Dr Jo Schoeman
Urological Surgeon

        

Prostate Surgery

Laser Trans Urethral Prostate Vaporisation Greenlight Laser

Endoscopic ablation/ vaporization of a benign enlarged prostate, using laser. This allows patients on anti-coagulation therapy to continue their medication with minimal risk of hemorrhage or clotting. It also allows a shorter hospital stay with minimal risk. A preoepartive PSA should be normal prior to surgery, otherwise needs work-up for prostate cancer where indicated.

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Low Dose Brachytherapy

This is the alternate management option for a localized prostate cancer.

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Radical Perineal Prostatectomy

Discontinued

This is an alternative to a Radical Retropubic Prostatectomy for low-intermediate risk prostate cancer. Prostates are generally smaller than 50cc. Only a handful of surgeons in Australia offer this.

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Radical retropubic prostatectomy with or without pelvic lymphadenectomy

This has now been replaced by a ROBOTIC ASSISTED technique. Principles remain similar, speak to Jo about this

This is the surgical management option for a prostate cancer which fits all the criteria set out by the Urology Society of Australia for Surgery. It is the complete removal of the prostate, seminal vesicles and bladder neck. It may include a pelvic lymphadenectomy. Most centers now offer this Robotically.

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Retro-pubic / Suprapubic open Prostatectomy (Robotic assisted)

This procedure is performed when the prostate gland is enlarged to such an extent that medication cannot relieve the urinary symptoms. A robotic assisted technique is available.

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Saline / Gyrus Trans Urethral Prostate Resection

The endoscopic resection of benign prostate enlargement. Usually done for large prostates, larger than 150cc, or prostates where PSA is elevated and biopsies have been negative, in order not to miss a Prostate cancer diagnosis.

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Trans Perineal Ultrasound Guided Prostate Biopsies / Saturation TPUS biopsies

This is diagnostic procedure used to make a diagnosis for an elevated PSA. 12 biopsies are taken of the prostate. The 3 possibilities of an elevated PSA is: Benign Prostate Hyperplasia, Prostatitis or Prostate Cancer. Saturation biopsies include 24 biopsies and are generally recommended second time round. With the use of preoperative 3T MRI scanning, accurate minimal targeted biopsies can be taken.

The technique has changed to a trans-rectal guided trans-perineal prostate biopsy, therefore avoiding the rectal cavity to reduce infection rates to 0%

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Trans urethral Bladder Neck Resection

For those guys with normal sized prostates but a prominent bladder neck causing all the irritating symptoms of an enlarged prostate.

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Trans Urethral de-roofing of Prostate Abcess

Non invasive opening of an abscess found in the prostate, Very similar to a TURP with the exception that the bladder neck is preserved thus maintaining prograde ejaculation to some extent.

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