About this page. This is a plain English summary of open prostatectomy for an enlarged prostate (BPH). It does not replace medical advice from your own doctor or specialist.
For full information and references, please read the detailed page.
What is open prostatectomy?
Open prostatectomy is the operation where the surgeon makes a cut in the lower abdomen and shells out the obstructing inner part of the prostate through that incision. The outer shell, or capsule, of the prostate is left in place.
This is an open operation for a non-cancerous (benign) enlarged prostate. It is different from a radical prostatectomy, which is done to remove the whole prostate for prostate cancer. The names are similar, but the operations are different.
When is it used?
This operation is used very rarely now. Dr Kooner has not needed to do an open prostatectomy for around ten years, because the holmium laser allows the same result to be achieved through the urethra without an abdominal cut.
Open prostatectomy is now usually reserved for unusual situations, such as:
- A very large prostate that cannot be treated easily through the urethra.
- A very large bladder stone that needs to be removed at the same time.
- An out-pouching (diverticulum) of the bladder that needs surgical correction.
How it is done, in plain terms
- You have a general anaesthetic.
- The surgeon makes a cut in the lower abdomen.
- The plane between the inner adenoma (the obstructing part) and the outer capsule of the prostate is found.
- The adenoma is shelled out, leaving the capsule behind.
- The bladder and abdomen are closed and a catheter is left in.
- You stay in hospital for a few days.
Important things to know
- This is a fairly big operation with a long recovery compared with TURP or laser. Bleeding can be significant and a transfusion may sometimes be needed.
- The same long-term effects as TURP can occur: retrograde ejaculation, possible scarring, and rarely incontinence.
- For most large prostates the holmium laser does the same job through the urethra and is the preferred option in Dr Kooner's practice today.
- Open prostatectomy is now reserved for the small number of men in whom an endoscopic operation is not possible or another problem (a stone, a diverticulum) needs to be dealt with at the same time.
What you can do next
- Read the full detailed page with references and patient brochures.
- Short version: all the BPH surgical options.
- Short version: holmium laser - the modern keyhole alternative.
- Short version: TURP.
- Request a second opinion on a treatment plan.
- Call 02 8382 6980 to make an appointment.