Prostate Health: Prostatectomy

An enlarged prostate is a very common with men. If your prostate is creating problems and you have damaged in your bladder, you may have to have it removed. This procedure is called a prostatectomy.

Prostate problems are very common in men.  These can usually be treated with medications; however, if the prostate is greatly enlarged, if the bladder has been damaged, or if the patient has complications prohibiting other procedures, a prostatectomy may be necessary.  This may also be performed if cancer is detected.

A prostatectomy is sometimes the best and safest approach.

A prostatectomy is performed under general or regional anesthesia. The surgeon makes an external incision in the lower abdomen or in the perineum (area between the rectum and the scrotum).

If the surgeon accesses the prostate from the abdomen, the procedure is called suprapubic or retropubic prostatectomy.  If the surgery is performed through the perineum, it is called perineal prostatectomy. Once access is gained, the prostate is removed.

After prostate surgery, a urinary catheter is inserted to ensure bladder emptying.  Although you will only stay in the hospital for 2 to 3 days, you may keep the catheter for a week or two.  At this time, urine output and color and continuous bladder irrigation are monitored.

Blood in the urine is an expected side effect of prostate surgery.  The bladder irrigation is used to maintain the effectiveness of the urinary catheter, remove blood clots, and cleanse the surgical area. If bladder spasms occur, the surgeon should be notified.

Once you have been discharged from the hospital, you should abstain from sexual intercourse for 6 weeks after surgery. Strenuous activity and lifting is to be avoided throughout the recovery period, which can take up to 8 weeks.

There are possible risks from this surgery, which could include incontinence and impotence.  Depending on the procedure, stress urinary incontinence may result when pressure is put on abdominal muscles.

Another risk is impotence, it is shown that up to 80% of men experience erection problems after this surgery.  The nerves that control a man’s ability to have an erection are right next to the prostate gland.  They can be damaged or removed during the surgery.   It is possible that after months or years even, men with erection problems may regain their ability to obtain an erection.

When considering whether to undergo a prostatectomy, you should consider your personal wishes, age, other medical conditions you may have, the stage and grade of your cancer, and your PSA level.  Your age and overall health will make a difference in how treatment may affect your quality of life, especially since you may experience urinary problems and sexual problems.

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