The prostate is a small gland-like structure located below the bladder and in front of the rectum in males. It is an important part of the male reproductive system, as it is responsible for secreting portions of the seminal fluid. The prostate can become enlarged; a common condition known as benign prostate hyperplasia (BPH), and cancer of the prostate is common, affecting 1 in 6 men at some point in their lives, according to the American Cancer Society. There are several different prostate surgery procedures available to treat these conditions.
Radical Prostatectomy
A radical prostatectomy, the removal of the entire prostate and some surrounding tissue, is a major surgery that requires general anesthesia. This type of prostate surgery may be necessary when the prostate is so enlarged it has caused damage to nearby organs such as the bladder. It is also used as a treatment for prostate cancer that has not yet spread beyond the prostate.
The most commonly performed prostatectomy procedure is the retropubic prostatectomy, according to The Prostate Cancer Foundation. This procedure is performed through an incision in the abdomen.
Another type of prostatectomy less commonly used is the perineal prostatectomy. This procedure removes the prostate through an incision in the perineum, the space between the scrotum and the anus.
There are nerve-sparing prostate procedures that aim to retain the nerve bundles on each side of the prostate that are necessary for erectile function. A unilateral procedure spares one side, and Prostate Cancer Treatment Guide reports that 13 to 48 percent of men regain erectile function. The bilateral procedure; however, spares both nerves, and 68 percent of patients regain their erectile function, according to Prostate Cancer Treatment Guide.
Transurethral Resection
A transurethral resection of the prostate, also known as a TURP, is the procedure performed for approximately 90 percent of men who have benign prostate hyperplasia (BPH), according to the National Kidney and Urologic Diseases Information Clearinghouse. The procedure is safer than a radical prostatectomy and requires less recovery time.
During a TURP procedure, the doctor uses a resectoscope, a 12-inch-long tool that has a loop at the end that can cut tissue and seal blood vessels. The resectoscope is inserted through the penis and into the prostate gland to remove tissue that is impeding the urethra or otherwise causing problems. The most common side effect of this procedure is retrograde ejaculation, a condition in which the semen flows backward into the bladder during climax.
Transurethral Incision
A transurethral incision of the prostate (TUIP), also used to treat BPH, is similar to TURP in that the doctor enters through the penis. During this procedure, however, there is no tissue removed. During a TUIP, the doctor makes several small incisions in the portion of the bladder neck where the bladder and urethra join to widen the urethra and help urine flow more freely. Small incisions may also be made in the prostate gland to alleviate pressure on the urethra. This procedure is simpler to perform and does not have serious complications, according to the doctors at the Mayo Clinic, but it can only be performed when the prostate is still relatively small.
References
- The Prostate Cancer Foundation: Prostatectomy
- National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC): Prostate Enlargement
- American Cancer Society: Prostate Cancer
- Prostate Cancer Treatment Guide: Risks and Complications of Prostatectomy
- The Mayo Clinic: Transurethral Incision of the Prostate
