Description

Open Prostatectomy Open prostatectomy is a surgical procedure used to remove part or all of the prostate gland, usually for severe benign prostatic hyperplasia (BPH) or prostate cancer. Unlike TURP, which is performed through the urethra, open prostatectomy involves an incision in the lower abdomen or perineum. Types of Open Prostatectomy Simple Prostatectomy (for BPH) Removes only the enlarged part of the prostate. The outer prostate capsule remains intact. Radical Prostatectomy (for Prostate Cancer) Removes the entire prostate, seminal vesicles, and sometimes nearby lymph nodes. Can be performed via open surgery or robotic-assisted laparoscopic surgery. Indications for Open Prostatectomy Severe BPH (very large prostate, >80–100g) Prostate cancer (localized but aggressive) Bladder stones or damage due to long-term BPH Urinary retention not resolved with other treatments Recurrent UTIs due to obstruction Surgical Approaches 1. Retropubic Prostatectomy (Most Common) Incision in the lower abdomen. Allows removal of the prostate while preserving nerves for erectile function. 2. Perineal Prostatectomy (Less Common) Incision between the scrotum and anus. Shorter recovery but higher risk of erectile dysfunction. 3. Suprapubic Prostatectomy Incision in the lower abdomen, and the bladder is opened to access the prostate. Used for very large prostates. Procedure Overview Anesthesia: General or spinal anesthesia. Incision: Made in the lower abdomen or perineum. Prostate Removal: Either part (simple) or all (radical) of the prostate is removed. Bladder and Urethra Connection: If the prostate is fully removed, the bladder is reconnected to the urethra. Catheter Placement: A Foley catheter is inserted for 1–2 weeks to aid healing. Surgery Duration: 2–4 hours Hospital Stay: 3–7 days Post-Operative Care Catheter care: Left in place for urine drainage. Hydration: Helps prevent blood clot formation. Pain management: Given as needed. Activity restriction: Avoid heavy lifting for 6 weeks. Pelvic floor exercises (e.g., Kegels) to strengthen bladder control. Follow-up visits to monitor healing and PSA levels (for cancer patients). Potential Complications Bleeding (higher risk than TURP) Urinary incontinence (temporary or permanent) Erectile dysfunction (nerve damage may occur) Infections (UTIs, wound infections) Bladder neck contracture (scarring leading to obstruction)

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