Prostatectomy in Iran: All you need to know

Prostatectomy is a medical term that is used to describe a surgery for removing the entire prostate gland or a part of it.

Causes of prostate surgery

Prostate surgery or prostatectomy is a surgery used as a treatment for several conditions that affect the prostate like:

• Benign prostatic hyperplasia (BPH): Known also as noncancerous prostate enlargement. It is a condition where the prostate’s size increases, causing an inability to urinate or trouble to urinate among other symptoms.
• Prostatism: Prostatism is a condition that happens when the enlarged prostate obstructs the bladder neck.
• Prostatitis: Prostatitis is a prostate disease that is accompanied by groin pain and difficulty urinating.
• Prostatalgia: It is a medical condition that makes you feel pain and that is caused by an enlarged prostate or prostate inflammation. Prostatalgia can occur at any age.
• Prostate cancer: It is a condition that arises after prostate cells start to multiply abnormally and grow fast.

Prostatectomy surgery types

There are mainly 2 types of prostatectomy, each of which has several approaches. Each type of them has its unique advantages and disadvantages, and the surgeon chooses the prostate surgery option that best fits you based on your condition.

Open prostatectomy

It is also called traditional prostatectomy, and it involves making an incision in your skin and removing the prostate or a part of it. The most common approaches of open prostatectomy are:

• Radical retropubic: The surgeon will make an incision from the belly to the pubic bone to remove the prostate.
• Radical perineal approach: The surgeon will make the incision between the rectum and scrotum.

Laparoscopic Prostatectomy

Laparoscopic prostatectomy, also called prostatectomy keyhole surgery, is a minimally invasive surgery. This surgery is performed by making several tiny incisions instead of the traditional open surgery. It involves using a laparoscope to remove the prostate. The main approaches in laparoscopic prostatectomy are:

• Laparoscopic radical prostatectomy: The surgeon will use a laparoscope and perform through the tiny cuts.
• Robotic-assisted laparoscopic radical prostatectomy: It is similar to the first one except that it is performed with the help of a robotic arm. Prostate surgery da Vinci method is an example of this approach.

Prostate surgery da Vinci method

When the daVinci method is used, the surgeon can remove the prostate while making smaller incisions. He/she will be controlling the robotic arm using a small instrument. There will a high-definition camera providing images from inside your body.

If you undergo prostate surgery using the da Vinci method, you will probably gain a faster return of erectile function, urinary continence than patients who have an open prostatectomy. Fewer complications appear after having prostate surgery using the da Vinci method.

Prostate surgery by laser

Prostate surgery by laser is used to treat patients who suffer from moderate to severe urinary retention due to enlarged prostate (BPH). The procedure involves inserting a scope through the penis into the urethra and passing a laser to remove the tissues that prevent urine to flow.

There are different types of prostate laser surgery like:

• Photoselective vaporization of the prostate (PVP)
• Holmium laser ablation of the prostate (HoLAP)
• Holmium laser enucleation of the prostate (HoLEP)

The surgeon will choose the right surgery type for you based on a handful of factors, including the size of the prostate gland and your condition and general health.

When you have prostate laser surgery, you will decrease the risk of bleeding, stay in the hospital for a shorter time and recover faster after the surgery.

Prostatectomy surgery steps

The steps of each prostatectomy surgery are different from the other. However, there are some similarities between open surgery approaches. In general, the common steps include:

• Removing the prostate gland from the surrounding tissues and removing the seminal vesicles
• Reattaching the urethra to the neck of the bladder
• Sometimes the surgeon removes the lymph nodes in the pelvis
• The surgeon might leave Jackson-Pratt drain in the belly to remove excess fluids and a catheter for draining urine.

The difference between the operations comes in the location of the incision and sometimes in the used instruments (robotic arm or laparoscope may be used).

How to prepare for prostatectomy?

Preparing yourself well for prostatectomy will reduce the risk of having unwanted side effects of the surgery. Before you go to the hospital to have a prostatectomy, you need to:

1. Tell the doctor if you are taking any blood thinners to see if you need to stop taking them.
2. Tell the doctor about any other medications you are taking.
3. You might need to stop taking supplements, especially if you are taking any herbal supplement.
4. You need to stop drinking alcohol and smoking for a month before the surgery.
5. Tell your doctor if you suffer from sleep apnea as it can cause some problems during surgery.
6. You should stop eating and drinking at least 12 hours before the surgery and eat something light before that.

