What is a Prostatectomy?

The male prostate gland is an endocrine gland that stores and secretes a fluid which makes up 30% of semen volume. In older men, the prostate gland has an increased tendency to become inflamed, and the risk of cancer developing in the gland also increases. One treatment option for prostate conditions is prostatectomy, the surgical removal of part or all of the prostate gland.

Chronic prostate inflammation and other conditions that cause prostate enlargement often restrict urine flow as the enlarged gland presses against the urethra. Prostate-removal surgery may be carried out to correct chronic prostate enlargement and restore urine flow. Alternatively, the procedure may be carried out to remove the gland if it becomes cancerous. The procedure can be carried out in one of several different ways, depending on the needs and wishes of the patient.

In a radical prostatectomy, the entire prostate gland is removed via a fairly invasive surgical procedure. During this procedure, the surgeon makes an incision in the lower abdomen or the perineum to access the prostate gland. The gland is then removed. Both methods are effective at removing the gland, but perineal-access surgery is no longer as common due to the possibility of nerve damage that can leave the patient impotent.

Laparoscopic prostatectomy is a modern type of surgery which is much less invasive due to the ability of the surgeon to operate through a smaller incision. The nature of this surgery means that patients usually require little in the way of post-operative treatment and can often leave the hospital only a day or two following surgery. Robotic prostatectomy is another modern technique in which surgery is carried using robotic arms which are controlled by the surgeon. It should be noted that laparoscopic and robotic surgery do not have any advantages in terms of improved surgical outcomes, and the potential side effects of these procedures are the same as for radical surgery.

Prostate-removal surgery can have permanent side effects, one of which is erectile dysfunction. The possibility of this side effect occurring depends on the type of surgical method used, and also on the reason for the surgery. If the prostate is removed due to cancer that has spread to the network of nerves that surround the prostate, temporary or permanent erectile dysfunction is a likely consequence of surgery. Another possible side effect of prostate surgery is incontinence. Post-prostatectomy incontinence occurs in up to 50% of men who undergo surgical prostate removal. For many men this is only a temporary side effect, but some men may need additional treatment if incontinence persists.