Prostatectomy: Purpose, Procedure, Benefits and Side Effects

A prostatectomy is a surgical procedure to remove all or part of the prostate gland. Depending on the specific procedure and reasons for surgery, either all of the prostate (a radical prostatectomy) or only a portion may be removed.

• Radical Prostatectomy: Radical prostatectomy is a major operation to remove the entire prostate gland and nearby tissue. This type of surgery is most often used to treat prostate cancer that has not spread beyond the prostate gland, called localised prostate cancer. The surgeon may also remove nearby lymph nodes if they are affected by the cancer or if there is a risk of the cancer spreading to other parts of your body.
• Laparoscopic Prostatectomy: Laparoscopic or robotic-assisted laparoscopic prostatectomy is a newer type of minimally invasive treatment for localised prostate cancer and involves the use of laparoscopes (thin tubes with tiny cameras) that allow surgeons to perform surgery through several small keyhole abdominal incisions.
• Cryosurgical Ablation of the Prostate (CAPP): Cryosurgical ablation of the prostate (CAPP) is an emerging approach for treating localised prostate cancers that involves using extreme cold temperatures to freeze and destroy cancerous tissue within the organ without cutting it out surgically.

• Reduced risk of developing or worsening prostate cancer: By removing the cancerous or abnormal tissue, the risk of developing or worsening prostate cancer is diminished significantly.
• Improved quality of life: Prostatectomy often results in a significant decrease in lower urinary tract symptoms (LUTS) such as pain and frequency associated with BPH, allowing men to experience improved quality of life.
• High rate of success: Depending on the type and extent of the surgery and any other underlying medical conditions, most men have a high chance for remission from their symptoms following successful prostatectomy procedures.
• Reduced future health risks: Depending on whether a man is diagnosed with BPH or prostate cancer prior to undergoing a prostatectomy, this surgery may reduce his risk for future health risks related to these conditions such as bladder infections and/or kidney damage associated with an enlarged prostate gland caused by BPH, and possibly death due to untreated prostate cancer if left unchecked for too long.

• Prostatectomy is used to treat cancers such as prostate cancer, bladder cancer, and advanced cases of benign prostatic hyperplasia (BPH).
• It can also be done if a man is unable to pass urine due to blockage by the enlarged prostate gland.
• This procedure can improve urinary flow, reduce bothersome symptoms associated with BPH, and reduce the risk of further progression to more advanced stages of cancer.

The major potential risks associated with prostatectomy are:-

Here are some steps you should take when preparing for a prostatectomy:-

• Make sure you understand what type of prostatectomy will be performed and why it is necessary.
• Get any tests required before the surgery, such as imaging studies, blood tests, and tissue sampling (biopsies).
• Ask your doctor any questions you may have about the procedure, recovery time, and possible complications or side effects that could occur afterward.
• Follow any instructions about how to prepare for the surgery, such as stopping certain medications or fasting before the operation.
• Inform your doctor about current medications (including herbal supplements) that you’re taking and clarify any questions regarding their usage during recovery from surgery.
• Make sure there are arrangements in place for you to get home after leaving the hospital; someone should accompany you on discharge day in case of emergency situations
• Try to avoid extreme exhaustion if possible get plenty of sleep before entering into hospitalisation periods prior to undergoing prostatectomy

During the procedure, the surgeon will make an incision in the lower abdomen or perineum and remove part or all of the prostate gland. The prostate may be examined under a microscope to determine if there are any malignant cells present.

If malignant cells are found, further treatment such as radiation therapy and/or chemotherapy may be required. Prostatectomy is typically performed under general anaesthesia and can take anywhere from 2 to 4 hours depending on its complexity.

• The patient should be evaluated regarding the possible risk factors associated with the tools and techniques utilised during a prostatectomy.
• Anaesthesia will be administered in order to ensure patient comfort throughout the duration of the surgery

• A catheter might need to be temporarily inserted into the bladder in order to remove excess fluid accumulation around or within the prostate gland.
• After gaining access through an abdominal incision, removal of all or part of the prostate gland is performed using various surgical instruments such as a scalpel, forceps, bipolar instruments or lasers depending on what method is deemed most suitable by your doctor.
• Upon completion of surgery, tissue samples may be taken for further testing and evaluation after they have been removed from inside your body.

• Following removal of tissue samples and closure of incisions, drains may be placed near where your prostate gland was removed in order to help drain away any excess fluid buildup.
• You might experience some swelling around your genitals which can be managed by ice packs or keeping your legs elevated when sitting up or lying down.
• A urinary catheter will likely remain for several days until proper healing has occurred.

The cost of a prostatectomy in India varies depending on the type of procedure and the hospital where it is performed.

On average, one can expect to pay anywhere between Rs. 25,000 to Rs. 4 lakhs for the procedure.

Additionally, if one has to undergo preoperative and post-operative care, then the cost may be higher.

• High-fibre foods: Whole grains, legumes, fruits and vegetables.
• Lean proteins: Fish, chicken, tofu and eggs.
• Low-fat dairy products: Milk, yoghourt and cheese.
• Water: 8-10 glasses daily
• Healthy fats: Olive oil, nuts and nut butters.

Yes, prostatectomy is a safe procedure with a high success rate. However, as with any surgery there are risks of possible complications, such as infection or bleeding. Your doctor will be able to provide more information about the specific risks associated with your particular situation and treatment plan.

Many people who have undergone a prostatectomy say that the procedure is not overly painful.

There are various levels of pain relief available during and after the procedure, such as medications and nerve blocks, as well as freezing or numbing medications.

The duration of recovery from a Prostatectomy generally ranges from 4–8 weeks. The typical recovery period for open Prostatectomy is usually less than for the laparoscopic approach to the procedure.

• The common side effects of prostatectomy include urinary incontinence, impotence, erectile dysfunction, or problems with ejaculation.
• Other potential side effects include damage to the bladder or rectum during surgery, temporary bladder control issues, infection, bleeding, irregular bowel movements, fatigue and poor sexual function.
• Some men may also experience depression due to the change in quality of life that often follows prostatectomy.

• After a prostatectomy, it can be helpful to make lifestyle changes to keep your body healthy and reduce the risk of health problems or complications. Here are some steps that may help:
• Follow your doctor’s instructions for post-operative care, including restrictions on sex and other activities as well as dietary advice.
• Drink plenty of fluids to prevent dehydration, since urinary incontinence is one of the possible side effects of surgery.
• Talk to your doctor about medications that can help with urinary incontinence and erectile dysfunction, which are both common after surgery.
• Consider getting physical therapy or other forms of rehabilitation after surgery in order to regain strength and prevent muscle weakness or atrophy in the pelvic area.
• Eat a healthy diet consisting of fruits, vegetables, lean protein sources and whole grains in order to stay strong throughout recovery.
• Exercise regularly to improve cardiovascular health and overall physical conditioning in order to promote healing post-surgery and aid in regaining strength throughout the body - especially in the pelvic area where muscles may have weakened from surgery.

The prostatectomy procedure is an effective way to treat prostate cancer and other benign prostate conditions. It has been found to be effective in reducing symptoms associated with these conditions and can reduce the risk of recurrence. As with any medical procedure, it is important to discuss all options with your physician before deciding on this or any other treatment option available for your specific situation.