Lasers can prevent prostate surgery side effectsStandard treatment causes erectile dysfunction in half of all cases
Prostate cancer is the most common cause of cancer in men. Surgery to remove the cancer is often successful but in half of all cases results in long-term sexual dysfunction. Now a new technique using robot controlled lasers may reduce the risk of damaging the crucial nerves necessary for erections and urinary continence.
In the procedure, the surgeon uses robotic instrumentation to remove the patient's prostate. This is aided by a CO2 laser, which dissects the plane between the nerves and the prostate, freeing the nerves and preserving them.
CO2 lasers are already widely used to treat head and neck cancers. A new, flexible, fibre-based delivery system is now making the treatment approach possible with robotic prostate cancer surgery.
One of the developers, Dr. Ketan Badani, explained: "Traditionally, we cut, clip or cauterize the tissue around the prostate nerves.
"However, these techniques can cause irreversible damage due to traction or heat injury. The CO2 laser may reduce this risk because it is low-heat and doesn't require much manipulation of the nerves."
The new study describes the use of the laser in 10 cases. It reports that the technology is easy to manipulate and very accurate. Patients experienced a return of urinary continence better than the norm, something the researchers found "extremely encouraging".
"Future research will determine if the technology can improve outcomes with regard to the ability of men to sustain an erection, and its long-term ability to prevent cancer recurrence.
"The precision of movement available through robotic surgery is already helping reduce the risk of sexual side effects, and the early evidence is that CO2 lasers will help us be even more accurate -- especially when preserving the sensitive nerve areas necessary for sexual function and urinary continence" Dr Badani said.
The technique was developed at New York Presbyterian Hospital and Columbia University Medical Centre and is described online in the Journal of Endourology.
This article was published on Fri 6 August 2010
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