A Gentler Surgery for Men: The da Vinci Prostatectomy

SUMMER 2012
F OR A P H YS I C I A N RE F ERR A L ,
C A L L ( 8 8 8 ) 4 4 4 - US M D
h e a lt h y
w w w. US M D A R L IN G TON . co m
It also makes every movement more precise.
Men whose surgeons use the da Vinci
system tend to:
• Lose less blood
• Feel less pain
• Leave the hospital and return to regular
activities sooner
In addition, some research suggests that
a man’s sexual function and his continence—
the ability to control when he goes to the
bathroom—may return faster after robotassisted surgery. And like other minimally
invasive procedures, da Vinci surgery leaves
only small scars.
A Gentler Surgery for Men:
The da Vinci Prostatectomy
Robots help surgeons treat cancer. It may sound like a science fiction
movie. But for men facing prostate cancer, it can be a real-life scene.
Not every man with prostate cancer
needs surgery. However, a radical prostatectomy—an operation to remove the prostate—might be an option if you:
• Have cancer that hasn’t spread
• Expect to live at least 10 more years
• Are in good health otherwise
• Are able to tolerate anesthesia
About one-third of men who undergo
prostate removal are operated on with the
da Vinci Surgical System, which was
approved for this procedure in 2001. The
da Vinci consists of a console, a screen, and
four robotic arms. The surgeon sits at the
console several feet from the operating
table and uses handles to move the arms.
One robotic arm holds a camera, while the
other three hold instruments that make
small cuts into the abdomen and remove
the prostate.
Benefits for Doctors
and Patients
Why would a surgeon need a robot’s help?
The system gives him or her a 3-D, supermagnified view of the inside of your pelvis.
Ask Your Doctor
About Your Options
Like all operations, the da Vinci prostatectomy
has risks. Any prostate surgery may cause
nerve damage and blood clots in the legs.
In addition, there’s a small chance the
robot could fail. If so, the surgeon would
complete the operation by hand or stop
it altogether.
Talk with your doctor about your
treatment choices. He or she can help
you decide if the da Vinci prostatectomy
is right for you. ■
the doctor
David Shepherd, M.D.
Urology
If you need a
specialist, please call
(888) 444-USMD for a
free physician referral.
INSIDE: Don’t Overlook Digestive Health ■ Get Help for Bladder Problems ■ Bariatric Seminars
f o r a p h y s i c I an r e f e r r al , c all ( 8 8 8 ) 4 4 4 - US M D
Your Digestive Tract: It’s Important!
I started medical school in August
of 1993. The lecture hall for the first year
students was completely full as we all sat
there anxiously awaiting the beginning of
our new careers. With open ears and minds
we listened as the chief of surgery began
our very first lecture: “Hippocrates once
said, ‘no manner of brains is worth a good
set of bowels.’” And then he walked out of
the classroom leaving us to think about
that statement.
Now that I am a colorectal surgeon, I
spend most of my day preaching that very
Hippocratic truth to the masses. There is
indeed no greater gift God can grant us
than a well-functioning digestive tract.
How the Digestive Tract Works
The digestive tract, or gastrointestinal (GI)
tract, is a long muscular tube that intermittently contracts to propel food from top to
bottom. The lining of this tube is responsible
for absorbing water, salts, and nutrients. It
also serves as a protective barrier against the
bacteria of the outside world. When you
have digestive problems, you are either having
problems with the muscular tube, the absorbent lining, or both.
An easy-to-understand analogy regarding the physical properties of the lining of
the colon takes us back to our childhood
experiences in the sand box. Dry loose
sand is easier to hold when you grab it
loosely. The tighter you squeeze the more
it wants to slip out between your fingers
and out the sides. When the muscular
colon squeezes hard, the lining wants to
squeeze out through the sides (creating
diverticular disease) and out the bottom
(creating hemorrhoids).
Help Is Available for Digestive
Tract Problems
The first treatment for these problems is
to encourage the patient to eat a high fiber
diet. Fiber bulks and softens the stool, lowering the pressure in the colon and minimizing both diverticulosis and hemorrhoids.
If this treatment fails, surgery often
becomes necessary.
The surgical approaches for both diverticulosis and hemorrhoids have become
minimally invasive. This means the newer
treatments cause less post-operative pain
and fewer days away from work. If you or
someone you know is suffering, schedule
an appointment today to discuss roboticassisted laparoscopic surgery for diverticulitis or Total Hemorrhoidal Dearterialization
for symptomatic hemorrhoids. ■
the doctor
Anna M. Toker, M.D.
Colon Rectal Surgery
If you need a
specialist, please call
(888) 444-USMD for a
free physician referral.
2 USMD Hospital at Arlington | www.USMDarlington.com
How Much Fiber
Do We Need?
The more calories you eat, the more
fiber your body requires. Government
health experts recommend 25 grams
per day for women and 38 grams per
day for men. But most of us eat only
about 15 grams daily.
If you stick to natural sources of
fiber like beans, whole grains, vegetables, nuts, and fruits, you’re unlikely to
eat too much fiber. Give your body a
chance to adjust to extra fiber by
starting slowly. Eating a bit more
every few days over a period of
weeks will help you avoid digestive
problems like bloating, gas, and diarrhea. Also, drink plenty of water to
help your body process the fiber. Too
much fiber can reduce absorption of
vitamins, minerals, and proteins. Avoid
this problem by eating mineral-rich,
high-fiber foods rather than relying
only on fiber supplements.
