Simple prostate removal is a procedure to remove the inside part of the prostate gland through a surgical cut in your lower belly, to treat an enlarged prostate.
Prostatectomy - simple; Suprapubic prostatectomy; Retropubic simple prostatectomy; Open prostatectomy
You will be given general anesthesia (asleep, pain-free) or spinal anesthesia (sedated, awake, pain-free). The procedure takes about 2 to 4 hours.
Your surgeon will make a surgical cut in your lower belly, from below the belly button to just above the penis. The prostate gland is removed through this cut.
The surgeon removes only the inner part of the prostate gland. The outer part is left behind (similar to scooping out the inside of an orange). After removing part of your prostate, the surgeon will close the outer shell of the prostate with stitches. A drain may be left in your belly to help remove extra fluids after surgery.
An enlarged prostate can cause problems with urinating and urinary tract infections. Removing part of the prostate gland can often make these symptoms better. Before you have surgery, your doctor will suggest you make changes in how you eat or drink. You may also be asked to try taking medicine.
Prostate removal can be performed in many different ways, depending on the size of the prostate and what caused your prostate to grow. Open simple prostatectomy is often used when the prostate is too large for less invasive surgery. However, this method does not treat prostate cancer (see: Radical prostatectomy).
Prostate removal may be recommended if you have:
Your prostate may also need to be removed if taking medicine and changing your diet do not help your symptoms.
Risks for any surgery are:
Other risks are:
You will have many visits with your doctor and tests before your surgery:
If you are a smoker, you should stop several weeks before the surgery. Your nurse or doctor can help.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
On the day of your surgery:
You will stay in the hospital for about 3 to 4 days.
You will need to stay in bed until the next morning. Afterwards, you will be asked to move around as much as possible. Your nurse will help you change positions in bed, show you exercises to keep blood flowing, and recommend coughing/deep breathing techniques. You should do these every 3 to 4 hours. You may need to wear special compression stockings and use a breathing device to keep your lungs clear.
Many men recover fully in about 6 weeks. You can expect to regain normal urination function, without leakage.
Thiel D, Petrou SP. Electroresection and open surgery. Urol Clin North Am. 2009;36(4):461-470, vi.
Han M, Partin AW. Retropubic and suprapubic open prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 89.