Prostate Surgery - Medical Negligence Lawyers

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Prostate Surgery

The male prostate gland is an egg-sized, irregularly shaped and multi-lobed gland that wraps around the urethra and sits directly below the bladder. For various reasons a prostate surgery is done, including having an enlarged prostate, called benign prostatic hypertrophy, and cancer of the prostate. While there are other treatments available, such as radiation, surgery is still a popular type of treatment for prostate disease.

There are three major procedures done in prostate surgery. These include an open prostatectomy, a robotic prostatectomy, and laparoscopic prostatectomy. The type of surgery chosen depends on the skill of the surgeon and the type of condition going on. There is also a transurethral prostatectomy, which cores out the middle of the prostate to make room for urine to pass.

Men with prostate problems report problems getting urination started, difficulty urinating, dribbling and problems emptying the bladder completely. These can be signs of just about any prostate problem so the doctor needs to do an exam and possibly do an ultrasound or other test, such as a PSH test, which measures the amount of circulating prostate hormone in the body. If cancer is suspected, a transrectal biopsy is done with samples sent for histology.

Major prostate surgeries include:

  • A prostatectomy, in which the prostate is removed.
  • A TURP, or transurethral resection of the prostate, done for benign prostatic hypertrophy.
  • Minimally invasive transurethral electro-vaporization of the prostate, also done for benign prostatic hypertrophy.
  • Transurethral microwave thermography, which uses heat to vaporize some of the prostate gland.

There are risks and complications to having prostate surgery. For example, a prostatectomy is very invasive and carries many of the same consequences of other surgeries. In fact, half of one percent of patients who have a prostatectomy for cancer die because of their procedure. The major side effect is getting a deep vein thrombosis that travels through the veins causing a pulmonary embolism. A pulmonary embolism is frequently deadly. For this reason, men having prostate surgery are asked to get up and walk as soon after the procedure as possible. DVTs occur in 10 percent of postoperative patients.

The patient can get a hernia where the surgical incision was laid down. For this reason, they are asked to avoid lifting 10 pounds or more for six weeks after the surgery. Lifting can also wreck the anastomosis between the bladder and the urethra. Damage to this area can lead to the need for surgical corrective surgery. To prevent problems at the anastomosis, you should avoid horseback riding, bicycling, motorcycle riding and heavy physical labor for at least six weeks.

Infection can occur at the incision site or where the catheter leaves the penis. Doctors recommend disinfectants at the site of the incision and alcohol application at the entrance to the urethra. Hydrogen peroxide can be used at this site as well, particularly following a bowel movement. The penis and rectum should be regularly cleaned with water and soap.

The prostatectomy is fraught with postoperative side effects, although other surgeries could have these side effects as well. Having incontinence and impotence are two of the most common. Leakage shows up about 2-3 weeks after the catheter is removed. This condition occurs in about 5 percent of postoperative patients. Some will have no control over the flow of their urine.

Impotence is also common after prostate surgery. There is a nerve-sparing surgery that is now done to keep the side effect of impotence away. There are two such techniques available: a unilateral technique and a bilateral technique. The bilateral technique has a greater chance of preserving penile function. People who have the bilateral technique have penile function 68 percent of the time. People who have the unilateral technique have a 13-48 percent chance of restoring penile function.

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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here