Prostate Cancer Detected Early After Surgery Follow-Up in Taiwan

A 69-year-old man in Hsinchu, Taiwan, was diagnosed with stage II prostate cancer after his prostate-specific antigen (PSA) levels continued to rise following surgery for an enlarged prostate. The patient, identified as Mr. Hsu, initially underwent laser surgery for his enlarged prostate in 2024 due to difficulties with urination. However, follow-up PSA tests revealed an anomaly, prompting further investigation in early 2025 at Hsinchu MacKay Memorial Hospital.

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Early prostate cancer may not have obvious symptoms. Men over 50 can discuss PSA blood tests and related evaluations with their doctor to increase the chances of early detection and timely treatment.

Dr. Li Dean, a urologist at the hospital, confirmed Mr. Hsu's diagnosis through a prostate biopsy. He then underwent a robot-assisted radical prostatectomy. Doctors highlighted that secondary surgeries for prostate cancer after initial procedures for an enlarged prostate can be more complex. Previous surgeries can cause adhesions and fibrosis, blurring anatomical planes and increasing the risk of intraoperative bleeding and postoperative complications like urinary incontinence.

Dr. Li explained that the Da Vinci robotic system was used for Mr. Hsu's surgery. This system provides high-definition 3D imaging and magnification, allowing surgeons to clearly identify tissue layers even with adhesions. The robotic arms' dexterity aids precise dissection and suturing within the narrow pelvic space, minimizing damage to surrounding nerves, blood vessels, and the urethra while ensuring complete tumor removal and accurate bladder-urethral anastomosis.

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Patients who have undergone prostate laser or other related surgeries, and subsequently require a radical prostatectomy for prostate cancer, may face increased surgical difficulty due to adhesions and fibrosis from the previous operation.

Prostate cancer symptoms can overlap with those of an enlarged prostate, such as frequent urination, nocturia, and difficulty urinating. Dr. Li emphasized that men over 50 should discuss PSA blood tests and related evaluations with their doctor to increase the chances of early detection and timely treatment. The Da Vinci system offers advantages over traditional open surgery and standard laparoscopic procedures, particularly for patients with prior surgical history and significant tissue adhesions, by enhancing visualization and precision.

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The Da Vinci robotic system, with its high-resolution 3D stereoscopic imaging and magnified view, helps the physician clearly identify tissue layers after adhesions. The flexible robotic arms allow for precise cutting, separation, and suturing in the narrow pelvic space.