Prostatectomy is an invasive surgical procedure that involves removal of the prostate gland, the gland located right beneath the bladder of male patients. According to the UCSF Medical Center, the most common indication for this procedure is to prevent the spread of a clinically localized prostate cancer. However, in a consensus compiled by the Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, it was found that doctors in the United Kingdom also perform this procedure in patients with noncancerous prostatic enlargement associated with acute or chronic renal retention with moderate to severe symptoms. Prostate surgery can result in several known complications.
Excessive Bleeding
Excessive bleeding is the most common surgical complication of prostatectomy. This is usually due to blood vessel injury during operation and can result in decreased blood pressure, anemia and sometimes overt hypovolemic shock, a condition in which all the organs fail to function because of insufficient blood supply. Excessive bleeding can be corrected by blood transfusion during or after the operation. However, based on the study published in the January 2003 edtion of the "Urologic Oncology" journal, prostatectomy can now be performed with decreased blood loss because of the shorter time used for the surgical procedure.
Damage to Neighboring Structures
Damage to the rectum and the ureters during prostatectomy is relatively rare. This may result from an accidental cut during surgery because these structures are anatomically adjacent to the prostate gland. However, damage to the rectum and the ureters can be immediately repaired during the operation.
Surgical Wound Infection
Surgical wound infection usually arises from poor surgical wound care and lack of or insufficient dosing of antibiotics after the surgical procedure. This can manifest as pus formation on the site of surgical incision. However, due to the advent of better post-operative care and broad spectrum antibiotics that can kill almost all infection-causing bacteria, infection can usually be prevented.
Bladder Neck Contracture
Bladder neck contracture is the narrowing of the bladder neck as a result of scar tissue brought about by the cut made during the surgical procedure. This problem can result in difficulty with urination and other problems associated with urination noted a few months after undergoing prostate surgery. However, this problem can be resolved by an outpatient surgery that can relax this contracture.
Deep Vein Thrombosis
Deep vein thrombosis is the formation of a blood clot in the veins of the legs brought about by sluggish circulation. This happens when the patient remains non-ambulatory after prostatectomy. This can be prevented by early ambulation and use of compression stockings after surgery. Some symptoms of deep vein thrombosis include pain and swelling in the affected leg or body part. Increased redness and a warm sensation can also develop in the affected area.
References
- UCSF Medical Center: Radical Prostatectomy
- University of Pittsburg Cancer Institute: Radical Retropubic Prostatectomy
- "Journal of Epidemiology and Community Health": Appropriate indications for prostatectomy in the UK
- "Urologic Oncology": Factors associated with blood loss during radical prostatectomy
- "Japanese Journal of Clinical Oncology": Early and Late Complications of Radical Retropubic Prostatectomy
