You might have come across the term Prostatectomy, but What is a Prostatectomy? A Prostatectomy is a surgical operation in which all or part of the prostate gland is removed. It is most often performed as a definitive treatment for prostate cancer, though it may also be recommended to relieve severe urinary problems caused by benign prostatic hyperplasia.
Let us have a clear understanding of the Prostatectomy procedure, its different types, and possible outcomes is an important step in making well informed healthcare decisions.
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What is a Prostatectomy?
A prostatectomy is a surgical procedure to remove all or part of the prostate gland. It’s most commonly performed to treat prostate cancer, but can also be used to address other conditions like Benign Prostatic Hyperplasia (BPH) when other treatments have not been successful.
For many, the idea of this surgery can be daunting, so understanding the process is the first step toward feeling confident and prepared.
How many types of Prostatectomy are there?
There are two main types of prostatectomy, each with different surgical approaches:
- Radical Prostatectomy: This is the complete removal of the prostate gland, as well as some of the surrounding tissue, including the seminal vesicles. This procedure is the standard treatment for localised prostate cancer. Know What Prostate Cancer is.
- Simple Prostatectomy: This procedure involves removing only the inner part of the prostate gland that is blocking urine flow. It’s typically performed to treat severe BPH.
Let us understand What is a Prostatectomy Procedure. Both of the two types of prostatectomy can be done using different surgical techniques:
- Open Surgery: A surgeon makes a single incision (either in the lower abdomen or between the scrotum and anus) to access and remove the prostate.
- Laparoscopic Surgery: This is a minimally invasive technique where the surgeon makes several small incisions. They use a camera and long instruments to perform the surgery.
- Robotic Assisted Laparoscopic Surgery: This is the most common approach for radical prostatectomy today. A surgeon uses a computerised console to control robotic arms, which hold and manipulate the surgical tools with enhanced precision and dexterity.
Is a Prostatectomy a Major Surgery?
Yes, a prostatectomy is considered a major surgery. It requires a general anaesthetic and involves the removal of a significant organ, which can lead to a hospital stay and a recovery period.
However, modern minimally invasive and robotic techniques have made the procedure much safer and the recovery far quicker than with traditional open surgery.
Who needs to have a Prostatectomy?
A prostatectomy is performed on men with a confirmed diagnosis of prostate cancer that is confined to the prostate gland (localised cancer). It may also be recommended for men with severe symptoms from a greatly enlarged prostate (BPH) that have not responded to other medical treatments.
How common are Prostatectomies?
Prostatectomy is a very common procedure. It is one of the most frequently performed surgeries for the treatment of prostate cancer, particularly in the UK and other Western countries, and its use is increasing with the adoption of robotic technology.
Can you live without your Prostate?
Yes, you can live without your prostate. While the prostate gland plays a role in reproduction by producing seminal fluid, it is not essential for survival. Once the prostate is removed, a man can no longer produce semen, but he can still have orgasms.
What does removing a prostate do to a man?
The removal of the prostate has two primary effects:
- Infertility: Because the prostate and seminal vesicles are removed, a man can no longer produce semen, making him infertile.
- Urinary and Sexual Function: The surgery can affect the nerves and muscles that control urinary and sexual function.
This can lead to temporary or, in some cases, long-term urinary incontinence and erectile dysfunction.
What happens before a Prostatectomy?
Before your surgery, you will have a consultation with a surgeon and anaesthetist. They will discuss the procedure, potential risks, and recovery. You will also have a pre-operative assessment, which may include blood tests and an ECG, to ensure you are fit for surgery.
What happens during a Prostatectomy?
The surgery is performed under general anaesthetic. Depending on the chosen approach, the surgeon will make one large or several small incisions. The surgeon then carefully dissects and removes the prostate gland, and any cancerous tissue that has spread, and then reconnects the bladder to the urethra.
How long does a Prostatectomy take?
The duration of the surgery depends on the technique used. A robotic-assisted prostatectomy typically takes about 2 to 4 hours, while an open surgery may take a bit longer. The surgeon’s experience and the complexity of the case also play a role.
