A record-breaking double surgery with the help of the robot: the prostate was removed for a tumor and an infrapubic penile prosthesis was implanted in the same operating session to guarantee the patient a quality of sexual life after radical prostatectomy. The double operation took place at the Asst Sette Laghi hospital in Circolo and the Macchi Foundation in Varese. The head physician of the UOC of Urology Federico Dehò with his colleagues Paolo Capogrosso and Gabriele Antonini carried out the exceptional intervention. The 62-year-old patient is doing well and was discharged in excellent physical condition. “Prostate cancer – explains Dehò – today represents the first oncological disease of man. Thanks to the screening and the technology at our disposal, it is possible to carry out an increasingly precocious diagnosis and to cure this morbid condition”.
“The possibility of carrying out a robot-assisted intervention allows us to protect and save as much as possible the anatomical structures, but unfortunately the erectile function is often irreparably compromised when for oncological reasons the nerves cannot be spared – underlines Dehò – The side effects are in one urinary incontinence in a small percentage and sexual impotence in a much higher percentage and can irreversibly alter the quality of our patients’ social and couple life.Furthermore, after surgery, due to the hypoxygenation of the cavernous bodies, the penis begins a process of retraction and shortening in length of about 0.5 cm per year. Precisely for this reason – he points out – we have devised a protocol for selected patients with a high-grade disease or with pre-existing erectile deficit, which allows to associate the robotic procedure for the implantation of the penile prosthesis to protect and guarantee the erect activity and above all to prevent the shortening of the penis”.
“The penile prosthesis – describes Antonini – is an endocavernous device made up of two inflatable cylinders which are inserted into the two natural cylinders of the penis, the corpora cavernosa. It allows to obtain an erection with a consistency and appearance that is indistinguishable from a natural erection and to have a penile rigidity only during sexual activity, allowing the erection to be hidden in other moments of relationship life. We carry out an infrapubic incision at the base of the penis of just 2 cm in about 15 minutes. Practically a small laparoscopic access which, associated with mini-invasiveness of the robot, allows the patient a very rapid physical recovery. We are the only center in Europe to carry it out and we allow sexual activity to resume two weeks later with an excellent aesthetic and functional result. The operation does not involve any damage to the nervous system, leaves the sensitivity of the penis unchanged and is completely invisible from the outside”.
“To date, this prosthetic surgery is not included in the Lea (essential levels of assistance) – Antonini specifies – and after the removal of the prostate, the man has only pills and injections available which do not always allow a return to a normal sexual life. Like the woman who undergoes a mastectomy for a tumor contextually implants a breast prosthesis, so the man who undergoes surgery for prostate cancer should have the possibility of implanting, where required or necessary, a prosthesis for an erection”.
