Has your doctor told you that you need to have surgery to remove your prostate gland? It's normal to feel a little scared and nervous when you're told that. "Is this a major operation?", "What will happen to me?", "What will my life be like after the operation?" You may have many questions in your mind. But don't worry, this is a surgery that is performed on many people and has successful results. Let's talk about this surgery called prostatectomy in a simple and clear way. Then you will get answers to many of the questions you have in mind.
First of all, what is Prostatectomy?
Simply put, prostatectomy is the surgical removal of all or part of your prostate gland.
Now you're probably wondering what the prostate gland is. It's a walnut-sized gland that's only found in men. It's located just below your bladder, around your urethra. The main function of this gland is to add a liquid component to your semen when it's ejaculated.
What types of prostatectomy surgeries are there?
There are two main types of prostatectomy surgery. The choice depends on your medical condition. Let's clearly understand the difference between the two.
| Type of surgery | Description | When is it usually done? |
|---|---|---|
| Simple Prostatectomy | This involves removing only the inner part of the prostate gland. It's like removing the pulp from an orange, leaving the peel intact. The outer skin of the gland is left behind. | When the prostate gland becomes enlarged due to a non-cancerous cause (e.g. BPH), it obstructs the flow of urine. |
| Radical Prostatectomy | This involves removing the entire prostate gland. Some of the surrounding tissue, the seminal vesicles, and sometimes even the lymph nodes, may also be removed. | As a treatment for cancer confined to the prostate gland. |
Surgical techniques - Open, Laparoscopic and Robotic
There are several ways to perform both of these types of surgeries.
- Open Surgery: In this procedure, the doctor makes a slightly larger incision in your lower abdomen, from your navel down, and removes the prostate gland. This is the traditional method.
- Laparoscopic Surgery: This is the most commonly used, less invasive method . Instead of a large incision, only a few very small incisions are made in the lower abdomen. A camera is inserted through one of the incisions, and special instruments are inserted through other incisions to perform the surgery.
- Robotic-assisted surgery: This is an advanced form of laparoscopic surgery. Here, the doctor performs the surgery using a robotic arm. This allows the surgeon to easily reach even the most delicate and complex areas and perform the surgery with great precision.
Laparoscopic and robotic surgeries are less painful, have shorter hospital stays, and recover more quickly. They also leave much less scarring.
What happens before the operation?
You will need to meet with your doctor before the surgery. There, you can discuss with him or her what type of surgery is best for you.
- Checking your health: Your blood pressure and heart rate are measured.
- Medication Information: You should tell your doctor about all the medications you are taking (both prescription and over-the-counter). Especially if you are taking blood thinners like aspirin , you may be asked to stop taking them a few days before surgery. But remember, never stop taking any medication without first asking your doctor.
- Awareness of Allergies: If you have any allergies to any medicine, food, or other substance, be sure to tell us about it.
- Fasting: You will be advised not to eat or drink anything after midnight the night before the surgery. If you must take any medication, you can take it with a sip of water.
What happens during and after the operation?
During the surgery, you will be put under general anesthesia . This means you will not feel any pain and will be completely asleep. Before the surgery begins , a urinary catheter will be placed in your bladder.
The surgery can take between 2 and 4 hours. After the surgery, you will be taken to a recovery room. You will be given pain medication to help you regain consciousness.
- Hospital stay: If you have robotic surgery, you will usually have to stay in the hospital for a day or two. Sometimes you can go home the same day. With open surgery, you may have to stay for three to four days.
- Food: Only liquid food is given on the first day. Later, they are gradually introduced to regular food.
- Walking: You will be encouraged to walk from the day after surgery. Walking helps you recover faster and prevents complications such as blood clots.
- Urinary catheter: This catheter will be left in place for a few days or a week or two. You will need to stay at home with it until it is removed.
When you go home, you will need to avoid lifting weights and strenuous exercise for a few weeks. The doctor will prescribe painkillers and laxatives for you.
What are the risks and possible complications of this surgery?
As with any surgery, there are risks. There may also be changes in your body after the surgery. It is important to be aware of this.
| Risk / Change | Simple explanation |
|---|---|
| Incontinence | In the early days after surgery, you may experience some leakage of urine, especially when coughing, laughing, or lifting. For most people, this condition gradually improves over a few weeks or months. |
| Erectile dysfunction | The nerves that are needed for sexual arousal run right next to the prostate gland. These nerves can be affected during surgery. This can cause difficulty in arousal. This condition can take several months to two years to improve. There are treatments for this. |
| Dry Orgasm | After the prostate gland and seminal vesicles are removed, semen does not come out during orgasm. However, the pleasure and sensation felt during orgasm are still there as usual. |
| Other general risks | As with any surgery, there are some risks, such as infection, excessive bleeding, and blood clots. |
When to see a doctor as soon as possible
If you develop any of the following symptoms after you go home, you should call your doctor immediately .
- Having a fever of more than 38 Celsius (100 Fahrenheit).
- Excessive bleeding or foul-smelling fluid from cuts.
- Redness, swelling, or increased pain around the wound.
- The stitches in the wound come loose and separate.
- If the pain is getting worse.
Take-Home Message
- Prostatectomy is a very successful surgery to treat conditions such as prostate cancer and BPH.
- Robotic surgery is now widely used, and it can reduce pain, hospitalization, and recovery time.
- After surgery, you may experience some urinary and sexual dysfunction, but most of these improve with time and there are treatments to manage them.
- Talk openly with your doctor about any questions or concerns you may have before and after surgery. It will give you a lot of mental strength.
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