What are the effects of prostate removal?

Male prostatitis is a very common and stubborn symptom. There is no good treatment. If the condition is too severe, the only option is prostate removal. But what are the effects of prostate removal? This question depends on the type of surgery you choose. Today's minimally invasive surgery has little impact on the body, and the patient is not in great pain. Recovery is also faster, but removal will affect sexual function.

Among open surgeries, suprapubic transvesical prostatectomy is the most commonly used procedure and is a basic surgical method that urologists must master. This procedure is relatively simple and easy to master, and rarely causes urinary incontinence after the operation. This surgical method is more appropriate for patients with other lesions in the bladder. However, this operation requires bladder incision, and if the prostate capsule is tightly adhered to the gland, the capsule may occasionally be torn, which will cause certain difficulties in hemostasis.

Retropubic prostatectomy does not require bladder incision. The prostate is removed under direct vision, and suprapubic cystostomy is not required. Recovery is fast after surgery. However, the surgery is more complicated, with more bleeding. Improper treatment may cause infection, urinary incontinence, etc.

The advantages of transperineal prostatectomy are small surgical scope, small damage, small impact on the whole body, and fast recovery after surgery. However, the anatomy of the perineum is complicated, the surgical field is poorly exposed, and it is easy to cause postoperative sexual dysfunction.

Transurethral resection of the prostate (TURP) causes less damage, less pain, quick recovery, and a wide range of surgical adaptations. This surgery requires certain equipment and high technical requirements for the surgeon. Currently, TURP has the best effect and is still the "gold standard" for BPH treatment.

Adaptation

Suprapubic prostatectomy

Indications and contraindications

In 1887, Belfield of the United States and in 1988, McGill of the United Kingdom described suprapubic prostatectomy. Later, Harris of Australia proposed suturing the bladder neck to stop bleeding, which made suprapubic prostatectomy more widely used. In 1914, Pilcher proposed using a small capsule to stop bleeding, which shortened the operation time, reduced intraoperative and postoperative bleeding, and reduced postoperative complications. The surgical indications are: (1) Prostatic hyperplasia (greater than 60 grams) causing obvious symptoms of bladder neck obstruction, residual urine volume greater than 50 ml, repeated bladder bleeding, infection, etc. (2) Prostatic hyperplasia combined with bladder stones, bladder diverticulum, and upper urinary tract hydrops, etc.

Patients who have been clearly diagnosed with prostate cancer before surgery are not suitable for resection via suprapubic transvesical surgery, whether conservative or radical. Patients with severe cardiovascular disease, obstructive pulmonary disease, severe diabetes, significant liver and kidney dysfunction, and systemic hemorrhagic diseases should not undergo open suprapubic transvesical prostatectomy before their condition is well treated or if they are estimated to be unable to tolerate open surgery despite active medical treatment.