The prostate is a gland the size of a walnut located below the bladder and before the rectum, whose function is to create a liquid that improves the quality of spermatozoa and thus increases fertility. After the age of 50, it is common to suffer from various pathologies such as benign prostatic hyperplasia, prostate enlargement, prostate cancer or prostatitis, urinary tract infection. In some cases the most effective treatment is its partial or complete removal.
Prostatectomy: prostate operation
Prostatectomy means removal of the prostate. This term encompasses two completely different types of surgery with different objectives.
Part of the prostate may be removed in patients with urinary symptoms that cannot be controlled with medical treatment. In this case the central part of the prostate is removed, which is the part that compresses the urethra, making it difficult for urine to exit the bladder. This surgery, with current technological advances, is almost always performed endoscopically, called transurethral resection, without having to perform open surgery, which greatly shortens the time of admission and recovery.
When the prostate is removed due to the presence of cancer, this surgery is called radical prostatectomy. This surgery is much more complex since it requires the removal of the entire prostate, seminal vesicles and in some cases the lymph nodes in the area. After removing the gland, the urinary tract must be reconstructed by suturing the bladder to the urethra. By performing this surgery laparoscopically, the recovery time is greatly reduced.
Prostatectomy: in which cases is it performed?
Surgery for benign prostatic hyperplasia (BPH) is indicated because of the patient’s symptoms. When these symptoms cause a loss of quality of life and cannot be controlled with oral medication, surgery is indicated.
In the case of localized prostate cancer, there are different treatment options in Urology depending on the patient’s age, type of tumor and associated diseases that could increase the surgical risk, but today, the most commonly used treatment is radical surgery.
Postoperative period after prostatectomy
In the case of surgery for BPH, the patient is usually discharged two days after surgery. From the beginning you will notice an increase in urinary flow and greater ease in emptying the bladder. In some cases, irritative symptoms may persist for the first few days, causing the patient to urinate frequently until the post-surgical inflammation subsides. If they are very uncomfortable, they are treated with oral medication until they subside shortly after the operation.
When a laparoscopic radical prostatectomy has been performed, the patient is usually discharged two days after the surgery, although in this case the patient wears a bladder catheter to protect the suture between the bladder and the urethra until it heals after 10 – 14 days. In spite of the catheter, except for physical efforts, the patient can go back to his usual routine. Subsequently the catheter is removed and the patient may initially present urine leaks that with pelvic floor rehabilitation exercises are usually corrected in a short time.
Care after prostate surgery
After a prostate resection for BPH, it is essential to drink plenty of fluids so that if any small bleeding occurs, clots do not form that could obstruct the urinary tract. Once the postoperative period is over, the patient will have to follow annual controls for the early diagnosis of prostate cancer, since the gland has not been completely eliminated, and this disease could appear as in any other man of his age.
In the case of laparoscopic radical prostatectomy, the patient will require local dressings of the access wounds up to 7-10 days after surgery. The bladder catheter will be maintained for 15 days, without requiring any special care. Subsequently, oncological controls will be carried out by periodic analysis of PSA (Prostate Specific Antigen). If these controls go well, the patient will not need any additional treatment.
.