Frequently Asked Questions
What is prostate?
Prostate is a male organ just below the bladder, in front of the rectum, surrounding the urethra.
What is the function of prostate?
Prostate is a male organ which starts functioning after puberty. The main function of prostate is to produce the fluid that nourishes and transports sperm. This ensures the fertilization of female eggs.
Do I have prostate?
Prostate is not an illness, it, is an organ. Boys are born with prostate. Prostate disease which is often misstated as term “prostate” is actually used for the benign prostate hyperlasia (BPH).
Split stream of urine, nocturia (nightly frequent urination), stop-start urination etc. are the symptoms of bph and are explained in detail in bph section of our website. To diagnose BPH, patients having the mentioned symptoms must consult urologists for examination. Men over 40 should have prostate examination each year even they don’t have any symptoms.
Does prostate enlargement (BPH) lead to prostate cancer?
BPH is completely different disease than prostate cancer. Confusing those two diseases is a common mistake. Prostate cancer occurs independently. Prostate enlargement does not lead to prostate cancer. And it is important to know that the treatment of BPH and prostate cancer are totally different.
Do I still have the risk of prostate cancer after BPH surgery?
Yes, there is still the risk of prostate cancer. As a rough description, the image of prostate is like an orange. It has also two parts like orange. The inner part is like fruit and the outer part (capsule) is like shell. Since BPH always occurs in the fruit, all the techniques of surgery (TUR-Bt, Greenlight, open surgery) are inward. So when we romove the fruit, the shell (capsule) still remains. As the prostate cancer occurs in the shell, the risk of prostate cancer remains after the BPH surgery, in order to eliminate the risk, men should’t neglect the annual prostate examination.
Does prostate surgery affect me sexually?
Patients do not have erectile dysfunction problem after BPH surgery. But during ejaculation the semen may enter the bladder instead of emerging through the penis. Then it exits during urination. This is not harmful but it can cause male infertility. If the patients are planning to have baby, they need to consult to the doctor to fix this problem.
What is PSA (Prostate-Specific Antigen)? Who should get a PSA test?
Psa is a protein produced by prostate gland and is necessary to fertilize female eggs by making the semen more liquid. Psa test is a blood test that measures the Prostate Specific Antigen in your blood. Psa level can increase when there is prostate cancer. However many other conditions such as inflamed or enlarged prostate can also increase the psa level. So it is complicated to determine what a high psa score means. For this reason, the evaluation of the test should be done by an urologist. Examinig the lab report by just focusing on the normal values may lead to wrong evaluation. We recommend every men over age 45 to get psa test annually. However if you have a family history of prostate cancer, you must get the psa test in earlier ages, annually with no neglect. This is vitally important.
Is it necessary to have biopsy to diagnose prostate cancer?
Suggesting that you might have prostate cancer, your doctor may recommend prostate biopsy. The treatment of prostate cancer is different than benign prostate hyperlasia. Leaving it on its own may have fatal outcome. Nowadays prostate cancer is curable completely if detected and treated early. Early diagnosis have vital impact on the treatment. Therefore, if needed, the patients should leave away the fears about prostate biopsy procedure and have it wıthout delay. The biopsy should be performed by experienced radiologists or urologists.
Unfortunately the bıopsies performed in unexperienced centers may result in some problems. Patients hearing about these negative events may have fears about the procedure. Avoiding the biopsy results in delay of the treaetment of cancer.
Another important point is targeting the suspicious area to biopsy. It is very critical for diagnosis the removed samples are examined by pathologists. Diagnosis and treatment of cancer is a team work.
What are the side effects of Radical Prostatectomy (prostate cancer surgery)?
The surgery performed for the treatment of prostate cancer is called radical prostatectomy and is totally different than the surgery of benign prostate hyperlasia. During the radical prostatectomy we remove the inner part of the prostate (stroma) together with the shell (capsule). The veining over the capsule can easily bleed and controlling of this situation can be archieved by well experienced urologists. Since high experience and knowledge is required, a limited number of urologists can perform this surgery. Recently in europe, the surgeons performing less than 10 such surgeries per year are not allowed to do so. Only the centers having high experience can perform this surgery. The experience of the surgeon and the quantitiy of the surgery he has performed have real impact on the results of the surgery.
Erectile dysfunction is a common side effect of the radical prostatectomy surgery. During the surgery the delicate surrounding of the prostate can be damaged. The prostate is a wall nut-sized organ and two tiny cavernous nerves are located along the sides of the prostate. These nerves are carrying signals to penis to fill with blood and to erect. During surgery, the surgeon may need to remove the nerves if they are too close to cancer. Even if they are not removed, they can be damaged. The trauma to the nerves which control erection is of the main cause of erectile dysfunction after radical prostatectomy.
Nowadays a few urologist use a special technique which is nerve-sparing radical prostatectomy which preserves nerve supply to the penis so that the erection will stay nearly as before the surgery. The decision to preserve the nerves depends on the risk of spread of the cancer. The right decision to the right patient and applying the special technique with utmost care results in a double happiness: the cancer is treated and nerves are protected.
I was told that my bladder should be removed due to bladder cancer and I will survıve with a bag on my abdomen after the surgery. Thinking of living wıth a bag all my life bothers me. What can be done?
Invasive bladder tumor surgery is compound of removal of bladder (radical cytectomy) + lymph node disection+urinary diversion. In men removal of baldder includes removal of prostate and seminal vesicles. In women radical cystectomy also includes removal of a part of vagina, uterus and ovaries. Removal of lymph nodes is common in both sex in order to eliminate the risk of spread of the cancer.
As the bladder which keeps the urine filtered from the kidneys is removed a new urinary tract is needed. The surgeon uses a piece of small intestine to create a tube that attached to ureters and connect your kidneys to an opening in your abdominal wall (stoma). A bag you carry on your abdomen sticks to your skin and collects urine until you drain it. This method is called Ileal Conduit method. As it smells when the bag is filled with urine and it is not so easy to live with a bag on the body, this method causes difficulty in social life.
Orthotopic neobladder is an other method to create a new bladder. The surgeon uses a piece of small intestine to create a sphere-shaped pouch as a new bladder. The new bladder is located in the same location as the original one and it works as original bladder and there is no bag. The problem is that there are a few surgeons who can accomplish this method. After the surgery there is no problem in daytime but for the nights we ask the patients to set an alarm and wake up to urinate in every 2 or 3 hours otherwise they may have incontinence.
There is a cyst in my kidney. Does cyst turn into cancer?
Not all the kidney cyts are in the same form. They are categorized in accordance with their tendancy to become cancer. The most commonly used one is bosniak categorization. According to bosniak categorization, type 1 cysts which are simple and have smooth surface do not need additional treatment while type 2 cyts have the risk to become cancer up to 5% and have to be followed up periodically. Coming to type 3 and type 4 cyts, they are cancerous. 50 % of type 3 are should be removed as they are cancerous. Type 4 is known as cystic state of the kidney tumor and should be removed urgently.