What is an open benign prostatectomy?
An open prostatectomy is an effective surgical method for removing the prostate when the prostate is large in size or volume (50-60 grams or cubic centimeters).
When is the surgery performed?
In advanced tumor stages, as the prostate gland continues to grow, patients should undergo a prostatectomy to remove the part of the prostate that is pressing on or obstructing the bladder outlet. Blockage of the urinary tract can cause the patient slow cumulative damage such as recurrent urinary tract infections, expanded bladder volume, or kidney damage.
About the open benign prostatectomy procedure
Open prostatectomy surgery is performed under general or regional anesthesia. The surgeon makes a low transverse incision in the lower abdomen and spreads apart the muscles of the abdominal wall to reach the prostate capsule (a band of tissue). The surgeon removes the benign tissue that is blocking the passage of urine through either the capsule or the bladder. The surgeon then closes the capsule or bladder and leaves a catheter in the penis for a few days to drain urine from the body. The removed tissue is sent for pathological examination.
In a suprapubic prostatectomy (SPP), the surgeon opens the front wall of the bladder and removes the enlarged center of the prostate through this opening. The outer portion of the prostate is not removed. The bladder and abdominal wall are then closed.
In a radical perineal prostatectomy (RPP), the surgeon removes the entire prostate gland through an incision in the region between the anus and the scrotum (perineum).
What are the possible adverse effects of an open prostatectomy?
As with any invasive surgery, an enlarged prostate can have risks and complications. Surgical risks may be associated with anesthesia or the surgery itself.
Risks during or after surgery:
After prostate surgery, about 50-75% of patients will continue to experience orgasms without the ejaculation of semen (dry orgasm). The seminal fluid returns to the bladder and exits with urination. It is important to emphasize that a dry orgasm does not interfere at all with normal sexual function, but, of course, affects fertility.
Up to 5% of patients who have undergone an open benign prostatectomy report sexual dysfunction (sometimes to the point of complete impotence).
Permanent impairment of urinary control is very rare.