to view an animated version of this procedure.
A prostatectomy is a surgery to remove the prostate gland. The prostate gland is part of the male reproductive system.
It makes and stores the milky fluid that forms part of semen. The gland sits below the bladder and in front of the rectum. The urethra (the tube that flows urine out of the body) runs through the protate gland.
The procedure may be: Simple prostatectomy—removal of part of prostateRadical
prostatectomy—removal of entire prostate and some surrounding tissue
Anatomy of the Prostate
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A simple prostatectomy may be done to remove an enlarged prostate that is non-cancerous. A common cause of this type of growth is called
benign prostatic hyperplasia
(BPH). It can interfere with the flow of urine out of the body. The surgery is done to allow urine to flow through again.
A radical prostatectomy may be done to remove a prostate gland containing
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like: BleedingInfection
Inability to control urinary stream—incontinence
Inability to get an erection (erectile dysfunction) and other sexual difficulties
Blood clots in the legs or lungsSterilityInjury to the rectum or other nearby structuresAdditional surgery to repair a hernia of the groin
Factors that may increase the risk of complications include: ObesityChronic or recent illnessLung, kidney, liver, or heart diseaseSmokingProblems with
drug useUse of certain prescription medications
Diabetes or other chronic conditions
Before surgery your doctor may do the following: Physical examBlood and urine tests
Leading up to the procedure: Arrange for a ride home.
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.The night before, have a light meal. Do not eat or drink anything after midnight.
or spinal anesthesia
will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a specific section of your body numb.
The procedure can be done as: Open surgery—An incision is made in the skin to allow the doctor to see the prostate.Laparoscopic
surgery—Only very small incisions are needed. The surgery is done with specialized tools and a tiny camera that is passed through the incisions.
surgery—Similar to laparoscopic with use of small incisions, but the surgery is done with robotic tools that the surgeon controls.
An incision is made in the lower abdomen. The doctor will be able to see the prostate through this incision. The inner part of your prostate gland will then be removed. This procedure is not as common in the United States. It is considered when you have a non-cancerous enlargement of the prostate.
An incision will be made in the lower abdomen between the belly button and pubic bone. The prostate gland and pelvic lymph nodes will be visible through this incision. The prostate will be detached from the bladder and urethra. The urethra is then reattached to the bladder. A main goal of treatment is to try to preserve nerve function related to bladder function and erections. Lymph node tissue may also be removed for testing. Your doctor may use these test results to decide whether or not to remove more tissue.
An incision is made in the skin between the anus and your scrotum. The prostate can be detached and removed through this incision. This is a less common surgical option because of some limits such as: Lack of access to the lymph nodesHigher risk of nerve damage
Five small, keyhole incisions are made in the abdomen. Robotic arms and a small camera will be passed through these incisions. The robotic tools allow wider and more flexible range of motion. The robotic arms will be controlled by a doctor at a console. The prostate and other tissue will be cut out with these robotic arms. This type of procedure may cause less scarring than other methods.
A catheter tube will be inserted to drain your bladder.
Water may be flushed through the catheter to reduce blood in the urine.
The catheter may be left in place for up to 3 weeks. This will let you urinate more easily during the healing period. After a radical prostatectomy, a
may also be placed to help fluid drain from the surgery site.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.
You will monitored in the recovery room. The hospital staff will check your breathing, blood pressure, and pulse. Right after the procedure, you may be given medication such as: Pain medicationMedications to prevent blood clotsAntibiotics if an infection is present or possible
During your stay, the hospital staff will take steps to reduce your chance of infection, such as: Washing their handsWearing gloves or masksKeeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as: Washing your hands often and reminding your healthcare providers to do the sameReminding your healthcare providers to wear gloves or masksNot allowing others to touch your incision
Complete recovery may take up to 6 weeks. During this time you may have to change or restrict activities until your doctor says it is okay. Arrange for help at home for a couple of days.
You may be given specific exercises to do at home to promote healing and maintain strength. Pain can be managed with medications.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision sitePersitent nausea and/or vomiting Pain that you cannot control with medicationsPain, burning, urgency or frequency of urination, or persistent blood in the urinePoor drainage from Foley catheterAbdominal swelling or painCough, shortness of breath, or chest painHeadaches, muscle aches, lightheadedness, or general ill feelingConstipationNew or worsening symptoms
If you think you have an emergency, call for medical help right away.
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http://www.dynamed.com/topics/dmp~AN~T114483/Prostate-cancer: O'Reilly EA, Burke JP, O'Connell PR. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg. 2012;255(5):846-853.
Last reviewed September 2016 by Mohei Abouzied, MD, FACP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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