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Open prostatectomy is the surgical removal of the prostate gland. It is done under a general or spinal anesthetic. Usually, an incision is made through the lower abdomen, although sometimes the incision is made between the rectum and the base of the penis. A catheter may be placed in the bladder through the lower abdominal skin to help flush the bladder (postoperative bladder irrigation) and another catheter comes out of the penis to drain the urine. The procedure requires a slightly longer hospital stay and recovery period than transurethral resection of the prostate (TURP).
Open prostatectomy is not done very often for benign enlargement of the prostate. It may be recommended if:
A prostatectomy also reduces the chances that another surgery will be needed, which is a potential problem when TURP is used.
If you have been treated for prostate cancer, an open prostatectomy cannot be done.
Open prostatectomy requires several days in the hospital. A catheter is left in place for 3 to 5 days. You may go home with a urinary catheter in place. Your doctor will give you instructions about how to care for your catheter at home.
Open prostatectomy usually is used for men who want surgery to treat their benign prostatic hyperplasia (BPH) symptoms and who have very enlarged prostates.
Open prostatectomy almost always improves symptoms.footnote 1
The risks of open prostatectomy include:
Surgery usually is not needed to treat BPH, but some men may choose it. Choosing surgery depends largely on your preferences and comfort with the idea of having surgery. Things to think about include your expectation of the results, the severity of your symptoms, and the possibility of having complications.
Men who have severe symptoms before surgery often have great improvement in their quality of life following surgery. Men whose symptoms are mild may find that surgery does not greatly improve their quality of life. They may want to think carefully before deciding to have surgery to treat BPH.
AUA Practice Guidelines Committee (2010). AUA guideline on management of benign prostatic hyperplasia. Chapter 3: Results of the treatment outcomes analyses. Available online: http://www.auanet.org/content/guidelines-and-quality-care/clinical-guidelines.cfm?sub=bph.
Han M, Partin AW (2012). Retropubic and suprapubic open prostatectomy. In AJ Wein et al., eds., Campbell-Walsh Urology, 10th ed., vol. 3, pp. 2695–2703. Philadelphia: Saunders.
Current as of: May 27, 2019
Author: Healthwise StaffMedical Review: E. Gregory Thompson, MD - Internal MedicineAdam Husney, MD - Family MedicineJ. Curtis Nickel, MD, FRCSC - Urology
Current as of: May 27, 2019
E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & J. Curtis Nickel, MD, FRCSC - Urology
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