Doctor Nguyen Hoang Duc, Head of Urology, Center for Urology - Nephrology - Andrology, Tam Anh General Hospital Ho Chi Minh City, reported that the patient's prostate weighed over 170 grams, significantly larger than the normal approximately 30 grams. This was the direct cause of repeated urinary retention, leading to frequent emergency hospitalizations.

Tests showed a prostate-specific antigen (PSA) level of 170 ng/mL, 40 times higher than normal. MRI results revealed that the tumor had grown through the outer capsule, corresponding to stage T3. Additionally, a biopsy indicated a Gleason score of 9, placing it in the very high-risk group, signifying highly malignant cancer cells with rapid growth and a higher-than-usual potential to invade surrounding tissues.

Doctor Duc explained that the patient's prostate was excessively large. Radiation therapy could cause prostate swelling, worsening urinary tract obstruction, leading to prolonged urinary retention and the need for a long-term urine bag. Meanwhile, open or conventional laparoscopic surgery carried high risks of significant blood loss, urine leakage complications, or rectal damage. Doctors decided to perform surgery using the Da Vinci Xi robot.

Using 3D images magnified 10-15 times, doctors clearly identified blood vessels and the area around the tumor. The flexible robotic arms assisted doctors in dissecting the tumor close to the rectum and iliac vascular bundle, minimizing damage to healthy tissue. After tumor removal, doctors reconstructed the urinary tract between the bladder and urethra. Due to the prostate's large size, the suturing distance was wider than usual. The robot facilitated precise stitches in the deep and narrow surgical field, reducing the risk of postoperative urine leakage.

One day after surgery, Mr. Tien was able to walk gently and was discharged on the fifth day. He is scheduled for adjuvant radiation therapy and hormonal treatment to suppress testosterone 4-6 weeks post-surgery, aiming to prevent recurrence.

Doctor Duc (seated) controls the Da Vinci Xi robot to remove the patient's prostate. Photo: Tam Anh General Hospital

Prostate cancer is a common cancer in men, often progressing silently with few symptoms in its early stages. When the tumor grows large, patients may experience difficulty urinating, frequent urination, intermittent urination, blood in the urine, or pelvic pain.

Depending on the disease stage, doctors may choose various treatment methods: active surveillance for low-risk cases, radical prostatectomy, radiation therapy, hormonal therapy to suppress testosterone, or chemotherapy for metastatic cancers.

Doctor Duc recommends that men aged 50 and older undergo specialized urological examinations and regular PSA tests for early detection and effective treatment.

Dinh Lam

*Patient's name has been changed