Prostatectomy

Procedure Information

What is Prostatectomy?

The prostate gland is located in the male pelvis, just below the urinary bladder. It is surrounded by the urethra which carries urine from the bladder to the penis. Prostatectomy refers to the removal of part or all of the prostate gland. 

Why would I get a Prostatectomy?

The most common indication for this procedure is prostate cancer and prostatic enlargement that is causing severe obstruction symptoms. Your physician may recommend radical prostatectomy or simple prostatectomy depending on your case.

Radical prostatectomy is used to remove the whole gland and the surrounding tissue, but simple prostatectomy doesn’t always involve the removal of the entire prostate. Radical prostatectomy is generally indicated in cases of prostatic cancer while simple prostatectomy is indicated in cases of benign prostatic hyperplasia.

Prostatic enlargement is also called benign prostatic hyperplasia, or BPH. Symptoms of BPH include the following: 

• Increased urination frequency at night.
• Difficulty starting urination.
• Weak urine stream.
• Inability to completely empty the bladder.

What happens during Prostatectomy?

Prostatectomy is usually done under general anesthesia. This means that you won’t be awake during the procedure. What happens next depends on the type of prostatectomy.

Radical prostatectomy can be done in different techniques like: 

• Robot-assisted radical prostatectomy, your surgeon will make 5 small incisions in your lower abdomen. Through these holes, a robotically controlled camera and other arms will be inserted. The surgeon will remove the prostate through one of the keyhole incisions.
• Open radical prostatectomy, your surgeon will make an incision in the lower abdomen from below the navel to above the pubic bone. He or she will carefully dissect the prostate gland from the surrounding tissue and takes it away. Then, the incision will be closed with sutures.

Simple prostatectomy may be done to relieve symptoms of BPH. It is usually performed as a minimally invasive procedure with robotic assistance. It involves the removal of the part that is causing obstruction, not the whole prostate.

What to expect after Prostatectomy?

Once the surgery is done, you should expect that: 

• IV pain medications will be given to you to control any pain.
• You will most likely go home one day after surgery.
• You will return home with a catheter in place.

Generally, patients take about four to six weeks to get back to their regular routine. If you had a simple prostatectomy, you still will be able to have an orgasm. However, you will ejaculate little to no semen. In cases of radical prostatectomy, full erectile function recovery can take as long as 18 months.

Conclusion

You should visit your physician after the surgery to make sure that there are no problems. You will need to see your doctor 6 weeks after the procedure then again every three months after the first year.

A simple prostatectomy will decrease the frequency and severity of symptoms related to prostate enlargement. You will not need any follow-up treatment for your BPH after you had the procedure. 

A Robot-assisted prostatectomy is preferred over traditional prostatectomy because it results in less pain, tissue trauma, and a faster recovery period. You will be able to return to your normal activity, with minor restrictions, around four weeks after the procedure.

Citations

Mayo Clinic: Prostatectomy

Cleveland Clinic: Robotic Radical Prostatectomy