The actual fact is that the actual people are not only the most effective, but also the most effective. The actual PSA is 15.28ng/ml, much higher than the normal value of 4ng/ml, and the doctor said it could be prostate cancer. The doctor said that it might be prostate cancer. This scared old Xu and his partner, and after many inquiries, they decided to go to the Department of Urology at Peking University Hospital, the birthplace of urology in China, to ask Dr. Zhang Qian what should be done. In the clinic, Dr. Zhang Qian inquired in detail about Lao Xu’s condition and examination results, and gave him a detailed physical examination and prostate examination. Lao Xu asked: How can we diagnose prostate cancer at the earliest? Dr. Zhang replied: In western countries, prostate cancer is a highly prevalent malignant tumor in men, and it is also the number one tumor disease in men’s mortality rate, so they now attach great importance to prostate cancer screening. The so-called prostate cancer screening is actually very simple, it is the prostate finger and blood PSA test, just like the ones you have done in the primary hospital. For older men like you, we recommend screening for prostate cancer from the age of 50. If someone in your family has had prostate cancer before, we recommend starting the screening at age 45. The doctor also asked, “Do I have prostate cancer now? Dr. Zhang replied: The screening result is only a preliminary screening, and further tests are needed to confirm the diagnosis. Based on your current information, it is too early to make a diagnosis of prostate cancer. I recommend that you undergo further MRI to confirm the location and extent of the prostate nodules detected in the physical examination, and then, under ultrasound guidance, undergo a prostate puncture biopsy. The actual results will determine the further treatment plan. The actual results of the MRI and the prostate puncture biopsy are the same as the ones you have had. The pathological results of the puncture examination indicate that you have early-stage prostate cancer with a malignancy score of 9 out of 10, indicating a very high degree of malignancy. The so-called early stage means that the tumor is confined inside the prostate and we have a chance to eradicate it through surgical methods. According to the current examination results, your partner is suffering from prostate cancer, and the degree of malignancy is very high. Fortunately, the tumor is still at an early stage and we have the opportunity to eradicate it through surgery. Given his current overall physical condition, surgery is the best treatment. Lao Xu asked: What are the other treatments for prostate cancer besides surgery? Dr. Zhang answered: There are four methods to treat prostate cancer. They are surgery, radiation therapy, endocrine therapy and chemotherapy. We have corresponding treatment methods for different stages of cancer development. For very early stage prostate cancer, which is a very small cancer confined to the prostate gland, we can treat it with traditional surgery or the newly emerged endoradiotherapy, which can usually achieve the purpose of curing the tumor. For early stage prostate cancer, that is, cancer that is still in the prostate but is more extensive, we usually take the surgical approach. Prompt treatment at this stage can also lead to a cure. If the disease progresses further and spreads to organs other than the prostate to the point where systemic metastasis occurs, endocrine therapy, radiation therapy and chemotherapy treatments should be considered. In your case, if your body can tolerate it and you wish to treat the tumor, I still think surgery is the most appropriate choice. Old Xu’s partner asked again: What is the danger of this surgery to the body? After the surgery to remove the prostate, the patient will lose the ability to ejaculate, but whether the patient can retain the erectile function depends on the extent of tumor invasion. For some patients with early stage prostate cancer, if the condition meets the requirements, we can use the surgery to preserve the erectile function. The prostate gland is at the very bottom of the male pelvis, usually as big as a plum or as big as an apple, with complex surrounding structures and narrow space, so radical prostate cancer surgery is one of the most difficult surgeries in urology. A perfect radical prostatectomy is like a “capsule” surgery, which can remove the prostate gland completely without damaging the surrounding organs and without affecting urination and erectile function too much. With the advancement of technology, the surgery has become less and less invasive. Our radical prostate cancer surgery through laparoscopic technology can achieve the realm of “precision, accuracy and accuracy”, with less trauma, faster