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Urinary Tract Cancers

Prostate surgery

04/13/2006

Question:

Wouldn`t it be easier to operate on the prostate by going through the rectum rather than through the front or between the legs?

Has this procedure been done through the rectum yet?

If not, are there any plans?

Whilst I realise that operating through the rectum introduces an initial problem of cleanliness, there are successfull operations to remove the appendix and bowl cancer, therefore going through the rectum would appear to be a better direction to go with more access than conventional methods.

Answer:

Good question.  By going through the rectum and removing the prostate there is a high probability that a fistula (connection) between the rectum and urinary tract would occur resulting in urine passing into the rectum and a very high likelihood of urinary trait infection.  Also if radiation therapy is needed post-operatively there would be a high complication rate secondary to the likelihood of radiation damage to the rectum which had been opened to gain access to the prostate.  This is not a problem with biopsy but would be with surgery.

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Response by:

Martin I Resnick, MD Martin I Resnick, MD
Formerly, Professor of Urology
School of Medicine
Case Western Reserve University