samples of prostate tissue for laboratory analysis.
  • The results confirm the presence of cancer and determine its aggressiveness (Gleason score).

What to do after a diagnosis

Once the diagnosis has been made, several stages follow :

  • Determine the stage of the cancer (localised or metastatic).
  • Discuss treatment options tailored to your situation (surgery, radiotherapy, hormone therapy, etc.).

When should you go for screening?

  • From the age of 50: annual consultation for men with no risk factors.
  • From the age of 40-45: If you have a family history of prostate cancer or if you belong to a high-risk population (men of African origin, for example).
  • If you experience unusual urinary symptoms, even if you are younger.

Conclusion

Prostate cancer may be silent in its early stages, but signs such as urinary problems, pain or blood in the urine should be taken seriously. Early detection is essential to improve the chances of treatment and cure.

To find out more, or to consult a specialist, book an appointment at the Colmar Urology Center. We’re here to support you at every stage of your healthcare journey.

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Ranking - Le Point 2021

Ranking - Le Point Health Magazine 2021

The “Le Point” magazine has just unveiled its ranking of the best public/private hospitals and clinics in France for 2021.

We are happy to share the rankings for some of the disorders that can be treated at the Colmar Urology Centre.

> The Colmar Urology Centre is ranked 5th for the prostate cancer surgery

Ranking among 177 hospitals and clinics performing prostate cancer surgery.

> The Colmar Urology Centre is ranked 12th for the bladder cancer surgery

Ranking among 299 hospitals performing bladder cancer surgery.

> The Colmar Urology Centre is ranked 7th for the prostate adenoma surgery

Ranking among 282 hospitals performing bladder cancer surgery.

> The Colmar Urology Centre is ranked 13th for the treatment of urinary calculi

Ranking among 348 hospitals taking care of urinary calculi

 The “Le Point” journalists have taken into account various criteria in order to establish a ranking of the 1400 health-care institutions in France (hospitals and clinics). To get more information about the methodology, you can refer to this article.

 
 

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