Surgery Overview
Open prostatectomy is the surgical removal of
an enlarged (noncancerous)
. It is done under a
or
anesthetic. Usually, an incision is made
through the lower abdomen, although sometimes the incision is made between the
rectum and the base of the penis. A
may be placed in the bladder through the
lower abdominal skin to help flush the bladder (postoperative bladder
irrigation) and another catheter comes out of the penis to drain the urine. The
procedure requires a slightly longer hospital stay and recovery period than
transurethral resection of the prostate ().
Open prostatectomies may be needed only for men with very enlarged
prostate glands (it may be more effective than TURP in relieving the blockage
of urine flow), for men with bladder diverticula (pockets) or stones, and if
TURP is not possible. A prostatectomy also reduces the possibility that another
surgery will be needed, which is a potential problem when TURP is used. But if
you have been treated for prostate cancer, an open prostatectomy cannot be
done.
What To Expect After Surgery
Open prostatectomy requires several
days in the hospital.1 A catheter is left in place for
3 to 5 days. You may go home with a urinary catheter in place. Your doctor will
give you instructions about
at home.
Why It Is Done
Open prostatectomy usually is used
for men who want surgery to treat their
symptoms and who
have very enlarged prostates.
How Well It Works
Open prostatectomy almost always
improves symptoms. Men generally notice about a 10-point improvement in their
American Urological Association (AUA) symptom index
scores after surgery.2 For example, if your symptom
score is 25 (indicating severe symptoms), this surgery might reduce it to about
15 (indicating moderate symptoms).
Risks
The risks of open prostatectomy include:
- The possible need for a
. Slightly more men require a blood
transfusion after open prostatectomy than after TURP.
- An inability
to have sexual intercourse because of erection problems. This occurs in less
than 5% of men and is more frequent in older men than younger men.1
- Complete or partial inability to hold back urine
(incontinence).
- Ejaculation of semen into the bladder instead of
out through the penis (retrograde ejaculation). Although this is not harmful,
it may cause fertility problems.