Open Prostatectomy is the prostrate surgery performed to remove a greatly enlarged prostrate gland. This surgical procedure is called Open Prostatectomy as the incision has to be made by the doctors in the patients abdomen to remove the prostrate tissue unlike the other endoscopic procedures for treating enlarged prostrate where a tube is inserted through the urethra to remove damaged prostate tissues.

Open Prostatectomy is advised by doctors for complicated prostate enlargement cases, where great inflammation is seen, if the patient has gall bladder stones or if his bladder is damaged. In Open Prostatectomy the inner portion of the prostate gland causing enlargement is removed leaving the outer portion of this walnut shaped gland intact.

Problem Symptoms and Purpose of Conducting Open Prostatectomy

A number of changes are observed in the prostrate gland as the age of the male increases. This gland is just the size of a pea at birth and reaches it full shape when the man reaches his mid twenties. No problem is seen in the gland till mid forties, when due to sudden hormonal imbalance in the male's body the cell multiplication starts in the prostate gland causing its enlargement. This problem is commonly known as BHP (Benign Prostatic Hyperplasia). The problem symptoms include:

• Pain or burning sensation during urination
• Bladder irritation and increase in urination frequency
• Urine retention and straining to urinate
  

Though doctors try to treat these symptoms using various advanced medicines and non surgical procedures, surgery becomes important if the severity of the problem increases, for example if blood stains appear in urine, bladder stones form or in case of any problem in the kidneys.

Open Prostatectomy is suggested for treating only 2-3% of the complicated cases where the prostate is excessively enlarged and starts weighing between 80-100 gm. Open Prostatectomy cannot be performed on prostate cancer patients or persons with previous history of pelvic surgery.

Different Open Prostatectomy Procedures

There are two different styles of Open Prostatectomy known as retropubic approach or suprapubic procedure. Surgery is performed after giving the patient local or general anesthesia. Local anesthesia is preferred as it reduces blood loss and also decreases the occurrence of complications like pulmonary embolus or deep vein thrombosis.

Retropubic Prostatectomy is preferred over Suprapubic Prostatectomy as:

• During retropubic surgery surgeons get a direct view of the prostrate tumor which helps them in making accurate incisions.
• Due to clear exposure of prostrate it is easier to control bleeding after surgery.
• Also there is almost negligible surgical trauma to the patient's urinary bladder.
  

On the other hand suprapubic procedures are preferred for treating obese patients and also cases having severe bladder complications as in this procedure the urologist has a clear view of the patient's bladder.

Patient's Aftercare

As Open Prostatectomy is a complex surgical procedure the patient has to remain in the hospital for next 4-7 days under the doctors' supervision. Usually for the first few days after the surgery the patient is put on a liquid diet and the surgeon has to closely monitor and keep track of fluid status and urinary output. A urethral catheter is attached to the patient for at least 2-3 days and is removed if no traces of blood are seen in the urine. If all the vital signs of the patient are found to be okay the patient is discharged after 4 days and can resume with moderate activities in just a couple of weeks, though full healing is complete in 4-6 weeks.

Side Effects of Open Prostatectomy

With major medical advancements doctors are able to control the blood loss rate. Patients recovering from Open Prostatectomy may experience urinary incontinence and retrograde ejaculation is observed in quiet a few cases. 3-5% of the Open Prostatectomy patients reports problem of erectile dysfunction.