Prostatectomy refers to a surgical removal of the entire or part of the prostate gland. The procedure is used in the treatment of prostate cancer. In fact, in 60% of prostate cancer cases, patients have to undergo this treatment.
Prostatectomy is also used in the treatment of urinary tract complications caused by BPH (benign prostatic hyperplasia).
There are two types of prostatectomy procedures: open simple prostatectomy and radical prostatectomy.
Open simple prostatectomy
This is a partial removal of the prostate gland. The surgeon only removes the part of the prostate that is problematic, usually the inner core of the prostate. It is often performed on patients whose prostate is enlarged to the point that it causes problematic urination, the most common symptom of BPH. A lot of men aged 60 and above undergo this procedure.
The urethra is a tube responsible for carrying urine from the bladder to the penis. The prostate gland surrounds the urethra. When the prostate gland enlarges it puts pressure on the urethra and interferes with urination. Patients with an enlarged prostate experience symptoms like frequent urination, recurrent urinary tract infections, bladder stones and problematic urination. Under such circumstances, open simple prostatectomy is a common treatment option.
To prepare for the procedure you have to discuss medication with your doctor. Drugs like aspirin thin blood and can cause excessive bleeding during surgery. The doctor also needs to check for other conditions. Finally, the patient's activities are restricted, he empties his bowel using an enema kit, and fasts several hours before the surgery.
The risks associated with open simple prostatectomy include erectile dysfunction, excessive bleeding, urinary tract infections, dry ejaculation, narrowing of the urethra and injury to internal organs. Recovery after the surgery takes 6 to 8 weeks.
Radical prostatectomy is the removal of the whole prostate gland and some surrounding tissue. This is the procedure used for prostate cancer patients. Radical prostatectomy can be done alone, or it can be combined with hormone therapy and chemotherapy.
There are three types of approaches to radical prostatectomy: robotic approach (the most popular), open radical approach, and laparoscopic approach. In the robotic prostatectomy, surgeons use mechanical devices with cameras. Small cuts are made and there is less tissue trauma, blood loss and pain after surgery compared to the other approaches. Patients also recover faster after the robotic type of prostatectomy.
Preparation and risk of radical prostatectomy are the same as in the case of open simple prostatectomy, though the same side effects are usually more severe after radical prostatectomy. Also, additional side effects for patients who undergo this procedure are formation of cysts, change in penis length and, in rare occasions, injuries to the rectum. Recovery for patients who undergo radical prostatectomy usually takes shorter, than in open simple prostatectomy procedure.