Open prostatectomy

Overview:

Open prostatectomy is a surgical treatment done in males to remove prostate glands. This surgery is done when the prostate has benign prostate enlargement or prostate cancer. It removes part or all of the prostate gland. This surgery is done in men and those assigned males at birth.

The prostate gland represents male reproductive organ located in the pelvis area. It is part of the male reproductive system and secretes a part of the fluid in the semen. Any abnormal growth in the prostate can lead to a benign enlargement called the benign prostate enlargement or an uncontrolled growth of tumor cells leading to prostate cancer.

Indications:

It is indicated to treat a variety of prostate cancers. Cancers of the prostate are called adenocarcinomas which develop from the cells of the prostate glands. Prostatectomy is also recommended to treat a condition called benign prostate hyperplasia or enlargement. Prostate enlargement is a condition that blocks the urethra and affects the way one urinates. Clinical symptoms where prostatectomy is done include:

A frequent need to urinate.
Urgency in urination
Difficulty in starting to pee.
Peeing for a longer time than usual
Urinating more times at night
Discontinuous flow of urine
Unable to empty the bladder completely.
Frequent urinary tract infections

Types of prostatectomy:

The prostate gland has two parts. They are the inner portion that contains the gland and the outer portion that forms a covering on the gland called the capsule. It is surrounded by other glands called the seminal vesicles, lymph nodes, and vas deferens (a tube that carries the semen or ejaculate). Prostatectomy removes either only the glands or the entire parts surrounding it. Based on this prostatectomy is of two types. They are simple and radical prostatectomy.

Simple prostatectomy: In simple prostatectomy, a small incision or cut is made on the inner portion of the abdomen to remove the inner part of the prostate. The outer part called the capsule is left intact. This can be done by open prostatectomy or laparoscopic prostatectomy. This surgery is done when there is benign prostate enlargement.
Radical prostatectomy: In a Radical prostatectomy, a cut is made on the area between the belly button and pubic bone, and the entire prostate gland along with the fat and tissues are removed. The tissues removed include the seminal vesicles, lymph nodes, and vas deferens. This can be done as open surgery or laparoscopic surgery. This surgery is done when there is prostate cancer.

Before the procedure:

Before undergoing prostate removal, an individual should understand the importance and necessity of the procedure by discussing it with the healthcare provider (HCP). All the medications taken by the individual should be informed to the HCP along with the history of previous diseases, infections, surgeries, and allergies. Based on the medications taken, some medicines are advised to stop depending on the health condition and risk vs. benefits. These include over-the-counter medications, blood thinners, and opioid painkillers. Medicines will be prescribed by the HCP before undergoing the surgery.

Certain routine blood and urine investigations are carried out to rule out any infections or other conditions not known to the individual. Advanced imaging techniques like MRI, CT scan, or ultrasound may be done to study the extent of the tumor spread or the damage. Depending on the extent of the spread of the disease, either simple prostatectomy or radical nephrectomy is planned.

It is better to discuss and know the type of prostatectomy done with the HCP. Prostatectomy is done on an empty stomach. Hence it is advisable to stop eating or drinking 8 hours before the procedure.

During the procedure:

A prostatectomy is done under general anesthesia in a hospital. Spinal or epidural anesthesia is also given during prostatectomy to numb the body from the pelvis and below. Medications called sedatives will be given to calm down during the surgery. A thin tube called a catheter is placed to help in urination. Open prostatectomy involves using a single long incision to remove the prostate gland. It is again of two types.

Retropubic Prostatectomy: This is done by giving a long cut from the belly button down to the pubic area.
Perineal prostatectomy: This is done by cutting the skin between the anus and scrotum. This has the disadvantage of erection problems in the future. However, it has the advantage of faster recovery, shorter operation time, and less pain during the procedure.

After removing the necessary affected structures, drains are placed in the skin and the surgical site is closed with sutures.

After the procedure:

After the surgery, the individual is taken to a recovery room and monitored until the vitals stabilize. Vitals are often checked for signs of bleeding or distress and necessary blood tests are also done. Patients are discharged based on their condition and the method of prostatectomy chosen, generally after 1-2 days. Medications for pain and infections are prescribed. Instructions are given on the diet and exercises. It is advised not to be involved for at least six weeks in strenuous activities like heavy lifting, strenuous exercise, including contact sports, and sexual intercourse after the surgery. The urinary catheter will be removed 7-10 days after surgery.

Risks and complications:

Though prostatectomy is safe, there are certain risks and complications. Bleeding, infections, trauma to the internal organs, urinary tract infections due to the catheter, and allergic reactions to the medications are some of the risks associated with the procedure. Other complications include erectile dysfunction (impotence), narrowing of the urethra, and formation of cysts.

Conclusion:

Prostatectomy is a surgical procedure done in men for prostate cancer or benign prostate hyperplasia. It can be done partially or can remove entire tissue surrounding the prostate based on the extent of the disease. It helps to increase the quality of life and overall wellbeing of individuals with prostate issues.

Popular Searches :

Specialities

Urology

Available Locations

View all

Fortis Hospital, Kalyan, Mumbai

4.5
4.5

know More Book an appointment
S L Raheja Hospital, Mumbai

4.7
4.7

know More Book an appointment
Hiranandani Fortis Hospital, Vashi, Mumbai

4.7
4.7

know More Book an appointment
Fortis Memorial Research Institute, Gurgaon

4.5
4.5

know More Book an appointment
Fortis Hospital, Noida

4.0
4.0

know More Book an appointment
Fortis Hospital, Mulund, Mumbai

4.6
4.6

know More Book an appointment
Fortis Hospital, Mohali

4.6
4.6

know More Book an appointment
Fortis Hospital, Ludhiana

4.4
4.4

know More Book an appointment
Fortis Escorts Heart Institute, New Delhi

4.6
4.6

know More Book an appointment
Fortis Hospital, Anandpur, Kolkata

4.1
4.1

know More Book an appointment
Fortis Hospital & Kidney Institute, Gariahat, Kolkata

4.2
4.2

know More Book an appointment
Fortis Hospital - Greater Noida

4.5
4.5

know More Book an appointment
Fortis Hospital, Shalimar Bagh, New Delhi

4.6
4.6

know More Book an appointment
Fortis Flt. Lt. Rajan Dhall Hospital, Vasant Kunj

4.5
4.5

know More Book an appointment
Fortis Escorts Hospital, Jaipur

4.4
4.4

know More Book an appointment
Fortis Escorts Hospital, Faridabad

4.7
4.7

know More Book an appointment
Fortis Escorts Hospital, Amritsar

4.1
4.1

know More Book an appointment