PROSTATE GLAND REMOVAL, SUPRAPUBIC

General Information

DEFINITION--Removal of part or all of an enlarged prostate gland through an opening in the lower abdomen.

BODY PARTS INVOLVED--Prostate gland; bladder; rectum; urethra.

REASONS FOR SURGERY--Restoration of normal passage of urine.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Stress; smoking; obesity.
• Poor nutrition.
• Recent illness, especially upper-respiratory infection.
• Alcoholism or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; sedatives; hypnotics; or cocaine.

What To Expect

WHO OPERATES--Urologist.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; kidney function studies; intravenous pyelogram (See Glossary) chest x-ray; ECG (See Glossary).
• After surgery: Blood studies.

ANESTHESIA

• Spinal anesthesia by injection.
• General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the lower abdomen.
• The bladder and urethra are opened, and the enlarged parts of the prostate gland cut free and removed.
• Two catheters are placed in the bladder, and a tube to drain secretions is placed next to the bladder. The urethra and bladder are closed with sutures. One of the catheters will pass through the penis, and the other will be brought out through the incision along with the drain.
• The muscles are repositioned and sewn in place. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Inability to control urinary stream.
• Impotence (usually) and sterility.

AVERAGE HOSPITAL STAY--3 to 5 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Resuming daily activities, including work, as soon as you are able can help the healing process.
• Resume driving 5 weeks after returning home.
• Resume sexual relations when able.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing. Avoid coffee, tea, cocoa, cola drinks, alcoholic beverages and any food or spice that aggravates symptoms.

Call Your Doctor If

† Pain, swelling, redness or drainage increases in the surgical area.

• You experience excessive bleeding.
• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience new symptoms, such as: nausea; vomiting; constipation; abdominal swelling or pain; or difficulty with urination.