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Prostatectomy is an Operation for removal of enlarged Prostate Gland.

There are 2 Commonly Used Techniques

TUR 'P' or Trans Urethral Removal of prostate. This is done with an instrument inserted in the penis & the prostate is removed in small chips or pieces using electric or laser energy.

Prostate Specimen
Open Prostatectomy
Here a transverse or vertical cut is made in the lower part of the abdomen to remove the prostate gland. Between the 2, TUR'P' is the most commonly performed operation.

Type of Anaesthesia
A general or spinal anaesthesia is used. The operation commonly takes 1 to 1 1/2 hours. This disease is seen in elderly patients, most of whom may already be suffering from diseases such as diabetes or hypertension. All the precautions are taken to make the surgery & anaesthesia safe for such patients.

The Post Operative Period
All patients, in the post operative period will have a tube (catheter) in the penis to drain the urine. Occasionally a second tube (catheter) may be put in the bladder for a short while, from the front of the abdomen. A certain amount of bleeding in the urine is inevitable & some patients might need a blood transfusion. Patients are also given intravenous fluids (saline) during the first 24 hrs. Depending on the type of anaesthetic used, patients are allowed to drink & eat after 4 to 6 hours (after the operation).

Patients are also given antibiotics for the first 24 to 48 hrs. Some patients might need these for longer periods. In endoscopic operation, [TUR P] the patients are ambulatory from day 1 of the operation. Usually the catheter is removed 48 hrs after the operation. In open prostate operation, the patients may be a bit restricted in their mobility due to pain & the catheter may be removed a day or two later.

Once the catheter is removed, patients may have to pass urine very frequently (sometimes every 15 - 20 minutes) for the first few hours & it might come without much warning. This settles within 24 hours. Sometimes, patients may pass some blood in their urine, which settles by drinking plenty of liquids. A large glass of water every hour should be the rule! Usually patients are sent home, within 24 hours after catheter removal. In some patients, catheter may need to be inserted again for a day or so before things start working properly. People having a tendency towards constipation should ensure that they have a satisfactory motion before the catheter is removed & hence may need laxatives.

Some Common Problems After Going Home
The frequency of passing urine can go on up to a few weeks in certain patients. Also, it is quite common to experience some burning towards the end of urination & some patients might pass blood again in the urine, usually at the end of 3 weeks. If this does not settle inspite of drinking plenty of liquids, it is advisable to contact your doctor. You need to complete the course of any medication that your doctor may have prescribed & you must ensure a good bowel motion each day.

Sex Life After Surgery
You can enjoy your normal sex life when you feel comfortable. Some patients may not have a satisfactory semen discharge at the time of intercourse (retrograde ejaculation) & in about 10% of patients, quality of erections may be impaired.

Regrowth of The Prostate
As these operations remove only the obstructing portion of the prostate gland, regrowth of the same is not uncommon, especially after a TUR 'P' and this can happen anywhere between 5 to 10 yrs after the original operation. Some patients may in that case need a second operation. Also it is possible for a patient to develop prostate cancer, even after undergoing a TUR P. Hence regular health check up even after prostate surgery is recommended.