The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm. Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia.
Pre-treatment education is the first step to making a decision about your treatment. All types of prostate surgery can be done with general anaesthesia, which puts you to sleep, or spinal anaesthesia, which number the lower half of your body. Your doctor will recommend a type of anaesthesia based on your situation.
The goal of your surgery is to:
- Cure your condition
- Maintain urinary continence
- Maintain the ability to have erections
- Minimise side effects
- Minimise pain before, during, and after surgery
Types of Prostate Surgery
The goal of prostate surgery will heavily depend on your condition. For example, the goal of prostate cancer surgery is to remove cancerous tissue. The goal of BPH surgery is to remove prostate tissue and restore the normal flow of urine.
Open prostatectomy is also known as traditional open surgery or an open approach. Your surgeon will make an incision through your skin to remove the prostate and nearby tissues. There are two main approaches, as we explain here:
Radical Retropubic: Your surgeon will make the cut from your belly button to your pubic bone. In a fair few cases, the surgeon will only remove your prostate. However, if they do suspect the cancer may have started to spread, they will remove some lymph nodes for testing. Your surgeon may decide to not continue the surgery if they learn that the cancer has spread.
Radical Perineal Approach: Your surgeon will begin by making a cut in the space between your rectum and scrotum. This is often done when you have other medical conditions that complicate the retropubic surgery. In this position, your surgeon cannot remove the lymph nodes. This surgery takes less time than retropubic surgery, but there is a higher risk of erectile dysfunction.
Just be sure that for either of these approaches you are under general, spinal or epidural anaesthesia.
Laparoscopic surgery is a minimally invasive approach to prostate surgery. There are two main approaches to this kind of procedure as well:
Laparoscopic Radical prostatectomy: This surgery requires multiple tiny cuts so the surgeon can insert small surgical instruments. Your surgeon will use a thin tube with a camera to see into the area.
If you feel you have prostate cancer, then you should get in touch with your GP straight away.