Mr Thyer offers specialist management of prostate cancer.
Mr Thyer has a special interest in robotic and laparoscopic surgery for prostate and kidney cancer but also performs surgery for many other urological conditions.
The kidney is a paired organ in the upper abdomen that filters the blood of waste then excretes this filtered waste in the form of urine. The urine is transported from the kidney via the ureter to the bladder in the pelvis where it is stored.
When a tumour develops on the internal lining of a single section of ureter then a segmental ureterectomy can be performed to remove just the affected section of ureter. This has the advantage of sparing the whole kidney and ureter from removal. The disadvantage is that the tumour may recur at a later date in the ureter. Mr Thyer will have performed ureteroscopy to ensure there is no tumour elsewhere in the kidney or other parts of the ureter prior to recommending this operation. The distal or segmental ureterectomy can be performed using an open, laparoscopic or robotic approach.
Ten days prior to the procedure you should:
On arrival at hospital you will be prepared for theatre by nursing staff. Mr Thyer will see you just prior to being taken into the operating theatre. You will require a general anaesthetic of approximately 3 hours. Mr Thyer will make a series of 5 small incisions in the abdomen to allow the passage of the robotic instruments. The ureter will be dissected free from its surrounding structures and the section containing tumour removed. The ureter will be re-joined using sutures or the ureter may be reimplanted directly into the top of the bladder. The ureter and tumour will sent to a pathologist for microscopic examination (you may incur a pathologist fee). A catheter will be placed in the bladder to remain for 2 weeks. A ureteric stent will remain in the ureter for a period of 6 weeks to prevent leakage of urine through the suture line. After the operation a drain will be left in the abdomen. Most people are in hospital 2 nights then discharged home after Mr Thyer’s review.
You will require a CT cystogram at 2 weeks to ensure there is no leak of urine from the bladder or ureter. If the CT is satisfactory then the catheter can be removed from the bladder usually the same day. Mr Thyer’s rooms will contact you to arrange follow up to check your progress, wounds and pathology 3 weeks following the operation. You should take laxatives, wear compression stockings, drink plenty of water and avoid heavy lifting for 3 weeks following the procedure. You should not drive a motor vehicle until seen by Mr Thyer at the follow up appointment. Flexible cystoscopy to remove the ureteric stent will be required at 6 weeks following the operation and then every 6 months to ensure there is no cancer recurrence in the bladder.
Following the procedure, you should contact Mr Thyer if you: