Prostatectomy includes a variety of surgical procedures for the removal of prostate glands or parts of it. The prostate gland is present in the male pelvis under the urinary bladder. The prostate gland surrounds the urethra, which carries urine to the penis from the urinary bladder.
Surgeons perform prostatectomy in several ways, which depends upon:
- The condition of the patient
- Appropriate treatment option
Types of prostate surgeries:
The main indication of this procedure is localized prostate cancer.
Surgeons use different techniques which are as follows:
- Robot-assisted radical prostatectomy:
In this surgery, the surgeon makes several small incisions in the lower abdomen to reach the prostate gland. After approaching, the doctor removes the prostate gland with the help of a computer-assisted device, which makes the movement of the physician’s hands precise.
- Laparoscopic radical prostatectomy:
Similar to the other techniques, the surgeon makes small incisions in the lower abdomen. In this technique, doctors use specialized tools and inserts to remove the gland.
- Open radical prostatectomy:
Surgery involves the removal of the prostate gland through an incision in the lower abdomen. It is also known as retropubic surgery.
- Simple prostatectomy:
Surgeons recommend this surgery for the patients who are suffering from severe urinary symptoms. Surgeons can either perform this surgery openly or through robot machines. The enlargement of the prostate gland is a condition known as BPH or benign prostatic hyperplasia. Simple prostatectomy does not remove the entire gland form the body. This technique only removes the portion of the prostate, which is blocking the flow of urine.
Indications of prostatectomy:
Most often, this procedure is beneficial for treating localized prostate cancers. Surgeons either perform it alone or in combination with other treatments. Other treatments involve chemotherapy, radiation therapy, hormonal therapy, and targeted therapy.
Prostatectomy removes:
- Entire prostate gland
- Seminal vesicles
- Lymph nodes and their surrounding tissues.
The most important indication of prostatectomy is BPH.
This surgery eases the complications and urinary symptoms as:
- A frequent need for urination
- Difficulty with the initiation of urination
- Prolonged or slow urination
- Increased frequency of urination at night time (also known as nocturia)
- Recurrent starting and stopping while urinating
- The feeling of unease or incomplete emptying of the urinary bladder
- Infections of urinary tract
- The inability of urinations.
Simple prostatectomy has a higher risk of complications, which result in a long time for recovery.
Risks of the surgery:
The most common risks associated with prostatectomy are:
- Bleeding and infections of urinary tract
- Urinary incontinence and erectile dysfunction (also known as impotence)
- Injury to the rectum
- Narrowing of the stricture of urethra or neck of the bladder
- Formation of cysts which contain lymph or lymphocele
- Injury to adjacent or surrounding structures.
Pre-op preparations:
Before performing the surgery, the surgeon will observe the bladder and urethra through cystoscopy. Cystoscopy allows the doctor to check and examine the urinary system and prostate size. Your physician can also perform some tests to measure the flow of urine and prostate.
You should follow the instructions of your doctor before undergoing any treatment.
Procedure:
Surgeons select the technique according to the requirements of the patient.
The surgeon can choose from the following techniques:
- Robot-assisted radical prostatectomy – the robotic surgery allows more precise and smaller incisions which promotes the faster recoveries than other techniques
- Standard retropubic radical prostatectomy – the incision is made through the navel to the pubic bone. Incisions closed after the removal of prostate gland from the body
- Simple prostatectomy – a procedure which involves the use of cystoscope for observing urethra and bladder
Post-op time and recovery:
Once the surgery is complete, your doctor will shift you to the room.
- You will have some pain medications to manage your incisional pain.
- It is likely for the patient to go home within one to two days of the surgery. Most of the men require to stay on a urinary catheter for one and a half weeks after surgery.
- Your recovery depends upon your care of the body:
- Resume normal daily life activities and gradually increase the intensity
- Avoid driving for a couple of days after surgery
- Make sure to do a follow-up to your doctor for removal of stitches
- take good care of your diet.
- Always try to eat healthily.
Results:
Robot-assisted surgery results in faster recovery and less blood loss. You can return to your normal life in 2 to 4 weeks of the surgery.
Open simple prostatectomy can provide long-term relief for enlargement of the prostate gland. It is an invasive procedure, but its serious complications are very less likely to occur. Most of the men did not need any follow-up after the treatment of BPH with simple prostatectomy.
Conclusion:
Prostate cancer is a common disease among men. Several surgeries for the removal of prostate glands are available. Every procedure needs some pre-operative preparations and post-op care. If you follow the guidelines from the doctors, then you can have a faster recovery and a good prognosis of the disease.