Common surgical procedures for treating prostate cancer

Surgery is the primary method of treating prostate cancer. Generally, patients with highly malignant prostate cancer, prostate masses limited to the prostate during rectal examination, and prostate cancer without infiltration of the tumor and rectal mucosa but with symptoms of pushing and metastasis should undergo surgical treatment as long as the patient is in good condition and capable of undergoing surgery.

The following are some of the techniques that are currently commonly used:

1. Radical prostatectomy: Radical prostatectomy for prostate cancer includes the prostate body and prostate capsule to achieve the purpose of eliminating all tumor tissues in the body. During the operation, the degree of tumor infiltration behind the bladder base and near the seminal vesicles and the presence of lymph node metastasis in the pelvic area can be simultaneously explored.

2. Extended radical prostatectomy: Mainly suitable for stage C prostate cancer, high-frequency electrosurgical unit is used to extensively remove the local tumor in situ, with special attention paid to removing the base of the bladder, the residual part after seminal vesicle and vasectomy, the fascia behind the bladder, and the urogenital diaphragm surrounding the membranous urethra.

3. Transurethral resection of the prostate (TURP): It is suitable for the elderly and frail who have already developed complications such as urinary obstruction. For patients with local lesions that have reached stage C, TURP can only relieve symptoms and there is no possibility of cure. TURP can prevent the occurrence of uremia and improve the quality of life of patients. Many patients can undergo repeated transurethral resections to relieve bladder orifice obstruction.

4. Bilateral orchiectomy: 95% of male hormones come from the testicles. Testicular removal removes the source of testosterone production, slowing the growth of androgen-dependent prostate cancer or causing it to regress. However, orchiectomy can cause secondary adrenal cortical zona reticularis hyperplasia, and is often combined with other therapies to achieve better results.

5. Pelvic lymph node dissection: The incidence of pelvic lymph node metastasis in prostate cancer is relatively high, so the pelvic lymph node metastasis should be fully examined during the operation. If metastasis is found, pelvic lymph node dissection should be performed at the same time.