Open Prostatectomy

What is Open Prostatectomy?

Open simple prostatectomy is a surgical procedure to relieve the urinary symptoms of an enlarged prostate (BPH- Benign prostatic hyperplasia)). Open prostatectomy is usually for patients with acute urinary symptoms or very enlarged prostate and, the obstructive part of the affected prostate that blocks urine flow, is removed by incision.

Open Prostatectomy Is Beneficial For Patients With:

  • Bladder stone.
  • Highly enlarged prostate.
  • Prostate hemorrhage.
  • Other bladder and urinary problems.

Treatment Is Required To Cure:

  • Complications due to blocked urine flow like:
  • Urgent/frequent urine sensation.
  • Slow/ difficult urination.
  • Nocturia.
  • Obstructive urination.
  • UTI’s.
  • Urine inability
  • Incomplete urination.
  • The feeling you can’t completely empty your bladder
  • To prevent complications such as:
  • Occurrence of bladder stones.
  • Occurrence of blood in urine.
  • High frequency of UTI’s
  • Uncontrolled urination

Diagnosis Tests:

  • Digital rectal exam.
  • Blood/ Urine tests.
  • Urine flow analysis.
  • Cytoscopy.
  • Ultrasound scan.
  • Prostrate biopsy.
  • Scrotal ultrasound- Doppler mode.

Preparation:

  • Avoid blood thinning agents Plavix (clopidrogel) and Coumadin (Warfarin).
  • With the consultation of your doctor, avoid pain relievers like ibuprofen/ naproxen sodium/ aspirin, etc.
  • Avoid eating/ drinking after midnight.

Benign Prostatic Hyperplasia Treatment:

  • Cystoscopy after anasthetia.
  • A flexible, long, thin viewscope is inserted through penis tip.
  • Urethra/ bladder/ prostate area is observed.
  • A foley catheter tube is inserted into the penis tip into the bladder.
  • During procedure, this tube is known to drain the urine.
  • Then, a cut/ incision below the navel is made below the navel.
  • An incision may need to be used to access the prostate through the bladder.
  • Another option is laparoscopy or robotic laparoscopy where several small incisions are made instead of a single one.
  • This surgery is also used to treat bladder problem and hernia.
  • Removal of the obstructive part of enlarged prostate takes places.
  • One or two temporary urine drain tubes are placed, one suprapubic- into bladder, second pelvic drain- surgery area.

Open Prostatectomy Complications:

  • Heavy bleeding which may require further treatment.
  • Longer recovery time.
  • High susceptibility.
  • Urinary tract infection.
  • Reduce bladder control.
  • Dry/ retrograded orgasm.
  • Erectile dysfunction.
  • Difficult urination.

Follow-up:

  • Few days hospitalization.
  • Inflated balloon place in removed prostate area by the doctor.
  • Irrigation of bladder by saline.
  • IV- Intravenous pain medications.
  • Walking exercise as directed by the urologist.
  • Removal of suprapubic tube.
  • Urinary catheter for a week to 10 days.
  • Every one or two week doctor visit.
  • Resume gradual activity in about 4 to 6 weeks.
  • No driving till catheter is in place.
  • After 6-8 weeks, can resume sexual activity.

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient.