Prostatectomy / Robotic Prostatectomy

Overview of Prostatectomy

A prostatectomy is done to remove part or all of the prostate gland. It can be used for several reasons; many depend on the reason the prostate gland is needing to be removed.

What is the Prostate?

The prostate gland is located in the male pelvis, below the urinary bladder. It is what surrounds the urethra. The urethra is what carries the urine from the bladder to the penis.

Why Is a Prostatectomy Done?

A prostatectomy can be done for a variety of reasons. The most common is a prostatectomy because of cancer. A radical prostatectomy is done to remove the entire prostate and any of the surrounding lymph nodes. This is used as a treatment for men that have prostate cancer that has been localized. This type of surgery is typically done with a couple of techniques.

A robot-assisted radical prostatectomy is when the physician makes very small incisions in the low abdomen. Then the physician will sit at the console and will move the robot. The robot is able to make very precise movements.

An open radical prostatectomy is when an incision is made in the lower abdomen and removes the prostate. This procedure can also be called a retropubic surgery.

A laparoscopic radical prostatectomy is done when your physician makes small incisions in the lower abdomen. Then from here, the physician will take special tools to remove the prostate.

An enlarged prostate will typically be treated with a simple prostatectomy. This is recommended for men that are experiencing urinary problems and also have a very large prostate gland. This simple prostatectomy is typically done if cancer is not present. A simple prostatectomy can be done with a robot or as an open procedure. When a prostate is enlarged, it is often called benign prostatic hyperplasia, shortened to BPH. A simple prostatectomy does not remove the whole prostate, but it removes the part of the prostate that blocks the urine flow.

Most commonly, a prostatectomy is done to treat prostate cancer that is contained to the prostate. If the cancer is spread, then the prostatectomy may be paired with other treatments like chemotherapy, hormone therapy, or radiation.

The surgery is typically done to aid in treating many symptoms like:

  • Inability to urinate
  • Frequent and urgent need to urinate
  • Urinary tract infections
  • Slow urination
  • Increased urination at night
  • Feeling as if you cannot empty your bladder

Risks of a Prostatectomy

A prostatectomy is typically a very safe procedure, however, with any surgery, there are minor risks. If you are having a prostatectomy, then you may experience the following:

  • Bleeding
  • Formation of cysts containing lymph, also lymphocele
  • Narrowing of the urethra, also called stricture
  • Urinary tract infection
  • Urinary incontinence
  • Erectile dysfunction
  • Injury to the rectum

Preparing for a Prostatectomy

Before your procedure, your physician will look inside the bladder and the urethra. This procedure is called a cystoscopy. This procedure will let the physician to see the prostate and the entire urinary system. You may also be asked to perform other tests, such as the blood test, urine test, or a test to measure the prostate.

Before your procedure, then you will want to ensure you have all of the instructions from your physician If you have any questions, be sure to ask them during your appointment.

If you are on any medications, then you will want to tell your physician. Your medication list should include anything that you take, whether it is a prescription or over the counter or supplements. This is essential, especially for those that take any blood-thinning medications. You may be asked to stop taking certain medications in the days leading up to the surgery. Additionally, you will want to let your physician know of any medication allergies that you have.

You may be asked to fast before the surgery as well. You may not be allowed to eat or drink anything after midnight. If your physician has allowed you to continue with your medications or supplements, then you may be allowed to take a small sip of water to take the medications.

Lastly, you may be required to do an enema before surgery. If your physician requires this procedure, then you will be given a bowel prep before surgery and there will be instructions that are included.

You may be asked to pack a bag with certain items to bring to the hospital. These items may include a list of medications, your advance directive, and glasses/hearing aids/ and dentures. You will also be asked to bring anything that will make you more comfortable. For example, a brush, comb, comfortable clothing, music players, books, or anything else that you may prefer. You will also be asked to not bring things such as jewelry into surgery.

Before your surgery, you will want to make arrangements for after surgery. Talk with your physician about how long you will be in the hospital. Once you know this, then you will be able to plan for your ride home. You will not be allowed to drive right after the surgery. You will also be limited on what activities that you can be a part of. Talk with your physician about the recovery timelines.

What to Expect in a Prostatectomy

Before the procedure, your physician will give you a general anesthetic. This means that you will not be conscious for the procedure. You will also be given antibiotics before the surgery. This antibiotic will help to prevent infections.

The actual procedure will depend on what type of prostatectomy you are having. There are three main types of prostatectomy. A robotic-assisted radical prostatectomy is done through some small incisions and your physician will sit in front of the robot. This type of surgery is typically more precise than others.

A standard retropubic radical prostatectomy is done when your physician makes a small incision in the lower abdomen. The prostate gland is then dissected from the body along with the surrounding nerves. This is typically the lower risk of nerve damage.

A simple prostatectomy begins with a cystoscopy. Another tube will then be inserted, which will drain the fluids while you are awake.

After the surgery, you may be given an IV of medications for pain. Once you are off the IV, then you may be given medications for the pain. It is also important that you are up and walking the day after the surgery. You may get to go home the day of the surgery if your physician believes that it is safe to do so. You will need to return in one to two weeks to have the staples removed. A urinary catheter will be in five to ten days.

Be sure that you know exactly what your post-surgery steps are. You will need to resume activities very gradually. You will not be able to drive for a little while. It is also essential that you keep up with all of your follow up appointments.

Request An Appointment

To request an appointment with Urology, call 251-343-9090. To request an appointment with Radiation Oncology, call 251-414-5665.

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