Our Summary

The study discusses prostatectomy, a surgical procedure used to treat benign prostatic hyperplasia (BPH), a condition where the prostate gland is enlarged. This condition can cause problems with urination. The paper examines how the approach to treating BPH has changed, with surgery now mainly being used for patients who don’t respond to medication, have severe symptoms, or have a particularly large prostate gland.

Traditionally, an open surgery approach has been used, which can improve symptoms but also comes with risks and complications. However, advances in technology mean that less invasive methods can now be used, such as laser surgery or laparoscopic surgery.

The researchers reviewed various articles and studies on the different methods of prostatectomy, and found that both traditional and minimally invasive approaches can be performed safely in the right patients. They suggest that the decision on which method to use should be based on the individual patient’s clinical situation.

FAQs

  1. What is a prostatectomy and why is it performed?
  2. How has the approach to treating benign prostatic hyperplasia (BPH) changed over time?
  3. How do traditional and minimally invasive methods of prostatectomy compare in terms of safety and effectiveness?

Doctor’s Tip

One helpful tip a doctor might tell a patient about prostatectomy is to make sure to follow all pre-operative instructions provided by the healthcare team, such as fasting before surgery and stopping certain medications. Additionally, it’s important to discuss any concerns or questions with the healthcare team beforehand and to have a support system in place for after the procedure to help with recovery. Lastly, following post-operative instructions, such as taking prescribed medications and attending follow-up appointments, is crucial for a successful recovery.

Suitable For

Patients who are typically recommended for prostatectomy include:

  • Patients who have not responded to medication for BPH
  • Patients with severe symptoms related to BPH
  • Patients with a particularly large prostate gland
  • Patients who have complications related to BPH, such as recurrent urinary tract infections or urinary retention
  • Patients who have not been able to tolerate or have not benefitted from other treatments for BPH

It is important for patients to discuss their symptoms and treatment options with their healthcare provider to determine if prostatectomy is the best course of action for their individual situation.

Timeline

Before prostatectomy:

  1. Patient experiences symptoms of BPH such as frequent urination, difficulty starting or stopping urination, weak urine stream, etc.
  2. Patient undergoes medical evaluation and tests to confirm diagnosis of BPH.
  3. Patient may be prescribed medication to manage symptoms, but if symptoms persist or worsen, surgery may be recommended.
  4. Patient discusses treatment options with their healthcare provider and makes a decision to undergo prostatectomy.

After prostatectomy:

  1. Patient undergoes pre-operative preparation, which may include blood tests, imaging tests, and discussions with the surgical team.
  2. Patient undergoes prostatectomy surgery, either through traditional open surgery or a minimally invasive method.
  3. Patient stays in the hospital for a few days for monitoring and recovery.
  4. Patient may experience side effects such as pain, urinary incontinence, and erectile dysfunction in the immediate post-operative period.
  5. Patient follows up with their healthcare provider for monitoring and management of any complications or side effects.
  6. Over time, patient’s symptoms of BPH improve, and they experience a better quality of life with improved urinary function.

What to Ask Your Doctor

Some questions a patient should ask their doctor about prostatectomy include:

  1. What are the potential risks and complications associated with prostatectomy?
  2. What are the benefits of traditional open surgery compared to minimally invasive methods such as laser or laparoscopic surgery?
  3. How long is the recovery process expected to be after prostatectomy?
  4. Will I need to make any lifestyle changes or take any medications after the surgery?
  5. What are the chances of experiencing urinary incontinence or erectile dysfunction after the procedure?
  6. How long do the effects of the surgery typically last?
  7. Are there any alternative treatments for BPH that I should consider before opting for surgery?
  8. How many prostatectomy procedures have you performed, and what is your success rate?
  9. Can you provide me with information on the different types of prostatectomy procedures available and help me decide which one is best for my situation?
  10. What can I expect in terms of follow-up care and monitoring after the surgery?

Reference

Authors: Ferretti M, Phillips J. Journal: Can J Urol. 2015 Oct;22 Suppl 1:60-6. PMID: 26497345