Prostatectomy: what it is, indications, types (and how it is done)

Prostatectomy is a surgery in which complete (radical prostatectomy) or partial removal of the prostate is performed and is normally indicated for the treatment of some cases of benign prostatic hyperplasia or prostate cancer.

The prostate is an organ that is part of the male genital system and is responsible for producing a fluid that protects and nourishes sperm in semen. Understand better what the prostate is and its function.

If you have any doubts about prostatectomy, it is recommended to consult a urologist, who is the best doctor to clarify the indications and risks of the surgery, as well as the type of prostatectomy most suitable for each case.

When is it indicated

Prostatectomy is normally indicated for the treatment of some cases of benign prostatic hyperplasia and prostate cancer, when the tumor has not yet spread outside the prostate, after a detailed evaluation carried out by a urologist.

If you want to make an appointment, you can find the urologist closest to you using the tool below:

Preparing for prostatectomy

To prepare for prostatectomy, it is important to talk to the urologist to clarify any doubts about the surgery and carry out the pre-operative tests recommended by the doctor, such as blood count and electrocardiogram.

The person must also inform the doctor about their health problems, including allergies, and the medications they take, and it may be advisable to stop using anticoagulants for a few days before the prostatectomy according to the doctor’s instructions.

In addition, an absolute fast of at least 8 hours before surgery is normally recommended. Therefore, during this period, the person should not eat or drink liquids.

How it is made

Prostatectomy is normally performed by a urologist, in the hospital and under general anesthesia. Therefore, the person usually does not feel pain and sleeps during the procedure. It can be done through open or laparoscopic surgery and takes between 2 and 4 hours. Find out what laparoscopy is and when it is indicated.

During a prostatectomy, only part of the prostate may be removed, called a simple prostatectomy, or the entire organ, also known as a radical prostatectomy. Especially in radical prostatectomy, sometimes the seminal glands and lymph nodes are also removed.

Types of prostatectomy

The main types of prostatectomy are:

1. Laparoscopic radical prostatectomy

It is a type of prostatectomy in which the prostate is removed using special tools and a thin tube with a camera attached, which are inserted into the abdomen through small holes in the skin.

2. Robotic radical prostatectomy

Robotic radical prostatectomy is performed with the help of a robot that is controlled by the surgeon using a remote control and is similar to prostatectomy performed laparoscopically.

3. Prostatectomia transvesical

Transvesical prostatectomy is a type of prostatectomy in which a cut is made in the lower abdomen and bladder wall to remove part of the prostate.

4. Open radical prostatectomy

Open radical prostatectomy is a type of prostatectomy that is performed using a scalpel to make cuts and reach the prostate. The initial cut can be made in the lower part of the abdomen, known as retropubic radical prostatectomy, or between the anus and the scrotum, known as perineal radical prostatectomy.

Recovery after prostatectomy

After prostatectomy, it is common to stay in hospital for up to 4 days to monitor the initial recovery period and it may take around 4 to 6 weeks to return to normal tasks.

For the first few days, a liquid diet may be necessary until the body begins to accept solid foods. It is also common for a person to need to use a urinary catheter for 2 to 14 days, depending on the type of prostatectomy performed, to allow the bladder to recover.

It is recommended to avoid physical exertion and sexual intercourse, especially in the first few weeks, according to your doctor’s advice. Even after the recovery period, complete improvement in erectile function usually takes 6 to 12 months.

Possible risks

The main risks of prostatectomy are:

• Lower production or absence of semen;
• Urinary incontinence;
• Erection difficulty;
• Infection at the surgical site;
• Hematoma eruptions;
• Venous thrombosis;
• Bleeding.

However, although some men may notice changes in semen production or develop erectile dysfunction after prostatectomy, it is still possible to have orgasms and other pleasurable sensations during intercourse.