Finally, if you’ve been treated for
a digestive problem, ask your doctor
how much fiber you should eat.
f o r a p h y s i c I an r e f e r r al , c all ( 8 8 8 ) 4 4 4 - US M D
Don’t Let Bladder Problems
Limit Your Life
Make a list of your 10 closest
female friends. If they’re like most women
in the U.S.:
• Between one and two of them have an
overactive bladder
• Five of them likely have had a urinary
tract infection (UTI), and two or three
of those had another one shortly after
• Five of them have some degree of urinary incontinence
Didn’t know? It’s no wonder. Urological
issues are difficult to discuss with your
doctor, let alone your pals. They can make
you feel isolated and keep you from the
activities you enjoy.
But talking with your health care team is
the first step in finding relief. Use the following facts on three common bladder problems as a springboard for your discussion.
Fact #1
Overactive bladder occurs when the muscles that control your flow squeeze too
often. This means you’re often struck with
a sudden, overwhelming urge to go, even if
your bladder’s not yet full. Doctors aren’t
sure exactly what causes overactive bladder,
but nerve damage may be to blame. There
are increased signals between your bladder
and brain that give you the urge to go
when you do not want to. It is estimated
that 30 million Americans have this but
only about 3 million (10%) seek help for it.
Fact #2
Medications can help your muscles relax
and provide relief. Or your doctor may
recommend behavioral therapies such as
timed urination or changing the amount of
fluids you drink. If these fail, then minimally
invasive procedures, such as a bladder
pacemaker or bladder injections, are available to help. Your urologist can determine
if you are a good candidate for this.
or other medications to prevent them.
Studies have shown this therapy is more
effective than another common treatment,
cranberry pills, at preventing future infections. Your urologist may need to rule out
other potential causes such as anatomic
abnormalities or bladder problems.
Urinary incontinence has become more
common in recent years, finds a new study
in the Journal of Urology. Women are nearly four times as likely as men to have trouble controlling their bladders. And it’s not
just a problem after menopause. Younger
women often leak urine when they cough,
laugh, or exercise.
What You Can Do
Fact #3
Urinary tract infections result from an
invasion of disease-causing bacteria into
your bladder or urethra, the tube through
which urine flows out of your body.
Symptoms include a more frequent urge
to urinate, a burning pain when you do
go, and cloudy or foul-smelling urine.
Some women are more prone to UTIs
than others. If you get more than two per
year, talk with your doctor. He or she may
recommend taking low doses of antibiotics
Kegel exercises can help initially. To do
them, squeeze the muscles you’d use to
stop the flow of urine. Hold for three
counts. Relax for three counts. Lifestyle
changes such as losing excess weight,
avoiding alcohol, and not lifting heavy
objects may also help. A minimally invasive
surgery, called a sling, is an option and can
usually be done in about 20 minutes with
success rates of about 90%. Your urologist
can discuss with you whether or not you
are a candidate for this procedure. ■
the doctor
Keith Xavier, M.D.
Urology
If you need a
specialist, please call
(888) 444-USMD for a
free physician referral.
Living Healthy, Summer 2012 | USMD Hospital at Arlington
3
USMD Hospital at Arlington
801 W. Interstate 20
Arlington, TX 76017
Presorted Standard
US Postage
PAID
USMD Hospital
at Arlington
Living healthy
Living Healthy is published by USMD Hospital
at Arlington to educate readers about issues
important to their health. It is not intended to
replace consultation with a personal physician.
© 2012. Printed in the U.S.A.
Printed on Recyclable Paper
10096M
upcoming
seminars
The following FREE seminars will be
offered at USMD Hospital at Arlington.
Bariatric Seminar
Dr. Lyons and Dr. Dyslin
6 p.m.
• July 19
• August 16
• September 20
Find out if procedures such as adjustable gastric band placement, gastric
bypass, or sleeve gastrectomy are an
option for you.
USMD Hospital
at Arlington
Welcomes
Dr. Wang
USMD Hospital at Arlington is
pleased to welcome C.K. Wang, M.D. He
is a urologic oncologist now practicing in
USMD Hospital at Arlington's Medical
Office Building. Dr. Wang is board certified
in internal medicine, hematology, and
oncology.
C.K. Wang, M.D.
Educational Background
Professional Experience
Dr. Wang received his undergraduate
degree from Washington University in
St. Louis in 1996 before attending the
University of Texas Health Science Center
in San Antonio for his medical school
training. He then completed his internal
medicine internship and residency at Case
Western Reserve University/University
Hospitals of Cleveland and his hematology/
oncology fellowship at the UT Southwestern
Medical Center in Dallas.
Dr. Wang practiced oncology in North
Texas for 5 years before joining Urology
Associates of North Texas in 2012. During
that time, he served as director of
oncology Services at Wise Regional Health
System from 2007-2010 and was instrumental in helping the oncology program obtain
its accreditation by the American College
of Surgeons.
Dr. Wang grew up in Dallas. He currently
lives in Fort Worth. ■
To sign up for one of these
FREE seminars, visit our website at usmdarlington.com and click
on “Seminars & Events.”
Snap this tag with
your smartphone for
a full list of calendar
events.
Free physician
referral
If you need a specialist,
please call (888) 444-USMD
for a free physician referral.