Changing lives via retzius sparing technique for prostate cancer

Written in association with: Mr Philip Charlesworth
Published:
Edited by: Sarah Sherlock

Many men will undergo a prostate removal for one reason or another, one of the reasons being prostate cancer. In all cases, patients want to be able to return to their normal lives as best and as soon as possible. Inspired consultant urologist, Mr Philip Charlesworth, gives us a clear description as to why the newer rezius sparing technique is the ideal procedure for treating prostate cancer.

 

retzius sparing prostate cancer

 

How are prostate removals more commonly done?

In a traditional robotic surgical removal of the prostate, the instruments come in at quite a wide angle and the bladder and the front of the prostate are approached. All the supporting structures and continence structures are included in playing a role, some of these being the bladder supports and ligaments on top of the prostate. This is the approach that we've used for many, many years.

 

 

How does the retzius sparing technique differ?

Now, retzius sparing is about sparing that area, that is called the space of retzius. If you spare that, you spare having to divide the supporting structures for the continence, for the sphincters, for the ability to then get early recovery of your continence after you've had your prostate removed.

 

 

How is the retzius sparing technique done?

The way that we do that is by coming underneath the prostate to start with. Next, we define where the erectile nerves are and we define where the prostate is. Then, we work our way up and round, shelling the prostate out and off the rectum, taking the cancer out. This allows us to leave all those important structures on top of the prostate and on top of the sphincter intact.

 

 

What is recovery like after the procedure?

Many patients nowadays that have retzius sparing recover a few days later when the catheter comes out. There is very little in the way of constant incontinence. As there is very little in the way of leakage, patients hardly have to use any pads and are often massively surprised about how quickly that is.

 

Now, clearly there will still be some patients that will struggle and need some rehab and need some support. Actually, when you look at the population of patients that have the retzius sparing procedure compared to having an anterior approach, the patients do better and get their continence back earlier. This has been proven on randomised control trials, and we are about to start another one to prove it still further

 

 

Why does this matter?

I think that the recovery results are really important. It's something I'm so passionate about because it matters. These patients I operate on want to get their lives back. They want to get back to work. They want to get back to their exercise and their sport. They want to get back on their bikes or go running. And the drier you are, the more control you have and the happier you are. And that has got to be good.

 

 

If you are experiencing prostate concerns and would like to see if the retzius sparing procedure is best for you, you can schedule a consultation on Mr Charesworth's Top Doctors profile.

By Mr Philip Charlesworth
Urology

Mr Philip Charlesworth is a highly accomplished British consultant urological surgeon, who practices in Berkshire and London. He has a sub-specialist interest in pelvic uro-oncology, specifically focusing on prostate cancer and bladder cancer, as well as an expertise in robotic surgery. Mr Charlesworth has been recently been appointed as a substantive consultant at The Royal Marsden Hospital. He is deeply committed to delivering exceptional cancer treatment and care, particularly focussed on the long term functional and quality of life outcomes of his patients.

Throughout his career, Mr Charlesworth has consistently pushed boundaries and strived for improved outcomes through his innovative surgical techniques. He is dedicated to excellence in minimally invasive procedures, particularly with Retzius-sparing (continence sparing) and nerve-sparing techniques (including NeuroSAFE frozen section) inrobotic prostatectomy. He has performed over 1500 complex cancer robotic and open surgical procedures with outstanding results, and is ranked as one of the highest volume robotic pelvic cancer surgeons in the UK.

As a consultant at The Royal Berkshire Hospital, Mr Charlesworth has played a pivotal role in developing and expanding the cystectomy/pelvic oncology and robotic surgery service. His high volume practice and enthusiasm for education and teaching, has attracted numerous international fellows (Australia, the Caribbean and Israel) over the past six years. All of whom have now developed minimally invasive pelvic oncology practices in their own countries across the globe.

Mr Charlesworth began his training at the University of Southampton. He completed a post-graduate degree at the Institute of Molecular Medicine, University of Oxford, specialising in the molecular genetics of urological malignancies from 2004 to 2007.

His surgical training was initially at the NHS and military hospitals on the south coast of the UK, gaining experience in general, transplant and vascular surgery. Further training encompassed expertise in robotic surgery, minimally invasive surgery and open surgery for major urological cancers, as well as surgical reconstruction.

Throughout his career, Mr. Charlesworth has collaborated with esteemed robotic surgical teams worldwide. He has worked at renowned institutions such as Regina Elena Hospital, National Cancer Institute in Rome, Italy, Harlev University Hospital in Copenhagen, Denmark, and the Karolinska Institute in Stockholm, Sweden. In 2012, he was honoured with The Urology Foundation (TUF) Preceptorship, providing him with the opportunity to work alongside Professor Indy Gill and his robotic surgical team at the University of Southern California Institute of Urology in Los Angeles, California, USA.

Currently, Mr Charlesworth's NHS practice is based at The Royal Berkshire Hospital, where he leads the Berkshire Cystectomy Robotic Team. In addition, he holds the position of Chairman of the Specialist Uro-Oncology Multidisciplinary Team (MDT) for the South Thames Valley Cancer Centre, overseeing the areas of East Berkshire, West Berkshire, and South Oxfordshire.

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