What You Should Know About Prostate Surgery

Prostate surgery entails extracting part or all of the prostate gland to provide relief from symptoms like bloody urine and painful urination.

Under local or general anesthesia, your surgeon will make an incision in your abdomen (stomach).

Your doctor may also try a less invasive solution with the UroLift system, which utilizes small implant devices to lift an enlarged prostate away from its position in front of the urethra.

Symptoms

If prostate cancer is contained to its gland, surgery may help improve urinary symptoms and stop its spread. Your doctor may suggest an open radical prostatectomy (RP).

At this procedure, your surgeon will make an upside-down U-shaped incision in your perineal area – between your scrotum and anus – before extracting both the prostate gland and seminal vesicles – connected to the urethra via semen tubes – for removal. They’ll also remove some surrounding tissue for testing purposes to see if cancer has spread further.

Most common side effects of prostate surgery are urinary incontinence and problems with sexual function, often called urinary incontinence, as well as issues with sexual functioning that usually improve over time or never go away completely. Surgeons attempt to save nerves that control erections but this may not always be possible, leading to difficulties getting or maintaining an erection, known as erectile dysfunction.

Diagnosis

If your enlarged prostate is causing urinary symptoms, surgery could be your solution. We offer various surgical procedures – the most popular being radical prostatectomy – which entails extracting both the prostate gland and nearby lymph nodes from its current position. Each procedure is customized specifically to the unique features of your cancer case.

Urologists specialize in urinary tract issues and will make an incision to gain access to your prostate, as well as remove some surrounding tissue to determine size and location of any cancer cells that might exist in it.

Laparoscopic prostatectomy requires fewer incisions than open surgery; during the procedure, your physician inserts a thin tube with a camera on its end (laparoscope) through an abdominal incision and uses other tools to extract part of your prostate gland. With this approach, we often avoid having to extract lymph nodes which helps speed recovery time after surgery. These methods may be less invasive but less effective.

Treatment options

Before surgery, discuss with your physician the goals and expected outcomes of treatment, along with any potential urinary, bowel or sexual side effects that might result. This process is known as shared decision-making.

Under anesthesia, your doctor will use transrectal ultrasound to locate the area of your prostate that needs to be excised. Once they know which region it is in, he or she will use needles inserted through your skin between your scrotum and anus connected to a device that injects very cold gases into your prostate and freezes cancerous cells- this procedure is known as cryosurgery.

Your doctor may recommend either extracting all or just part of the prostate depending on its size and how large it is, depending on your health and how it’s impacting you. When performing surgery, they will try to spare nerve bundles responsible for controlling erections during operation; this is more likely in older men with limited erections before surgery.

Recovery

Your recovery will take some time following either a prostatectomy or other procedure. Therefore, it is essential to set realistic expectations regarding long-term urinary and sexual function.

Your doctor will make one or two small cuts (incisions) in your penis to access your prostate gland, then insert a thin tube called a catheter into your bladder to drain urine from it. They may also prescribe PDE5 inhibitors such as sildenafil to increase blood flow to your penis and make getting an erection easier (PDE5 inhibitors).

Your surgeon will check your blood pressure and pulse during surgery, taking samples for lab analysis. Prior to surgery, aspirin and medications that increase your risk of bleeding such as ibuprofen (Advil, Motrin IB and others) or naproxen sodium (Aleve) should be avoided; your physician will inform you if any additional actions must be taken.