You might also need to do other things before the surgery depending on the type of prostatectomy you need to have. Your doctor will tell you what you need to do as he/she knows better about your condition.

Prostatectomy surgery time

Prostatectomy surgery time depends mainly on the type of prostatectomy you are undergoing. In general, it takes from 90 or 120 minutes to 4 hours to be performed. Prostatectomy is usually performed under general anesthesia.

What to expect after prostatectomy surgery?

After you undergo the surgery, you will wake up in the recovery room. Your vital signs will be monitored to make sure you are ok. You might need to stay in the hospital for the next day. You will have a urinary catheter when you wake up from the surgery.

After that, you will be able to go home but you should take a taxi or ask someone to drive you. The surgery location will begin to heal after a week or so, and then the catheter will be removed.

You might notice some blood in urine after prostatectomy, which is normal during the days following the surgery. Blood in the urine is common especially while the catheter is present.

It is possible to experience some bladder spasms after prostatectomy. These spasms can be painful a bit but they will get better later.

Prostate surgery pain

Many patients do not feel a lot of prostate pain after surgery, so it would be enough to take over-the-counter painkillers to deal with the possible discomfort. Some patients report that they do not feel any pain after prostatectomy surgery. If you feel severe pain, contact your doctor immediately.

Abdominal drain after prostatectomy surgery

When the lymph nodes are removed, you will have an abdominal drain to prevent fluids from collecting in your abdomen. The drain is usually removed when you leave the hospital but some patients go home with the drain and come back to remove it after a few days.

Prostate surgery diet

For a few days following the surgery, you need to eat light food until you have your first bowel movement. Stay away from the foods that can cause gases for a few days. After you have your bowel movement, you can resume your normal diet and eat whatever you want.

Prostatectomy surgery recovery

After you are discharged from the hospital, you should rest home for a while. For the following 6 weeks, you need to take things easy. For example, you need to:

• Avoid lifting heavy objects.
• Avoid driving for a while.
• Have someone to stay with you (a family member or a close friend for example) to help you prepare food and do the household chores.
• Avoid drinking any alcohol during the recovery period. Drinking alcohol can cause bladder irritation, thus slowing the recovery.
• Avoid vigorous activities and exercise as well as any exercise that affects the abdominal muscles.

Slow walking is ok after prostatectomy. You can walk on the road or using a treadmill.

PSA after prostatectomy surgery

Prostate gland cells produce a protein called PSA. The levels of PSA in the blood should be very low after prostatectomy within the next 4 to 6 weeks. If the levels of PSA go up after radical prostatectomy it will mean that you still have prostate cells somewhere in your body.

Prostate surgery pros and cons

As with every surgery, there are some risks associated with prostatectomy. You just need to weigh the risks and the advantages to see whether you should undergo prostatectomy or not.

Prostate surgery advantages

1. It may cure prostate cancer permanently.
2. It enables the doctor to remove the lymph nodes to test them.

Prostate surgery disadvantages

1. There is a risk of erectile dysfunction (ED).
2. There are several risks associated with the sedation.

Prostate surgery for elderly patients

Prostatectomy surgery is usually a good treatment for patients up to the age of 79. However, some of the doctors recommend that patients who are in their 70s should not undergo prostatectomy surgery. Elderly patients are more likely to suffer from prostatectomy surgery complications.

Prostatectomy surgery complications and side effects

Every surgery has some risks and possible side effects, and prostatectomy is not an exception. The possible prostatectomy surgery’s complications may include:

1. Bleeding
2. Urinary incontinence
3. Narrowing of the urethra or bladder neck
4. Urinary tract infection
5. Erectile dysfunction (impotence)
6. Formation of cysts containing lymph (lymphocele)
7. Blood clots in the leg or the lung
8. Infections at the site of the surgery

Prostatectomy is a safe procedure, but there might be a possibility of death during the surgery. The chances of death are rare, and the death rate is below 1%. Prostatectomy has a great success rate as research has shown that about 88.6% of men survive for the following 5 years and about 73% survive for the following 20 years.

How can I arrange to have prostatectomy in Iran?

If you consider having prostatectomy in Iran with an experienced Iranian surgeon, all you need to do is to contact AriaMedTour through our “Free Consultation” service or through WhatsApp or any of our social media accounts. Thereafter you do not need to worry about nothing because we will take care of everything you need before, during and after surgery whether when you are in Iran or after you return home.