Prostatectomy

What Is a Prostatectomy?

A prostatectomy is a curative procedure to remove all or part of an enlarged prostrate gland in male patients (usually 50 years or older).  Older men tend to be prone to either benign prostatic hyperplasia, which makes urination difficult, or prostrate cancer.   

If the patient’s disease is benign, transurethral resection of the prostate (TURP) is possible, where no incisions are necessary.  After administering general anesthesia, a catheter is put in place to drain the bladder.  Then, the surgeon inserts cutting instruments or a heated wire loop down a retroscope through the penis to excise the diseased prostrate tissue and seal the blood vessels.  At the end of this procedure, the surgeon washes the removed tissue into the bladder and flushes it out.  The catheter is left in place for 1 to 5 days to continue to drain urine and blood.  The ability to urinate improves several weeks after the procedure when the swelling reduces.   

When it’s possible that the patient is suffering from prostrate cancer, the surgeon employs one of two methods: radical retropubic prostatectomy or radical perineal prostatectomy.  During the former, the surgeon makes a horizontal incision in the lower abdomen and removes the pelvic lymph nodes to check for cancer cells.  If none are present, the surgeon removes the prostrate gland and inserts a catheter into the penis to drain the body of fluids for 14 to 21 days.   

During a radical perineal prostatectomy, the surgeon makes an incision above the rectum and beneath the scrotum when removing the lymph nodes.  This procedure is less invasive, and recovery is usually speedier.  On the other hand, it tends to damage the nerves associated with erection.   

Both procedures take between 1 and 4 hours.  Patients typically remain in the hospital for 3 to 5 days and return to work 3 to 5 weeks later.