You will be given general anesthesia (asleep, pain-free) or spinal anesthesia (sedated, awake, pain-free). The procedure takes about 2 to 4 hours.
Your surgeon will make a surgical cut in your lower belly. The cut will go from below the belly button to just above the penis. The prostate gland is removed through this cut.
The surgeon removes only the inner part of the prostate gland. The outer part is left behind. The process is similar to scooping out the inside of an orange. After removing part of your prostate, the surgeon will close the outer shell of the prostate with stitches. A drain may be left in your belly to help remove extra fluids after surgery.
Why the Procedure Is Performed
An enlarged prostate can cause problems with urinating. This can lead to urinary tract infections. Taking out part of the prostate gland can often make these symptoms better. Before you have surgery, your doctor may tell you some changes you can make in how you eat or drink. You may also be asked to try taking medicine.
Prostate removal can be done in many different ways. The kind of procedure you will have depends on the size of the prostate and what caused your prostate to grow. Open simple prostatectomy is often used when the prostate is too large for less invasive surgery. This means that the prostate weighs 100 grams or more. However, this method does not treat prostate cancer. Radical prostatectomy may be needed for cancer.
Prostate removal may be recommended if you have:
Problems emptying your bladder (urinary retention)
Many men recover in about 6 weeks. You can expect to be able to urinate as usual without leaking urine.
Han M, Partin AW. Retropubic and suprapubic open prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 94.
Thiel D, Petrou SP. Electroresection and open surgery. Urol Clin North Am. 2009;36(4):461-470, vi.
Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.