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High-volume surgeons no better at reducing postoperative incontinence (After radical prostatectomy)
Medical Xpress / University of Gothenburg / Scandinavian Journal of Urology ^ | Sept. 9, 2022 | Rebecka Arnsrud Godtman et al

Posted on 09/09/2022 6:06:42 PM PDT by ConservativeMind

In men who have had prostate cancer surgery, urinary incontinence is a common side effect. Its frequency varies from one surgeon to the next. In a major study, the number of surgeries performed by the urology surgeon made no difference to the patients' incontinence risk. This surprised researchers.

Prostate cancer is the most common form of cancer in men, with some 10,000 new cases detected annually in Sweden. If the tumor has not spread, the prostate gland is often operated on, usually with a robot-assisted, laparoscopic technique. Immediately after the procedure, almost all men are incontinent, because of disturbed activity in the sphincter (surrounding the upper part of the urethra) caused by the operation. This circular muscle is located just below the prostate. This urinary incontinence usually disappears after a few months, but there is a risk of it persisting.

"For other surgeries, patients of surgeons who perform the operations frequently are known to have fewer complications. It's a plausible association, since 'practice makes perfect.' But to our surprise, we couldn't see that link. In the men operated on by high-volume surgeons, the risk of postoperative urinary incontinence was no lower than in those whose surgeons were less experienced. This underlines the importance of feed-back to surgeons by use patient-reported outcome measures (PROM) in order to improve surgical technique to obtain better results," Godtman says.

One year after surgery, 14% of the men had urinary incontinence. The operations in the study were performed by 83 surgeons. For 15 of them, the patients had a lower incidence of incontinence than expected, while for six of the surgeons, the incidence among their patients was higher, regardless of how many procedures the surgeons performed during the study period.

(Excerpt) Read more at medicalxpress.com ...


TOPICS: Health/Medicine
KEYWORDS: prostate; prostatecancer; prostatesurgery
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This is a bummer, but the write up still says to ask your surgeons about their success rate with incontinence is before an operation.
1 posted on 09/09/2022 6:06:42 PM PDT by ConservativeMind
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To: Mazey; ckilmer; goodnesswins; Jane Long; BusterDog; jy8z; ProtectOurFreedom; matthew fuller; ...

The “Take Charge Of Your Health” Ping List

This high volume ping list is for health articles and studies which describe something you or your doctor, when informed, may be able to immediately implement for your benefit.

Email me to get on either the “Common/Top Issues” (20% fewer pings) or “Everything” list.

2 posted on 09/09/2022 6:07:23 PM PDT by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: ConservativeMind

I was treated with radiation, no incontinence thankfully


3 posted on 09/09/2022 6:18:27 PM PDT by UB355 (Slow Traffic keep Wright)
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To: ConservativeMind

I have been to Gothenburg

the city had a central steam plant and there were pipes under the streets that sent heat to all the houses/business

The ground reindeer meat was also good.


4 posted on 09/09/2022 6:19:04 PM PDT by algore
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To: ConservativeMind

I still don’t understand why an artificial sphincter hasn’t been invented.

I saw long ago where erectile disfunction was treated by a pump in the scrotum that would cause erection.

I would rather go to the bathroom this way, than all over myself.


5 posted on 09/09/2022 6:22:16 PM PDT by Empire_of_Liberty
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To: ConservativeMind
High-volume does not equal high quality. Doing the same thing wrong time after time gives the same bad results, no matter how many you do.
6 posted on 09/09/2022 6:26:22 PM PDT by neverevergiveup
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To: Empire_of_Liberty

“I still don’t understand why an artificial sphincter hasn’t been invented.”

Because doctors are taught to treat problems by whatever the government says to treat the problem with. They are not allowed to experiment or innovate. They are technicians who follow the government’s procedures. The government has no incentive to update their procedures. Doctors will still be doing the same things fifty years from now even if the rest of the world has moved on.

Having said that, my prostate was treated with heat. It shrank my prostate considerably and made life infinitely easier better. Although the process was invented to treat cancer it is not (or wasn’t at the time) government approved for that use and therefore if you have a cancer diagnosis you can’t be treated this way. (It works because cancer cells outrun their blood/cooling supply, but ordinary cells don’t.) It can be used to improve urine flow, which it is approved for. I asked the doctor if it could be used to treat cancer and he said that’s what he’d use if he had prostate cancer, but he wouldn’t tell anyone he’d done it for that reason.


7 posted on 09/09/2022 6:34:28 PM PDT by Gen.Blather (Wait! I said that out loud? )
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To: Gen.Blather

I had my Gleason 7 prostate cancer treated with TULSA-Pro and could not be more pleased. Outpatient, painless, all functions almost normal 2 years later, PSA .371.

Dr. Stephen Scionti in Sarasota, FL. Superb doc & team. FDA approved now but not covered by insurance. Should be.


8 posted on 09/09/2022 6:55:00 PM PDT by Arlis
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To: Arlis

Post 7 & 8
Thanks


9 posted on 09/09/2022 9:12:13 PM PDT by ptsal (Vote R.E.D. >>>Remove Every Democrat ***)
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To: Arlis

Thanks for that info!


