Prostate surgery that could save men's sex lives

by ROGER DOBSON, Daily Mail

Last updated at 11:23 12 October 2004

Less than three weeks after having his prostate removed, Donald Marsh was back playing golf and working out in the gym - thanks to a new operation for prostate cancer that is designed for a fast recovery with minimal risk of side-effects.

Mr Marsh is one of only a dozen men in the UK who have so far had the operation, but new research showing just how effective such surgery can be is expected to increase demand for the procedure.

"Three days after the operation, I was doing prescribed exercises," says 62-year-old Donald. "By day five, I was up and walking about with very little discomfort. Within three weeks, I was on the golf course playing in a competition. I couldn't believe it."

Less invasive

Each year, around 21,000 men are newly diagnosed with prostate cancer. Patients may be offered a wide range of treatments, including radical prostatectomy where the gland is removed surgically, radiotherapy, laser treatment, hormone therapy and cryosurgery.

Some techniques involve extensive surgery, with the likelihood of a long convalescence and the risk of adverse effects on sexual functioning and continence.

The new keyhole operation, known as Endoscopic Extraperitoneal Radical Prostatectomy (EERP), is for men whose prostate cancer has not spread beyond the gland itself. It is less invasive than traditional surgical techniques, which means faster recovery rates.

Other benefits are reduced pain levels, and potentially less risk of impotence or incontinence.

In the operation, five tiny holes are made in the abdomen below the belly button, through which the surgeon puts a narrow viewing telescope and surgical instruments. The surgeon then manipulates the equipment with the help of the telescope, and cuts and pulls out the whole gland.

Quicker recovery

The route that the surgeon uses to reach the gland is designed to lower the risk of cutting through other tissue, including the nerves that control sexual functioning and continence.

Shiv Bhanat, consultant urology surgeon at the BUPA Roding Hospital, who has carried out six such operations in the UK, says that the small entry holes and the technique used mean that recovery time is much quicker.

Mr Bhanat, who will report on the results from the first EERP operations in the UK at a medical conference later this month, says: "The aim is to cure the cancer without causing any damage to nerves. These side-effects can still happen, but they are less likely."

Donald Marsh, a businessman from Ilford, Essex, sought help for his prostate problem because he was waking up eight or more times a night needing to use the bathroom. His sleep was disturbed and he was constantly tired.

"In 1998, I had a prostate operation scrape, but more recently I started getting the symptoms again," he says. "I thought it was the same benign condition, but doctors discovered it was cancer.

"After talking through the risks and benefits, I decided on this laproscopic prostate procedure. It offered less post- operative risk rates and a faster recovery rate - which is important to me because I run my own business.

"It has all turned out very well. I have the all- clear now and the cancerous tissue has gone."