Procedure
The basic idea behind a prostatectomy is to remove the prostate while doing as little damage as possible to the surrounding tissues. As Medline explains, during a prostatectomy the prostate gland is removed along with the seminal vesicles, which are two sacs filled with fluid next to the prostate. During the removal process, the surgeon tries to avoid damaging or severing the nerves and blood vessels that supply the penis. Removal of the prostate also involves the removal of some of the urethra, so the surgeon must also reconnect the remaining ends of the urethra for proper urine flow. If prostate cancer is suspected, the lymph nodes near the prostate may also be removed to see if the cancer has spread.
Approaches
Although the underlying idea behind a prostatectomy is the same, many different approaches can be taken for this kind of surgery. UrologyHealth.org says one method is called a retropubic prostatectomy. With this surgery, a four-inch-long incision in the abdomen is made to gain access to the prostate. Another option is called a perineal prostatectomy. In this operation, the incision is made in the skin between the anus and the scrotum. A prostatectomy can also be done laparoscopically, in which several smaller (inch-long) incisions are made and the surgeon uses a special flexible camera (a laparoscopic) and tools to remove the prostate without making a large incision. Some surgeons use robotic arms to make extremely precise movements, which the surgeon can then control from a console.
Recovery
Once the patient's wounds have been sewn up and the anesthesia has worn off, the patient must have a urinary catheter in place to allow the bladder to drain while the urethra is healing. This catheter is left in for one to two weeks; the patient then must perform special exercises to help strengthen the muscles that control urinary flow. Often the patient has two drains put in next to the bladder that drain out through the lower abdomen, which helps prevent infection and keeps excess fluid from building up around the surgical area. These are removed before the patient leaves the hospital.
