Prostatectomy in Saudi Arabia

The prostate gland is present below the urinary bladder in men. It surrounds the urethra and produces fluid that helps in the movement of the semen. Prostatectomy is a surgery that involves total or partial removal of the prostate gland. It is commonly performed as a part of treatment for prostate cancer.

Types of Prostatectomy

Radical prostatectomy: This surgery involves the removal of the entire prostate gland along with the surrounding lymph nodes. The surgical techniques used to conduct radical prostatectomy include the following:

• Robot-assisted surgery: In this technique, several small incisions are made in the lower abdomen to remove the prostate gland.
• Open surgery: In this technique, an incision is made in the lower abdomen between the anus and scrotum to remove the prostate gland.
• Laparoscopic: In this technique, special surgical tools are inserted in the lower abdomen to remove the prostate gland.

Open simple prostatectomy: This surgical procedure involves removal of just the affected part of the prostate gland and is recommended for men with the cancerous prostate gland or benign prostatic hyperplasia (BPH).

Indications

• Prostate cancer
• Urinary tract infection
• Bladder stones
• Hematuria

Usually, general anaesthetic is given before the start of the procedure to make you unconscious. A spinal anaesthesia or an epidural anaesthesia will also be given, which causes numbness in the lower part of the body. Heart rate, blood pressure, and blood oxygen levels will be continuously monitored.

In retropubic surgery, the incision is made from the belly button to the pubic bone. In laparoscopic surgery, many small incisions are made through which a narrow tube (laparoscope) with a camera is inserted. The surgeon will see the internal structures on the monitor while performing the surgery. Robotic surgery is conducted in a few hospitals, where the surgical tools for the operation are used with the help of a robotic system. In perineal surgery, the incision is made in between the anus and the scrotum.

After making an incision, the prostate gland is removed and the incision is sutured. While removing the prostate gland, minor damage to the nerves is possible. The fluid is drained using a Jackson-Pratt drain. A catheter is inserted to drain the urine from the bladder.

The prostate-specific antigen (PSA) levels after radical prostatectomy are usually 0 after a month of the surgery. However, the PSA levels could be low in some patients even after the surgery. This is because some normal tissue is left behind even after the surgery.

• You will be moved from the operation theatre to the recovery room after the surgery.
• Your physician monitors blood pressure, pulse rate, and respiratory rate and then shifts you to the general room.
• Pain medications will be given to control the pain.
• You will be allowed to do minimal exercises to increase the blood flow.
• You will be discharged along with the catheter which will be in place for 5-10 days.  
• You need to gradually increase your normal daily activity.
• You can resume your sexual activity after 6-8 weeks of the procedure.
• Driving should be avoided until your surgeon permits you.
• If fever, redness, swelling, pain, and urinary incontinence are experienced then you should consult your physician.