recovery and better urinary control. After Dr. Zhang’s attentive answer, the old couple’s doubts were cleared. Dr. Zhang Qian was the main surgeon and performed the laparoscopic radical prostate cancer surgery for Lao Xu. The first hurdle is to open the pelvic floor fascia on both sides of the surgery. The posterior part of the pelvic floor fascia is the deep venous complex of the dorsal penis, which is fan-shaped and can easily cause massive bleeding once damaged. With the help of laparoscopic magnification, this structure can be clearly identified. Using a delicate laparoscopic instrument, Dr. Zhang lanced the dorsal deep penile vein complex with a single stitch, and passed this hurdle with flying colors. The second hurdle is the separation of the bladder neck. Separating the bladder neck from the prostate is a critical step for postoperative urinary control. If the bladder neck is preserved too little, urinary incontinence will easily occur after surgery; if the bladder neck is preserved too much, the tumor will not be removed cleanly. Dr. Zhang combined visual and tactile senses, repeatedly observed and carefully explored under the lumpectomy, and finally precisely disconnected the bladder neck. The third hurdle is to find the seminal vesicles. After dissecting the bladder neck, the next step is to find the seminal vesicles. The seminal vesicles are located behind the prostate and bladder, and finding them is the key to continue separating the prostate from the posterior side. Under clear laparoscopic observation, despite the small space, Dr. Zhang, through his extensive experience, quickly found the seminal vesicles in the posterior aspect of the prostate. The fourth hurdle, the separation of Di’s fascia The door to the posterior aspect of the prostate has been opened while still moving forward with care. In the process of separating Di’s fascia, avoiding damage to the rectum below is a crucial part of radical prostatectomy. Once the rectum is damaged or even perforated, it will be a catastrophic blow to the surgery. Dr. Zhang carefully observed under the laparoscope and meticulously separated with an ultrasonic knife. Finally, he also asked his assistant to check the integrity of the rectum through rectal palpation to ensure that nothing is wrong. The fifth hurdle, dealing with the neurovascular bundle After finishing the separation of the anterior, bottom and posterior sides, the next step was to carry out the separation of the two sides. At this point, the neurovascular bundle is involved. The neurovascular bundle is a structure that travels on both sides of the prostate, and its function is closely related to male erectile function. For very early stage prostate cancer, an intrafascial resection can preserve the neurovascular bundle intact, thus preserving the patient’s erectile function. Based on the results of MRI and puncture, Lao Xu’s tumor was located on the left side and was larger, so Dr. Zhang preserved the neurovascular bundle only for the right side. The sixth hurdle is the treatment of the prostate tip. The separation is just one last step away. The prostate is only as thick as the tip of a pen, but it is also the key to the patient’s ability to control urine after surgery. If the urethra of the prostate is too long, tumor tissue may remain, and if it is too short, urinary incontinence may occur after surgery. With the help of laparoscopy, Dr. Zhang accurately separated the prostate apical part, and thus completed the whole separation. The seventh hurdle, urethral reconstruction Urethral reconstruction is the essence of radical prostate cancer surgery. In the early open radical prostate cancer surgery, due to the limitation of the operation field and the narrow operation space, only urethral rendezvous was used in the urethral reconstruction, and the bladder urethra was not closed with silk sutures. This results in a high rate of urinary leakage and incontinence after surgery. With the help of laparoscopic high-definition vision and tiny instruments, Dr. Zhang Qian uses a single-stitch continuous suture anastomosis method. This method was fine and accurate, effectively preventing the occurrence of postoperative urinary leakage and greatly improving the patient’s postoperative urinary control. On the first day after the operation, Xu was assisted by his partner to go to the floor and was happily discharged home four days later. Before discharge, the head nurse of the ward advised Xu and his partner to do several things at home: 1. 2 weeks after surgery, the urinary catheter was removed in the outpatient clinic, and if needed, the pelvic floor muscles should be gradually exercised to restore the ability to control urine. 2. Follow the doctor’s instruction and have regular PSA review to monitor the recurrence and metastasis of the tumor.