Prostate is a gland present in men that sits right under the bladder. A tube, urethra, connecting to the bladder passes through the prostate till the tip of the penis. The urethra carries the urine from the bladder to the tip of the penis (outside the body). The main functionality of the prostate gland is to produce the seminal fluids that are sent out along with the sperms produced in the testicles during ejaculation. The muscles around the prostate also help in pushing the ejaculate out and also control the flow of urine through the urethra.
Prostatectomy, also called prostate surgery is performed on the prostate either to remove a part of it or the entire prostate depending on the medical condition at hand. Prostate surgery is performed when the person is suffering from BPH or inflammation of prostate that is obstructing the flow of urine or when the person is suffering from prostate cancer. In case of cancer of the prostate, prostatectomy may be done in conjunction with other treatments such as radiation therapy, chemotherapy and hormone therapy.
Types of prostate surgeries
Radical prostatectomy and simple prostatectomy are the two types of prostate surgeries performed.
Radical prostatectomy involves removing entire prostate gland and the surrounding lymph nodes. This is usually performed as a part of treating localised prostate cancer.
Simple prostatectomy involves removing only a part of prostate gland that has been infected and inflamed and blocking the flow of urine through the urethra.
Radical and simple prostatectomy surgeries can be performed in multiple ways including:
- Open prostatectomy – a conventional method that involves in cutting the abdomen open to remove the (full or part of) prostate gland.
- Laparoscopic or robot assisted prostatectomy – the modern way of operating on the internal organs especially those in the abdominal region. Few small incisions are performed on the abdomen through which few probes will be inserted. The prostate is removed through the probes and then the incisions are sutured. This is more precise and less damaging procedure in the sense that not many muscles/tissues are injured while small incisions are made.
Once your doctor decides on the type of prostate surgery, he/she will explain it to you what you can expect during and after the surgery, the benefits of each method. He/she will also explain to you how to prepare yourself and your body on the day of surgery. This will be an in-patient procedure and the patient will be observed for a few days after the surgery.
What are the risks of radical prostatectomy surgery?
Any surgery carries its own risks, so does radical prostatectomy surgery. They include:
- Bleeding at the site of incision
- Urinary tract infections
- Urinary Incontinence
- Erectile Dysfunction (impotence)
- Narrowing of the urethra
- Formation of cysts.
These are due to the fact that prostate is an important part of the reproductive system in a man. When the prostate is injured (by a surgery or due to an accident), most often the sexual health takes a hit. It may take up to 18 months for complete healing and recovering from erectile dysfunction in some people. A good surgeon will always keep his patients informed about what can be expected post surgery.
We have already mentioned that the muscles around the prostate controls urination. When the prostate is removed, partially or fully, this will lead to urinary incontinence. Urinary incontinence is referred to a condition when the urine leaks involuntarily. The injury to the muscles around the prostate during surgery can result in losing the grip over the urethra and as a result can lead to urinary incontinence.
Recovery after prostatectomy
Immediately after the surgery, the person will stay in hospital and IV fluids will be administered along with antibiotics to prevent possible infections. The patient will be allowed to go home after a couple of days when his doctor thinks that he is fine. A urinary catheter will be placed to pee for up to 10 days after the surgery. It may take a year to regain control on urinary bladder.
The person will be able to return to normal life and work after six weeks and he/she may have to continue visiting his doctor for a regular check up for few months. Sexual activities can be resumed once the person feels fit but in case where the prostate gland is completely removed, there won’t be much semen seen after ejaculating. It will look like a dry ejaculate.
FAQs on prostatectomy
What is the most common problem after prostatectomy?
Urinary incontinence and erectile dysfunction are the most common problems after prostatectomy. It depends on whether a simple or radical prostatectomy is performed.
Can you still have an erection if your prostate is removed?
Erectile dysfunction is very common in those men whose prostate was completely removed. This is because of weakening of all muscles around the prostate gland after the organ was removed. ED condition may better after 18 months post surgery.
What is the life expectancy after prostate surgery?
Life expectancy after prostate surgery is usually over 10 years. The overall health too is reported to be good after the surgery.