10 posted on 09/09/2022 9:16:05 PM PDT by Basket_of_Deplorables (Putin is behaving rationally.The war is on Biden and Obama. )
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To: algore
I have been to Gothenburg

I was there just the other day. They have a cool pony express station. Oh, wait, that's in Gothenburg, Nebraska.

11 posted on 09/09/2022 9:23:34 PM PDT by Tellurian (Your phone is your cattle tag.)
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To: ConservativeMind

Go to MD Anderson and you won’t have incontinence problems.

Their prostate cancer surgeons are the best. Send me a PM and I can tell you the three to ask for.


12 posted on 09/09/2022 10:02:53 PM PDT by WASCWatch ( WASC)
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To: Arlis

THAT PSA level is high enough that you should have it rechecked at least every six months.


13 posted on 09/09/2022 10:04:59 PM PDT by WASCWatch ( WASC)
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To: ConservativeMind

Anyone with prostate cancer should look into the Nanoknife procedure invented by Gary Onik. The text below is copied from https://www.canceractive.com/article/nanoknife-ire

Since 2009, experts in America (for example, at the University of Maryland Medical Center) have been using and studying Irreversible Electroporation, a new technique for treating hard-to-reach, and often inoperable soft tissue tumours (for example, liver and pancreatic tumours).

The Nanoknife was invented by Gary Onik, a retired interventional radiologist, and is manufactured in America by AngloDynamics as a Medical Device.

What is the Nanoknife IRE?

Be clear upfront - It’s not a knife, instead, fine needles are inserted into the body, usually after a small incision. These are placed around the tumour and then a current of up to 3000 volts is passed across the needles punching holes in the cancer cell walls. This causes the cancer cells to lyse - or leak, losing their contents. That’s why it is called Irreversible Electroporation!

The Nanoknife IRE is a form of Ablation (localised Hyperthermia) and offers another option for patients who have cancerous tumours that are close to blood vessels, ducts or nerves which may otherwise be damaged using other treatments. Unlike ablation, where localised high temperatures are used and may give problems if near blood vessels, no such side-effects occur with the Nanoknife. Ablation also damages the components of the cancer cell, whereas the contents of the cancer cell are unharmed in IRE. They merely leak into the surrounding tissue, rather like bursting a balloon, to be mopped up by the immune system.

Unlike chemo, this is a non-toxic treatment.
Unlike other treatment methods that use thermal ablation - either heating or freezing - to damage the biochemistry of the cancer cell, Irreversible Electroporation, or IRE, works by directly targeting the tumour walls.

Electricity is applied through probes inserted through the skin. Most usually these are simply two or more fine needles guided into the correct position around the tumour. Ultrasound or CT imaging helps doctors guide the placement of the probes precisely. Millisecond electrical pulses are then used between the needles to open the membranes in the cell walls within the tumour.

This irreversible damage causes the cancer cells to die, while nearby nerves, ducts and blood vessels apparently remain unharmed. IRE is performed under general anesthesia. Side-effects are minimal, although at the outset there was some concern over heart irregularities.

Recovery time is usually faster when compared to some other treatments, with minimal soreness from the needles themselves. There is little scarring because of the way IRE causes the cancer cells to open and die, taking advantage of the body’s natural healing ability.


14 posted on 09/10/2022 2:21:24 AM PDT by UnwashedPeasant (The pandemic we suffer from is not COVID. It is Marxist Democrat Leftism.)
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To: Arlis

TULSA-pro shows 100% of patients had no incontinence issues at three years.

https://tulsaprocedure.com/

That’s a keeper!


15 posted on 09/10/2022 4:03:51 AM PDT by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: WASCWatch

Was .227 = zero. Docs agree. I agree.

Have MRI on 23rd this month.

ALL procedures for prostate cancer show 1/3rd of patients see cancer return years after procedure. Even radical prostatectomy. Friend who had it a year before me is now facing cancer throughout his body 3 years later.

I investigated every possible procedure & every doc told me that.

I get annual MRI in addition to PSA tests every 6 months.


16 posted on 09/10/2022 5:36:10 AM PDT by Arlis
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To: ConservativeMind

My husband got HIFU (same as Tulsa) @ 6 years ago in Mexico with US doctor. Was not yet approved in US. Worked great.


17 posted on 09/10/2022 7:05:26 AM PDT by goodnesswins (The Chinese are teaching calculus to their 3rd graders while ours are trying to pick a pronoun.)
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To: Arlis

Had radical over 20 years ago at Johns Hopkins. PSA still undetectable. No incontinence.


18 posted on 09/11/2022 4:29:48 AM PDT by deweyfrank (Nobody's Perfect )
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To: deweyfrank

That’s great! You’re in the 2/3rds in whom it does not return........


19 posted on 09/11/2022 5:28:16 AM PDT by Arlis
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To: Arlis

You have made wise decisions. Sorry that your friend did not do the same.


20 posted on 09/11/2022 12:15:40 PM PDT by WASCWatch ( WASC)
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