PROSTATECTOMY

Prostatectomy is an operation to remove all or part of the prostate gland, which is part of the male urinary system and male reproductive system. Prostatectomy can be used to treat an enlarged prostate gland, which is stopping the flow of urine from the bladder or prostate cancer. Two types of prostatectomy can be performed--transurethral prostatectomy and open prostatectomy.

Transurethral prostatectomy is performed on about 90 percent of all enlarged prostates that require surgery and is done without making an incision. This procedure is done most often in patients whose prostate is moderately enlarged. If the enlargement is greater, then open prostatectomy is usually used.

During transurethral prostatectomy surgery, the healthcare provider passes a viewing and cutting instrument through the penis and into the prostate gland. The instrument contains an electric cutting edge. From inside the prostate, this cutter is used to remove part of the prostate. Open prostatectomy is performed through an incision in the abdomen or between the scrotum and the anus.

Pre-surgery instructions are necessary to prepare for the surgery. Preparations include having certain laboratory tests and not eating or drinking anything for 12 hours before surgery. Antibiotics may be prescribed for a few days before and after surgery to help prevent infection. Tell your healthcare provider if you have any allergies or have recently taken (or are currently taking) any medications, especially blood thinners or aspirin.

After surgery, patients are watched closely in the recovery room for some time. Patients undergoing transurethral prostatectomy spend 2 to 3 days in the hospital, while patients undergoing open prostatectomy may spend 5 to 7 days in the hospital.

After going home, patients should:

drink plenty of fluids (about 3 quarts per day) to help flush out any remaining blood in the urine or blood clots that may form in the bladder and
avoid activities that put strain on the abdomen, such as straining to have a bowel movement or heavy lifting

Common symptoms after prostatectomy include:

blood in the urine
urination that is frequent at first and sometimes painful or
mild urine leakage for a few weeks

Having prostatectomy carries some serious risks, including:

impotence (the inability to achieve and maintain an erection)
infertility (the inability to father a child) and
difficulty controlling urination, as well as other problems related to urinating normally

Discuss these risks with your healthcare provider before deciding to have the surgery. For most patients, benefits of the surgery include relief of bladder obstruction and urination problems.

Aternatives to prostatectomy that may be realistic for some men include:

watchful waiting, rather than surgery, while under the care of a healthcare provider and
prescription medications

Studies have shown that one-third to one-half of men with mild or moderate prostate enlargement symptoms get better on their own within 3 to 5 years. Another one-fifth to one-fourth remain the same.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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