Urology refers to a specialist field within medicine and surgery focused on the urinary tract of males, females and children as well as the male reproductive organs. Medical professionals and surgeons like Dr Lance Coetzee are trained to diagnose, treat and manage patients with urologic diseases.
Urologists focus on organs like the:
What is the function of the prostate?
The prostate is a gland of between 15 and 20 grams (normal size) and is located immediately below the bladder and in front of the rectum. It produces and stores seminal fluid to protect and enrich sperm. The most common prostate diseases are benign (aging) hyperplasia of the prostate resulting in decreased urine flow, prostate infections, and prostate cancer, which is the number one cancer in men and the second largest cause of death from cancer for men from the USA.
Common symptoms of prostate diseases include:
The prostate disorders we treat
Prostatitis
Prostatitis is an inflammation of the prostate gland, often resulting in swelling or pain, urination problems, sexual dysfunction, and general health problems, such as feeling tired and depressed. Prostatitis can be treated with dietary changes, antibiotics, and occasionally, surgery.
An enlarged prostate (better known as benign prostatic hyperplasia – BPH)
An enlarged prostate is common in aging men, with up to 90% of men over 80 presenting with this condition. BPH can be treated medicinally or through a common surgical procedure called a Transurethral Resection of the Prostate (TURP). During surgery a medical instrument called a resectoscope, which consists of a light, valves for irrigating fluid and an electrical loop is inserted through the tip of the penis into the urethra. The loop cuts tissue and seals the blood vessels. The removed tissue will be flushed into the bladder and out of the body through a catheter that is placed into the patient’s bladder through the penis.
Prostate cancer
Prostate cancer is the second most common cancer in men with 1 in 6 men likely to experience prostate cancer in their lifetimes. Small areas of cancer within the prostate are very common and may stay dormant (inactive) for many years making it very different from most other cancers.
Prostate cancer occurs when cells of the prostate begin to multiply out of control. Sometimes these cells may spread to other areas of the body, which in medical terms is known as metastasis. Prostate cancer is a slow growing cancer compared with other cancers and is usually diagnosed in the early stages before it starts to spread outside the prostate gland. However, it is possible that prostate cancer can be advanced when it is first diagnosed in men. This can also be the case for men who have previously been treated for early or locally advanced prostate cancer but whose cancer has recurred.
Prostate cancer can be categorised according to different stages:
Prostate treatment procedures
Radical prostatectomies
A radical prostatectomy is the most effective surgical procedure for patients who are in good health, have a long life expectancy and have cancer that appears to be confined to the prostate gland. It is a surgical procedure that removes the prostate gland and attached seminal vesicles in their entirety and in certain high risk cases also allows lymph nodes near the prostate to be removed at the same time. This procedure is often associated with the potential side effects of urinary incontinence and impotence, however, in an experienced surgeon’s hands both can be limited.
The first objective of a prostatectomy is to remove the cancer. The second objective is to spare the nerves bordering the prostate so that the patient can recover their normal pre-operative functional outcomes – bladder control and erectile function – post-surgery.
Dr Lance Coetzee offers the following treatment options through robotic surgery:
Robot-assisted prostatectomy
With a robot-assisted prostatectomy, Dr Coetzee is able to improve patient experiences and outcomes and is able to offer patients an effective, minimally invasive surgical approach. Surgeons are able to also see more via this method, be more precise, and have better control during surgery.
A robotic radical prostatectomy is also the most common treatment used for prostate cancer in the United States today, where robotics are used in about 80 to 85% of radical prostatectomies, and in South Africa where it is gaining in popularity due to the improved outcomes and minimal invasive nature of the surgery.
What are the benefits of a robot-assisted prostatectomy compared to a traditional surgical approach: