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Simple prostatectomy

Prostatectomy - simple; Suprapubic prostatectomy; Retropubic simple prostatectomy; Open prostatectomy; Millen procedure

Simple prostate removal is a procedure to remove the inside part of the prostate gland to treat an enlarged prostate. It is done through a surgical cut in your lower belly.

Description

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 pubic bone or it may be made horizontally just above the pubic bone. The bladder is opened and 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 and leaving the peel intact. 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. A catheter may also be left in the bladder. This catheter may be in the urethra or in the lower abdomen or you may have both. These catheters allow the bladder to rest and heal.

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 health care provider 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. However, this method does not treat prostate cancer. Radical prostatectomy may be needed for cancer.

Prostate removal may be recommended if you have:

Your prostate may also need to be removed if taking medicine and changing your diet do not help your symptoms.

Risks

Risks for any surgery are:

Other risks are:

Before the Procedure

You will have many visits with your doctor and tests before your surgery:

If you are a smoker, you should stop several weeks before the surgery. Your provider can help.

Always tell your provider what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.

During the weeks before your surgery:

On the day of your surgery:

After the Procedure

You will stay in the hospital for about 2 to 4 days.

You will leave surgery with a Foley catheter in your bladder. Some men have a suprapubic catheter in their belly wall to help drain the bladder.

Outlook (Prognosis)

Many men recover in about 6 weeks. You can expect to be able to urinate as usual without leaking urine.

Related Information

Enlarged prostate
Prostate resection - minimally invasive
Transurethral resection of the prostate
Enlarged prostate - what to ask your doctor
Transurethral resection of the prostate - discharge

References

Han M, Partin AW. Simple prostatectomy: open and robot-assisted laparoscopic approaches. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 147.

Roehrborn CG, Strand DG. Benign prostatic hyperplasia: etiology, pathophysiology, epidemiology, and natural history. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 144.

Zhao PT, Richstone L. Robotic-assisted and laparoscopic simple prostatectomy. In: Bishoff JT, Kavoussi LR, eds. Atlas of Laparoscopic and Robotic Urologic Surgery. 3rd ed. Philadelphia, PA: Elsevier; 2017:chap 32.

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Review Date: 4/18/2021  

Reviewed By: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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