Prostate problems

An increasing number of men experience problems with their prostate or have questions about their prostate. As the Urology Department, we try to support you as best we can in the detection, diagnosis and treatment of various prostate disorders.

Based on the most recent scientific insights and with the assistance of innovative techniques, we treat the following prostate disorders:

• Prostate cancer: a lot of progress has been made in the last few years in the detection and treatment of prostate cancer. These developments have resulted in more targeted diagnosis as well as improved treatment. This means that men live longer and, increasingly, without any debilitating side effects from the prostate cancer treatment.
• Enlarged prostate: the scientific term for this is Benign Prostate Hyperplasia (BPH). This is a benign prostate disorder that occurs in approximately half of men in their 50s and approximately 90% of men in their 70s. Very often, the symptoms can be treated with medication.

To ascertain the optimum treatment, we try to discuss cases as much as possible within our department. This means discussion with each individual patient but also internal discussion among the urologists. Patients with prostate problems are discussed daily in an accessible format to try to arrive, as a team, at the optimum treatment.

A prostate check-up starts with a consultation with one of our urologists. Please make sure to bring results of previous urinary and blood tests as well as any radiology examinations that have already been performed.

During your initial consultation, you may expect:

• a review of your medical history, test results and your referral letter
• a physical examination
• questions concerning general health, urinary problems and erectile dysfunction
• conversation about your daily activities and your expectations about any treatments

To detect prostate cancer, it may be necessary to collect blood samples to determine the Prostate-Specific Antigen (PSA). Sometimes, a specific urinary test may clarify the situation further. An MRI scan or even a prostate biopsy may be advised.

Then (after all aspects have been adequately examined), your urologist will try to draw up a personalised treatment plan for your specific prostate disorder, based on your personal symptoms. Any other treatment options (alternatives) will also be discussed. You will be able to ask questions, and your views will be taken into consideration.

Our department is regularly involved (a present as well as in the past) in national and international scientific research.

These scientific initiatives have resulted in, among others:

• highly targeted biopsy sampling when prostate cancer is suspected The MRI fusion biopsy technique being taught at our hospital to external urologist colleagues who want to master this technique.
• We were one of the first hospitals in Belgium to offer an innovative laser technique (Greenlight Laser PVP) for the treatment of Benign Prostate Hyperplasia. The department was involved in the first scientific publications about this. This technique currently is one of the standard treatments of Benign Prostate Hyperplasia in Europe and North America. Another, additional new laser technique (HoLEP) for the treatment of Benign Prostate Hyperplasia is also offered by our department.
• We were one of the first hospitals in the Ghent area to believe in the potential of the surgical robot for prostate cancer surgery. Various members of our department underwent training in this technique in Belgium and abroad.
• Thanks to our smooth collaboration with the Oncology Department of the Medical Integrated Cancer Centre in Ghent, we have often been the first in the country to offer a variety pharmaceutical therapies for advanced prostate cancer. This has led to scientific publications in respected journals. This new medication results in prolonged survival for many prostate cancer patients.

The radiotherapist, medical oncologist, specialised radiologist and pathologist discuss every new prostate cancer patient.

This is done with the objective of continued critical evaluation and discussion, so that we can always offer high-quality care and treatment.

For the different prostate disorders, new technology, new medication and less invasive surgery have always been offered and continue to be offered on a regular basis. This means that fewer and fewer people are being treated with classic open surgery these days. It is now also known that it is safe to adopt a watchful waiting approach and monitor for certain types of prostate cancer: surgery is therefore unnecessary for these types of cancer. Treatment of the different types of prostate disorders generally starts with medication or a procedure that is as minimally invasive as possible. This approach naturally reduces the risk of complications and ensures that you can resume your daily activities quickly.

Minimally invasive treatments for prostate cancer:

The department has specialised in minimally invasive treatments for prostate cancer, such as:

• Robot-assisted radical prostatectomy
• Brachytherapy for prostate cancer (implantation of radioactive seeds)

These techniques allow us to preserve the erectile nerves around the prostate as much, and as often as, possible. We consider this very important because this reduces the risk of side effects such as erectile dysfunction, urinary loss and other urinary problems.

Minimally invasive treatments for BPH (prostate enlargement):

• Photoselective vapourisation of the prostate (Greenlight Laser PVP): laser energy is used to remove the excess prostate tissue without pain and bleeding, solving the urinary problems.
• Holmium LaserEnucleation of the Prostate (HoLEP laser): a different type of laser energy is used to 'scoop out' the excess prostate tissue. The large block of prostate tissue thus obtained is then ground into small chunks in the bladder, and removed. This will solve the urinary problems.
• TransUrethral Resection of the Prostate (TURP): for certain patients, ‘drilling’ of the prostate is preferred. This technique has the additional benefit that no abdominal incision is required.