Prostatectomy
Prostate resection (prostatectomy) is performed in different ways to remove part or all of the prostate gland. The prostate gland is located in the male pelvis, below the bladder. The prostate surrounds the urethra, which carries urine from the bladder to the penis.
Prostatectomy is a surgical procedure that removes all or part of the prostate. The prostate gland is the size of a walnut, located between the bladder and the penis.
Prostate surgery may be needed to treat prostate cancer, serious urinary tract disease, or enlarged prostate (benign prostatic hyperplasia).
Reason for prostate surgery
Prostate surgery is usually performed to treat localized prostate cancer. Surgery is performed alone or in combination with radiation therapy, chemotherapy, and hormone therapy. In a prostatectomy for prostate cancer, the surgeon removes the entire prostate gland, the seminal vesicle, and part of the surrounding tissues, including the lymph nodes. Prostate surgery for prostate cancer is performed by open radical prostatectomy, laparoscopic radical prostatectomy and radical robotic prostatectomy. Simple prostate surgery is not widely used to treat prostate cancer, but it is sometimes used to treat urethral obstruction caused by an enlarged prostate. In a simple prostatectomy to treat an enlarged prostate, the entire prostate is not always removed. This surgery relieves the symptoms and complications of urinary obstruction; These symptoms are as follows:
- Urgent incontinence and frequent urination
- Difficulty starting to urinate
- Slow urine flow and prolonged bladder emptying
- Frequent urination at night (nocturia)
- Stopping and starting the flow of urine when emptying the bladder
- Feeling that the bladder is not completely emptied
- Urinary tract infections
- Inability to urinate
Types of prostatectomy
The surgeon recommends the appropriate method according to the existing complication:
1) Radical prostatectomy:
Radical prostatectomy is a procedure in which the entire prostate gland and surrounding lymph nodes are removed to treat localized prostate cancer. Radical prostate surgery is performed in different ways, which are described below:
Robotic radical prostatectomy: The surgeon makes small incisions in the lower abdomen and removes the prostate gland through these incisions. The surgeon sits behind the control desk and performs the operation with devices connected to a mechanical mechanical device (robot). The robotic device allows a more precise reaction to the surgeon's hand movement.
Open Radical Prostatectomy: The surgeon usually makes an incision in the lower abdomen and removes the prostate. This procedure is also called retropubic surgery.
Laparoscopic radical prostatectomy: The surgeon makes small incisions in the lower abdomen and inserts special devices into the body through these incisions to remove the prostate.
Complications of radical prostate surgery
In addition to the common complications associated with all surgeries, radical prostatectomy is associated with the possibility of the following specific complications:
* Bleeding
* Urinary tract infection
* urinary incontinence
* Erectile dysfunction (impotence)
* Damage to the rectum (rectum): This is a rare complication.
* Urethral stricture or bladder opening
* Lymphocyte cyst formation
2)Simple prostatectomy:
Simple prostate surgery is usually recommended for men who suffer from severe urinary symptoms and whose prostate gland is very large, but who do not have prostate cancer. Simple prostate surgery can be performed openly or robotically. In a simple prostatectomy, unlike a radical prostatectomy, the entire prostate gland is not removed and the surgeon removes only the part of the prostate that has blocked the flow of urine.
Risks and possible complications of simple prostatectomy
Complications of a simple open prostatectomy are as follows:
* Bleeding
* Damage to adjacent structures
* urinary incontinence
* Dry orgasm
* Erectile dysfunction (impotence)
* Urethral stricture or bladder opening
Before prostate surgery
Before having a prostate, your doctor may do a cystoscopy (a procedure that allows you to see inside the bladder and urethra.) Tell your doctor about any illnesses you have had before having a prostatectomy.
You may be asked to stop taking certain medications, such as aspirin, coumadin (warfarin), plavix (clopidogrel sulfur oxide), advil (ibuprofen), or alio (naproxen), a few weeks before surgery.
Tell your doctor if you smoke. Smoking disrupts the healing process after prostate surgery. You may be told to abstain from eating and drinking for several hours before surgery. You must follow your doctor's instructions carefully.
Recovery
Tubes to drain fluids from your body may be attached to your body after surgery.
A catheter or catheter may be attached to your bladder and you may pass urine through it for several days.
You will be given painkillers to increase comfort.
Most people are hospitalized for one to four days after prostate surgery.
The length of time you are hospitalized depends on your condition and the type of surgery you performed.
You may be asked to use a catheter inserted into your bladder for 5 to 10 days.
You will probably be able to resume your daily activities 4 to 6 weeks after your prostatectomy.
Post-treatment care
Although prostate surgery often removes all cancer cells, post-treatment care should not be neglected so that if the cancer returns, it can be diagnosed and treated in time. Periodic care after prostatectomy includes:
* Physical examinations
* Prostate-specific antigen (PSA) test to determine PSA levels and measure changes in these levels
* Digital anal examinations
*Perform a biopsy if necessary to look for suspicious tissue