Prostate
All about prostate surgery
In the case of some prostate problems, including prostate cancer, as well as enlargement or swelling and acute inflammation of the prostate, it is necessary to remove part or all of the prostate to save the patient’s life and prevent the progression of the disease. The surgeon and urologist will decide how to perform prostatectomy surgery with careful examination and according to the patient’s tests.
Prostatectomy is often performed to treat localized prostate cancer. This surgery may be used alone or together with radiation therapy, chemotherapy and hormone therapy. Performing a prostatectomy to treat prostatitis and its cancer involves removing the entire prostate and part of its surrounding tissue, including lymph nodes.
Surgery to remove the prostate may also be used to treat urethral obstruction caused by benign prostatic hyperplasia (BPH). Prostatectomy for the treatment of benign prostate enlargement includes simple open prostatectomy surgery. This surgery resolves urinary symptoms and complications caused by urinary obstruction due to BPH. These symptoms include:
. Urinary frequency, urgent need to urinate
. Difficulty starting to urinate
. slow urination (prolonged)
Increasing the frequency of urination at night
. Interruption of urine flow
. Inability to completely empty the bladder
. Urinary tract infection
. Inability to urinate
Depending on the treatment method, there are different types of prostatectomy surgery:
Radical prostatectomy surgery
This surgery is actually a treatment for men with localized prostate cancer. A surgeon can perform radical prostatectomy using different techniques, which include:
Radical prostatectomy surgery
Open radical prostatectomy surgery
Radical prostatectomy surgery by laparoscopic method
Simple open prostatectomy
This method is usually recommended for men who have severe urinary symptoms and an enlarged prostate gland. An enlarged prostate is known as benign prostatic hyperplasia or BPH. This surgery does not remove the entire prostate, and although it is performed as a radical prostatectomy, only part of it is removed. It removes the blockage from the prostate that has caused urinary retention. The surgical team will discuss the pros and cons of each technique and your preferences to determine which method is best for you.
Preparation for surgery
Before surgery, the doctor may want to perform a test that uses a scope to look inside the urethra and bladder (cystoscopy). This test allows the doctor to check the size of the prostate and examine the urinary tract. The doctor may also want to do other tests, such as blood tests or tests to measure the prostate and urine flow.
Follow your doctor’s instructions regarding pre-treatment measures. Here are some things to discuss with your doctor:
Medications: Tell your doctor about any prescription or over-the-counter medications or supplements you are taking. This is especially important if you use blood thinners and over-the-counter pain relievers such as aspirin. Your surgeon may ask you to stop taking medications that increase the risk of bleeding a few days before surgery.
Avoiding food before surgery: Your doctor will probably ask you to avoid eating and drinking after midnight before surgery. On the morning of the operation, take only the medicines prescribed by the doctor with a small amount of wat
Bowel preparation before surgery: Your surgeon may ask you to do an enema before surgery. You will be given instructions to perform an enema and clear your bowels on the morning of surgery.
Procedures after surgery: Ask your doctor how long you will need to stay in the hospital after the operation and plan ahead to return home because you will not be able to drive after the operation.
Activity limitation: You may not be able to work or perform heavy activities for several weeks after surgery. Ask your doctor how long it will take to heal.
Prostate removal surgery procedure
Before the surgery, you will be under general anesthesia, which means you will not be conscious during the procedure. Or spinal anesthesia may be used so that you are conscious during surgery but do not feel pain.
Open radical prostatectomy surgery
The surgeon makes an incision in the lower abdomen from below the navel to the top of the pubic bone. In rare cases, this incision is made between the anus and the scrotum (perineal surgery). After carefully cutting the prostate gland from the surrounding nerves and blood vessels, the surgeon separates the prostate along with the surrounding tissues. Finally, the incision is sutured.
Simple open prostatectomy surgery
After anesthesia, the doctor performs a cystoscopy. A flexible scope (cystoscope) is passed through the penis to see inside the urethra, bladder, and prostate area. Then the doctor places a tube (Foley catheter) inside the penis that extends to the bladder. This tube drains the urine during the operation. The doctor makes an incision below the navel, and depending on the method used by the doctor, it may be necessary to make an incision in the bladder to reach the prostate. If you have a hernia or bladder problems, your doctor may also use this surgery to treat these problems.
After the doctor removes the part of the prostate that is causing the symptoms, one or two temporary drainage tubes may be inserted through holes in the skin near the surgical site. One tube goes directly into the bladder (suprapubic tube) and the other tube goes into the area where the prostate was removed.
After surgery
After surgery, you should expect the following:
Intravenous painkillers are used.
Your doctor will ask you to walk on the day of surgery or the day after.
You will likely be discharged from the hospital the day after surgery.
When visiting home, a catheter is in place.
You should resume your activities gradually.
You will not be able to drive for a few days after the operation.
You should visit the doctor several times after the operation to make sure that you are in good condition.
Sexual activity is possible six to eight weeks after surgery.
Risks of radical prostatectomy surgery
The risks of this surgery are:
Urinary tract infection
urinary incontinence
erectile dysfunction (impotence)
Anal damage (in rare cases)
Urethral or bladder neck stricture
Formation of cysts containing lymph (lymphocele)
Risks of simple open prostatectomy surgery
Although open prostatectomy surgery is effective in relieving urinary symptoms, the risk of complications is higher and the recovery period is longer than other methods of treating enlarged prostate. Risks of open prostatectomy include:
. Heavy bleeding
Urinary tract infection
. urinary incontinence
. dry orgasm
Erectile dysfunction (impotence)
. Urethral or bladder neck stricture