Open Prostatectomy for Benign Prostatic Hyperplasia
Skip to the navigationSurgery Overview
Open prostatectomy is the surgical removal of
the prostate gland. It is done under a
general or
spinal anesthetic. Usually, an incision is made
through the lower abdomen, although sometimes the incision is made between the
rectum and the base of the penis. A
catheter may be placed in the bladder through the
lower abdominal skin to help flush the bladder (postoperative bladder
irrigation) and another
catheter
comes out of the penis to drain the urine. The
procedure requires a slightly longer hospital stay and recovery period than
transurethral resection of the prostate (TURP).
Open prostatectomy is not done very often for benign enlargement of the prostate. It may be recommended if:
- You have a very large prostate.
- You have bladder diverticula (pouches in the wall of the bladder) or bladder stones.
- TURP is not possible for another reason.
A prostatectomy also reduces the chances that another
surgery will be needed, which is a potential problem when TURP is used.
If
you have been treated for prostate cancer, an open prostatectomy cannot be
done.
What To Expect After Surgery
Open prostatectomy requires several
days in the hospital. A catheter is left in place for
3 to 5 days. You may go home with a urinary catheter in place. Your doctor will
give you instructions about
how to care for your catheter at home.
Why It Is Done
Open prostatectomy usually is used
for men who want surgery to treat their
benign prostatic hyperplasia (BPH) symptoms and who
have very enlarged prostates.
How Well It Works
Open prostatectomy almost always
improves symptoms.footnote 1
Risks
The risks of open prostatectomy include:
- The possible need for a
blood transfusion. Slightly more men require a blood
transfusion after open prostatectomy than after TURP.
- An inability
to have sexual intercourse because of erection problems. This occurs in less
than 5 out of 100 men and is more frequent in older men than in younger men.footnote 2
- A strong urge to urinate (overactive bladder), which can also cause leaking of urine (urge incontinence). This usually gets better within weeks or months.
- Complete or partial inability to hold back urine
(incontinence).
- Ejaculation of semen into the bladder instead of
out through the penis (retrograde ejaculation). This happens in 80 to 90 out of 100 men who have open prostatectomy. Although this is not harmful,
it may cause fertility problems.
What To Think About
Surgery usually is not needed to
treat BPH, but some men may choose it. Choosing surgery depends largely on
your preferences and comfort with the idea of having surgery. Things to
think about include your expectation of the results, the severity of your
symptoms, and the possibility of having complications.
Men who
have severe symptoms before surgery often have great improvement in their
quality of life following surgery. Men whose symptoms are mild may find that
surgery does not greatly improve their quality of life. They may want to think
carefully before deciding to have surgery to treat BPH.
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
References
Citations
- AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 3: Results of the treatment outcomes analyses. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
- Han M, Partin AW (2012). Retropubic and suprapubic open prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2695-2703. Philadelphia: Saunders.
Credits
ByHealthwise Staff
Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
Specialist Medical ReviewerJ. Curtis Nickel, MD, FRCSC - Urology
Current as ofMarch 14, 2017
Current as of:
March 14, 2017
AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 3: Results of the treatment outcomes analyses. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Han M, Partin AW (2012). Retropubic and suprapubic open prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2695-2703. Philadelphia: Saunders.