Prostatectomy: What to Expect During Surgery and Recovery?

What is a prostatectomy?

A prostatectomy is a surgical procedure for the partial or complete removal of the prostate gland and tissues surrounding it. This procedure may be performed to treat benign prostatic hyperplasia or prostate cancer. This process includes making a surgical incision and removing seminal vesicles and some nearby lymph nodes. This can be achieved with either of the two methods: 

  • A perineum incision (through the skin between the scrotum or the rectum)
  • The retropubic or suprapubic incision (lower abdomen)


Who should undergo radical prostatectomy?

Men younger than 75 years of age limited to prostate cancer benefit the radical prostatectomy. The test evaluation includes PSA level and biopsy which may also include CT scan, MRI scan, bone scan and ultrasound. If the cancer has not spread beyond the prostate then surgeons may include radiation therapy, hormone therapy or simply observing prostate cancer slowly. Depending on the risk of the cancer, pelvic lymph node dissection may be considered as well. 


The cost of prostate cancer surgery in India starts from $7500 which is very less compared to other western countries. There are various prostate cancer treatments India uses at different times depending on the stage of the cancer and the health status of the patient. 


Reasons for the procedure of prostatectomy:

The key goal of the procedure is to remove all prostate cancer.  Radical prostatectomy is used when the cancer is believed to be confined to the prostate gland. During the procedure, the prostate gland and some tissue around the gland including seminal vesicles is removed. Other less common reasons for radical prostatectomy includes:


  • Very low in the stream of urination

  • Inability to completely empty the bladder

  • Bladder stone with prostate enlargement

  • Recurrent bleeding from the prostate 

  • Increased pressure in the ureters and kidney from urinary retention 


There may be other reasons for your doctor to recommend a prostatectomy. This is the most common prostate cancer surgery in India which can be done in different ways. 


Prostatectomy surgery basics:

There are two approaches surgeons can use when performing  a prostatectomy, the end goal is the same for both surgery to remove and destroy prostate cancer.  


  • Robotic surgery:

Tiny incisions and robotic technology help doctors perform a precise, minimally invasive procedure with faster recovery time and smaller incisions. 


  • Open surgery: 

This procedure is the use of small tools and incisions. Open surgery is a more appropriate option than robotic surgery. 


A radical prostatectomy takes about two hours. Doctor’s will give you anesthesia so you won’t feel a thing. During the surgery, the doctor will do the following:


  • Remove the prostate 

  • Make a small incision to gain access to prostate 

  • Connect the catheter to the bladder, which allows urine to drain while the area heals. 

  • Reconnect the bladder to the urethra, the tube that carries urine outside of the body  


What to expect after radical prostatectomy:

After radical prostatectomy, the patient has to stay for two to three days in the hospital. During the surgery, a urinary catheter is inserted and some men need to wear the catheter home for a few weeks. At times, catheter is inserted into the skin for some patients after returning home. Pain after the radical prostatectomy can be controlled with use of medications. After your surgery heals, your catheter will be removed. This happens after 10 days of the surgery. This will also help decide if further treatment is necessary. It may take up to a few weeks to few months for urinary and sexual function to return to their maximum potential. For the first few months, you won’t be able to do strenuous activity or heavy lifting. You may return to work sooner if you work from home. Regular followup is advised by the doctor to make sure prostate cancer does not return back. After a month, your life will become back to normal. Some men may experience side effects such as erectile dysfunction and urinary incontinence. 

The side effects are temporary. If they are affecting your quality of life it may be time to seek help from your doctor.


Advantages of Prostatectomy surgery:

This surgery is the common choice to cure prostate cancer if it is not thought to have spread outside the gland. The advantages include the following:


  • Less scarring

  • Less blood loss

  • Erectile function

  • Less postoperative pain

  • Clinically superior results

  • Reduced risk of complications 

  • Shorter hospital stay 

  • Faster return of urinary continence 

  • Faster recovery and return to normal activities 


The cost of prostate cancer surgery in India is $7000-$8500 while in the UK the same treatment costs around $24,000. Rajiv Gandhi is the prefered choice when it comes to prostate cancer treatment India


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