Prostatectomy – Removal of the prostate gland

Description prostatectomy

Prostatectomy – surgery to remove the prostate gland. The prostate gland is part of the male reproductive system. It produces and stores seminal fluid (milk colored liquid, which is part of semen). Iron is a little below the bladder, front of the rectum. After prostate urethra passes (tube, through which the urine flows).

Types prostatectomy:

• Simple prostatectomy – Only removal of the prostate is performed;
• Radical prostatectomy – It carried out the removal of the prostate gland and some of the surrounding tissue.

Reasons for prostatectomy

• Simple prostatectomy can be performed, to reduce the symptoms of benign disorders, such as benign prostatic hyperplasia (DGPŽ). BPH is not prostate cancer, but it can cause problems with urination, because it puts pressure on the urethra;
• Radical prostatectomy – It can be done to remove the prostate gland, containing cancer cells.

Possible complications of prostatectomy

If you plan to prostatectomy, you need to know about possible complications, which may include:

• Bleeding;
• Infection;
• Urinary incontinence;
• The inability to achieve an erection (impotence) and other sexual difficulties;
• Blood clots in the legs and lungs;
• Infertility;
• Damage to the rectum or other nearby organs.

Factors, that may increase the risk of complications:

• Obesity;
• Chronic or recent illness;
• Lung Diseases, kidney, liver, or heart;
• Smoking;
• Alcohol abuse or drug use;
• The use of some drugs;
• Diabetes.

How is the removal of the prostate?

Preparing for prostatectomy

A doctor may be appointed as follows:

• Medical checkup;
• Blood and urine tests;
• Chest X-ray;
• Electrocardiogram – test, which detects heart activity by measurement of electrical current through the heart muscle;
• US – test, that uses sound waves to visualize the inside of the body;
• A bone scan or CT scan, If the doctor suspects cancer spread.

In the run-up procedure:

• Tell your doctor about taking any medications. A week before surgery you may be asked to stop taking certain drugs:
  • Aspirin or other anti-inflammatory drugs;
  • Blood thinners, such as clopidogrel (Plaviks) or warfarin;
• On the eve of the operation in the evening you can eat a light meal. Do not eat or drink for the night.

Anesthesia

When removing the prostate gland is used general anesthesia, which blocks the pain and the patient support in a sleep state during operation. Sometimes a spinal anesthesia, anaesthetises that the lower part of the body.

Procedure removal of the prostate

This procedure can be made public, laparoscopically or via Robotic Surgery.

Simple prostatectomy

The doctor makes an incision in the lower abdomen, to access the prostate. He then removes the inner part of the prostate. The operation is performed under a non-cancerous enlargement of the prostate gland.

Radical retropubic prostatectomy

The doctor makes an incision in the lower abdomen between the navel and pubic bone. This allows him to access the prostate and pelvic lymph nodes. The physician separates the prostate from the bladder and urethra, and then re-attached to the urethra to the bladder. The doctor will try to preserve the nerves, associated with the function of the bladder and adjacent organs. In some cases, the doctor will remove lymph node tissue for analysis, before continuing operation.

Perineal radical prostatectomy

The doctor makes an incision in the skin between the anus and the scrotum. Then he removes the prostate. This type of surgery is rarely performed, since it does not allow access to the lymph nodes. In carrying out this procedure, there is a high risk of nerve damage.

Robotic laparoscopic radical prostatectomy (RLRP)

The doctor makes five small incisions in the abdomen for the introduction of manipulators, including small chamber (laparoscope). During surgery, the doctor sits at a console and controls the manipulators, in which surgical instruments are fixed. With their help, it can cut the prostate and other tissues. This operation leaves the least amount of scarring.

After Prostatectomy

The catheter is inserted into the bladder to drain the urine. The catheter may be set up to 3 weeks. This will reduce the healing period. After a radical prostatectomy can be installed drainage tube to drain accumulated fluid.

How long will prostatectomy?

• Simple prostatectomy – 2-4 o'clock;
• Radical prostatectomy – 2-4 o'clock.

Prostatectomy – Will it hurt?

Anesthesia prevents pain during the procedure. You may feel some pain and discomfort:

• 7-10 days after open surgery;
• 3-4 days after laparoscopic surgery.

The average time of stay in the hospital after prostatectomy

Usually the duration of stay of 2-3 day. Your doctor may prolong hospitalization, if there were complications.

Care after prostatectomy

After returning home, follow these steps:, to ensure the normal recovery:

• We need to take medication, prescribed by a doctor:
  • The doctor may prescribe antibiotics to prevent infection and / or stool softeners to prevent constipation;
  • Maybe, You will need to take the medication for several weeks, normalizing bladder function;
  • For some time, you may need to take painkillers. It is recommended to take non-prescription pain relievers (eg, paracetamol) as needed;
  • Avoid taking aspirin or medicines aspirinsoderzhaschie;
• When you are in bed, you need to keep your feet in the raised position and movement. This will help prevent the formation of blood clots in the legs;
• Drink plenty of fluids. This will help to clear your bladder of urine and blood;
• Ask the doctor, when it is safe to shower, bath or expose the surgical site to water;
• Carefully wash your incision with mild soap and water;
• Do not drive, if the doctor has not given permission to do so;
• Avoid intensive exercise for six weeks after surgery;
• Avoid caffeine, alcohol, spicy foods or any other food or drink, that can affect the stomach, intestines, bladder or urinary tract;
• Be sure to follow your doctor's instructions.

Complete recovery after the operation usually takes about six weeks.

Contact your doctor after prostatectomy

After discharge from the hospital need to see a doctor, If the following symptoms:

• Signs of infection, including fever and chills;
• Redness, edema, strong pain, bleeding, or discharge from the incision;
• Nausea and / or vomiting, that do not pass after taking the prescribed medicines, and persist for more than two days after discharge from the hospital;
• Pain, which does not pass after taking pain medication appointed;
• Pain, burning, frequent urination or persistent blood in the urine;
• Plohoh drainage;
• Bloating and abdominal pain;
• Cough, shortness of breath or chest pain;
• Headache, muscle aches, dizziness or malaise;
• Constipation;
• Other painful symptoms.