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.
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:
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).
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.
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