What is open prostatectomy?

Open prostatectomy is a surgical procedure performed to remove the prostate gland, which is located just below the bladder and surrounds the urethra. In addressing conditions such as benign prostatic hyperplasia (BPH), prostate cancer, and other urinary-related issues, the conventional surgical method entails creating an incision in the lower abdomen. This incision allows for access to the prostate gland, which is then removed as part of the procedure. This approach is widely used to effectively manage these conditions and alleviate associated urinary difficulties.

When is open prostatectomy performed?

Open prostatectomy is usually recommended when the prostate gland is significantly enlarged or when other treatment options have been ineffective. This procedure is commonly performed for the following reasons:

• Benign Prostatic Hyperplasia (BPH): BPH, also known as benign prostatic hyperplasia, pertains to the non-cancerous enlargement of the prostate gland, resulting in urinary symptoms like frequent urination, weak urine flow or difficulty in fully emptying the bladder. In cases where medications, lifestyle adjustments, or minimally invasive procedures have not adequately alleviated the symptoms, open prostatectomy may be contemplated as a treatment option.
• Prostate Cancer: Open prostatectomy is a viable treatment option for localised prostate cancer, particularly when the cancer is limited to the prostate This surgical procedure enables the complete removal of the prostate, presenting the possibility of a curative outcome for the disease.

How is open prostatectomy performed?

Open prostatectomy is performed under general anaesthesia and involves the following steps:

• Incision: To access the prostate gland and its surrounding structures, the surgeon creates an incision in the lower abdomen. The direction of the incision, whether vertical or horizontal, is determined based on the specific case requirements.
• Exposure and Removal: The surgeon carefully separates the surrounding tissues to expose the prostate The urethra, which passes through the prostate, is then disconnected from the bladder. The prostate is detached from the surrounding tissues, and the blood vessels supplying it are sealed or tied off to minimise bleeding. The prostate gland is then removed.
• Reconstruction: Once the prostate is removed, the surgeon reconnects the urethra to the bladder using stitches or other techniques to restore normal urine flow. Subsequently, the abdominal incision is meticulously closed using either sutures or staples.
• Recovery: After the procedure, patients are monitored in a recovery area before being transferred to a hospital room. A temporary catheter is usually inserted to facilitate urine drainage from the bladder. The duration of hospitalisation depends on the specific circumstances, but most patients are discharged within a few days. It may take several weeks for complete recovery, during which patients are advised to refrain from engaging in strenuous activities and adhere to any post-operative instructions given by their surgeon.