Name of the Procedure:

Prostatectomy; retropubic, subtotal (Including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy)

Summary

A retropubic subtotal prostatectomy is a surgical procedure that involves the partial removal of the prostate gland through an incision in the lower abdomen. It also addresses postoperative bleeding control, vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy when necessary.

Purpose

The procedure primarily addresses issues related to an enlarged prostate, prostate cancer, or severe prostate infection. The goal is to relieve symptoms, improve urinary function, and remove cancerous tissues, if present.

Indications

• Enlarged prostate (benign prostatic hyperplasia)
• Prostate cancer
• Recurrent urinary retention
• Chronic prostatitis
• Severe urinary symptoms unresponsive to other treatments

Preparation

• Fasting for at least 8 hours prior to surgery.
• Adjustments to current medications, particularly blood thinners.
• Preoperative diagnostic tests such as blood work, ECG, and imaging studies.

Procedure Description

1. The patient is given general or spinal anesthesia.
2. A catheter is inserted to drain the bladder.
3. An incision is made in the lower abdomen to access the prostate gland.
4. The surgeon removes part of the prostate gland (subtotal removal).
5. Control of postoperative bleeding is ensured.
6. Additional procedures such as vasectomy, meatotomy, urethral calibration or dilation, and internal urethrotomy may be performed as needed.
7. The surgical area is closed with sutures, and a drain may be placed to prevent fluid accumulation.
8. The patient is monitored in the recovery room.

Duration

Typically, the procedure takes about 2 to 4 hours, depending on complexity.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Urologic surgeon
• Anesthesiologist
• Surgical nurses
• Scrub technologists

Risks and Complications

• Infection
• Bleeding
• Blood clots
• Injury to nearby organs
• Urinary incontinence
• Erectile dysfunction
• Urethral stricture

Benefits

• Relief of urinary symptoms
• Improved urinary flow
• Removal of cancerous tissue (if applicable)
• Reduced risk of prostate-related complications

Recovery

• Hospital stay of 1 to 3 days.
• Instructions for catheter care and wound care at home.
• Pain management with prescribed medications.
• Avoid heavy lifting and strenuous activities for 4 to 6 weeks.
• Follow-up appointments for suture removal and progress monitoring.

Alternatives

• Medication therapy (e.g., alpha-blockers, 5-alpha-reductase inhibitors)
• Minimally invasive procedures (e.g., transurethral resection of the prostate)
• Watchful waiting for less severe cases

Patient Experience

During the procedure, the patient will be under anesthesia and will not feel any pain. Postoperatively, there may be discomfort or pain managed by medication. Patients will experience a period of recovery involving rest, catheter care, and wound monitoring. Most patients can return to normal activities within a few weeks.