What happens after a Prostatectomy?
Immediately after the surgery, you will be in a recovery room. A catheter will be in place to drain urine from your bladder. Nurses will monitor your pain levels and vital signs. You will be encouraged to start walking as soon as possible to prevent blood clots.
How long is a hospital stay for a Prostatectomy?
The length of your hospital stay depends on the surgical method. Patients who undergo robotic or laparoscopic surgery typically stay in the hospital for 1 to 3 nights. Patients who have open surgery may require a slightly longer stay.
What are the advantages of a Prostatectomy?
- High Cure Rate: When the cancer is localised, a radical prostatectomy offers a very high chance of a complete cure.
- Minimally Invasive Benefits: With robotic or laparoscopic surgery, patients experience less blood loss, less post-operative pain, and a shorter hospital stay.
- Faster Recovery: Patients can often return to normal activities and work sooner.
What are the risks or complications of a Prostatectomy?
Like any major surgery, a prostatectomy carries risks:
- Urinary Incontinence: This is the most common side effect. It can be temporary or, in some cases, permanent.
- Erectile Dysfunction: Nerve damage during surgery can impact a man’s ability to have an erection.
- Blood Loss: While less common with modern techniques, it remains a risk.
- Infection: Infection at the incision site is a potential complication.
How does life change after prostate removal?
Life after prostate removal changes, but many men adapt well. The main adjustments are often related to urinary and sexual function. Many of these issues improve over time with rehabilitation, but a small percentage of men may experience long-term changes.
Can you have an erection after a Prostatectomy?
Yes, many men are able to have an erection after a prostatectomy, but it can take time. The nerves that control erections are very close to the prostate and can be damaged during surgery. Surgeons often use nerve-sparing techniques to protect them. Recovery of erectile function is a gradual process that can take up to 1-2 years and may require medical assistance.
What is the recovery time?
Full recovery can take several weeks to a few months.
- First few weeks: You will be encouraged to walk and gradually increase your activity.
- 6-8 weeks: Most people can return to light work and most daily activities.
- Full recovery: It can take up to 6 months to a year for your body to fully heal internally and for sexual and urinary function to improve.
When should I see a healthcare provider?
You should see your healthcare provider for regular follow-up appointments to monitor your recovery and check your PSA levels. You should call them immediately if you experience:
- A fever above 38°C (100.4°F).
- Increasing pain or swelling.
- Excessive bleeding or pus from the incision.
- Signs of a blood clot, such as leg pain or swelling.
- Difficulty urinating after the catheter is removed.
Conclusion
In conclusion, a prostatectomy is a significant procedure, but with modern surgical techniques, it has become safer and more effective than ever. Whether performed to treat cancer or BPH, understanding the different types and approaches is key. The advances in minimally invasive and robotic surgery have led to better patient outcomes, including quicker recovery and less pain.
Ultimately, an informed conversation with your healthcare provider is the best way to determine if a prostatectomy is the right choice for you.
FAQs
1. What is the main purpose of a prostatectomy?
The main purpose is to treat prostate cancer by completely removing the gland. It can also be performed to relieve severe urinary symptoms caused by a non-cancerous prostate enlargement.
2. How many types of prostatectomy are there?
There are two main types: a radical prostatectomy (to remove the entire gland for cancer) and a simple prostatectomy (to remove only the inner part of the gland for BPH).
3. What are the most common risks of the surgery?
The most common side effects are temporary or, in rare cases, long-term urinary incontinence (leakage) and erectile dysfunction. These often improve over time with proper recovery and rehabilitation.
4. What is the typical recovery time?
Recovery time varies based on the type of surgery. For minimally invasive procedures (laparoscopic or robotic), a hospital stay is typically 1-3 nights, and a return to normal activity can take a few weeks to a few months.
5. Can a man still have an erection after a prostatectomy?
Yes, many men are able to have erections after a prostatectomy, but it can take time for nerve function to recover. Surgeons often use nerve-sparing techniques to help preserve this function.
