A Comprehensive Guide to Prostatectomy Treatment

Prostatectomy is a surgical procedure used to partially or completely remove the prostate gland, mostly to treat prostate cancer or benign prostatic hyperplasia (BPH).

The procedure commonly involves making an incision and extracting the prostate gland or a portion of it. This can be done through a retropubic or suprapubic incision in the lower abdomen, or through a perineal incision located between the scrotum and the rectum.

Before undergoing a prostatectomy, a prostate biopsy is often required. This biopsy provides additional information needed for planning the surgery.

Types of Prostatectomy

Radical prostatectomy: This operation removes the entire prostate gland as well as the surrounding lymph nodes. The surgical techniques used to do 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 method to remove the prostate gland, a surgical incision is created in the lower abdomen between the anus and the scrotum.
Laparoscopic: This procedure involves inserting specific surgical tools into the lower abdomen to remove the prostate gland.

Signs and symptoms before prostatectomy can vary depending on the underlying condition, such as prostate cancer or benign prostatic hyperplasia (BPH). Common symptoms are as follows:

Difficulty urinating or frequent urination, especially at night.
Weak or interrupted urine flow.
Blood in the urine or semen.
Erectile dysfunction.
Pain or discomfort in the pelvic area.
Bone pain (if cancer has spread).
Unexplained weight loss.

Before undergoing a prostatectomy, several diagnostic tests are typically performed to assess the condition of the prostate and plan for surgery. These may include:

Digital Rectal Exam (DRE) is performed where the doctor inserts a gloved, lubricated finger into the rectum to feel for abnormalities in the prostate gland.
Prostate-specific Antigen (PSA) Test to measure the level of PSA, a protein produced by the prostate gland. Elevated PSA levels can indicate prostate conditions, including cancer.
Transrectal Ultrasound (TRUS) test where a probe is inserted into the rectum to generate images of the prostate gland using sound waves. It helps assess the size and structure of the prostate.
Biopsy: A procedure to obtain tissue samples from the prostate gland for examination under a microscope. This is done to confirm the presence of cancer cells and determine their aggressiveness.
Imaging Tests such as MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans to evaluate the extent of cancer and assess whether it has spread beyond the prostate.
Uroflowmetry measures the rate and amount of urine flow, which helps assess urinary function and obstruction caused by prostate enlargement.
Cystoscopy: To examine the inside of the urethra and bladder, often done to assess urinary symptoms.

Following surgery, you will be transferred from the operating room to the recovery area where the doctor will monitor your blood pressure, pulse rate, and breathing before transferring you to a regular room. Pain treatment medicines will be given as needed.

You will be encouraged to engage in gentle exercises to improve circulation. Upon discharge, you will have a catheter in place for 5-10 days.

As you recover, gradually increase your daily activities. Sexual activity can typically resume 6-8 weeks post-surgery, and driving should only be resumed with your surgeon's approval.

If you experience fever, redness, swelling, pain, or urinary incontinence, it is important to promptly consult your physician.