परिभाषा

A prostatectomy is a surgery to remove the prostate gland. The prostate gland is part of the male reproductive system. It makes and stores the milky fluid that forms part of semen. The gland sits below the bladder and in front of the rectum. The tube that urine flows out through also runs through the prostate.

The procedure may be:

  • Simple prostatectomy—removal of part of prostate
  • Radical prostatectomy—removal of entire prostate and some surrounding tissue

Prostatectomy 1

प्रक्रिया के कारण

A simple prostatectomy may be done to remove an enlarged prostate that is non-cancerous. A common cause of this type of growth is called benign prostatic hyperplasia (BPH). It can interfere with the flow of urine out of the body. The surgery is done to allow urine to flow through again.

A radical prostatectomy may be done to remove a prostate gland containing cancer.

संभावित जटिलताएँ

If you are planning to have a prostatectomy, your डॉक्टर एक सूची की समीक्षा करेंगे संभावित जटिलताओं में शामिल हो सकते हैं:

  • खून बह रहा है
  • संक्रमण
  • Inability to control urinary stream (incontinence)
  • Inability to get an erection (impotence) and other sexual difficulties
  • Blood clots in the legs or lungs
  • Sterility
  • Injury to the rectum or other nearby structures

जटिलताओं के जोखिम को बढ़ाने वाले कारकों में शामिल हैं:

  • मोटापा
  • पुरानी या हाल की बीमारी
  • Lung, kidney, liver, or heart disease
  • धूम्रपान
  • Alcohol abuse or drug use
  • कुछ नुस्खे वाली दवाओं का उपयोग
  • मधुमेह

क्या उम्मीद करें

प्रक्रिया से पहले

Before surgery your doctor may do the following:

  • शारीरिक परीक्षा
  • रक्त और मूत्र परीक्षण
  • Chest x-ray
  • Electrocardiogram (ECG, EKG)—a test that records the heart’s activity by measuring electrical currents through the heart muscle
  • अल्ट्रासाउंड-एक परीक्षण जो शरीर के अंदर की कल्पना करने के लिए ध्वनि तरंगों का उपयोग करता है
  • Bone scan or CT scan, if your doctor is concerned about a spreading cancer

प्रक्रिया से पहले:

  • अपनी दवाओं के बारे में अपने डॉक्टर से बात करें। आपको प्रक्रिया से एक सप्ताह पहले तक कुछ दवाएं लेने से रोकने के लिए कहा जा सकता है, जैसे:
    • एस्पिरिन या अन्य सूजनरोधी दवाएं
    • क्लोपिडोग्रेल (प्लाविक्स) या वारफेरिन (कौमडिन) जैसे रक्त पतले
  • The night before, have a light meal. Do not eat or drink anything after midnight.

बेहोशी

General or spinal anesthesia will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a section of your body numb.

प्रक्रिया का विवरण

The procedure can be done as:

  • Open surgery—incision is made in the skin to allow the doctor to see the prostate
  • Laparoscopic surgery—only very small incisions are needed; the surgery is done with specialized tools and a tiny camera that is passed through the incisions
  • Robot-assisted surgery—similar to laparoscopic with use of small incisions but the surgery is done with robotic tools that the surgeon controls

Simple Prostatectomy

An incision is made in the lower abdomen. The doctor will be able to see the prostate through this incision. The inner part of your prostate gland will then be removed. This procedure is not as common in the United States. It is considered when you have a non-cancerous enlargement of the prostate.

Radical Retropubic Prostatectomy

An incision will be made in the lower abdomen between the belly button and pubic bone. The prostate gland and pelvic lymph nodes will be visible through this incision. The prostate will be detached from the bladder and urethra. The urethra is then re-attached to the bladder. A main goal of treatment is to try to preserve nerve function related to bladder function and erections. Lymph node tissue may also be removed for testing. Your doctor may use these test results to decide whether or not to remove more tissue.

Perineal Radical Prostatectomy

An incision is made in the skin between your anus and your scrotum. The prostate can be detached and removed through this incision. This is a less common surgical option because of some limits such as:

  • Lack of access to the lymph nodes
  • Higher risk of nerve damage

Robot-assisted Laparoscopic Radical Prostatectomy (RALRP)

Five small, keyhole incisions are made in the abdomen. Robotic arms and a small camera will be passed through these incisions. The robotic tools allow wider and more flexible range of motion. The robotic arms will be controlled by a doctor at a console. The prostate and other tissue will be cut out with these robotic arms. This type of procedure may cause less scarring than other methods.

प्रक्रिया के बाद

A catheter tube will be inserted to drain your bladder. Water may be flushed through the catheter to reduce blood in the urine.

The catheter may be left in place for up to 3 weeks. This will let you urinate more easily during the healing period. After a radical prostatectomy, a drain may also be placed to help fluid drain from the surgery site.

इसमें कितना समय लगेगा?

  • Simple prostatectomy—2-4 hours
  • Radical prostatectomy—2-4 hours

क्या यह चोट पहुंचाएग?

Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for:

औसत अस्पताल में रहना

The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.

प्रक्रिया के बाद की देखभाल

जब आप घर लौटनासुचारू रिकवरी सुनिश्चित करने के लिए निम्नलिखित कार्य करें:

  • निर्देशानुसार दवाएं लें।
    • Your doctor may give you antibiotics to prevent infection. Stool softeners may also be given to prevent constipation.
    • You may need to take a medicine for several weeks to normalize your bladder function.
    • For a while, you may need prescription pain medicines. You will then be switched to non-prescription pain relievers (such as acetaminophen) as needed. Avoid taking aspirin or aspirin-containing products.
  • When resting in bed, keep legs elevated and moving. This will help to preventblood clots from forming in your legs.
  • उपचार को बढ़ावा देने के लिए, जितनी जल्दी हो सके सामान्य गतिविधियों को फिर से शुरू करें।
  • Drink plenty of liquids. Doing so will help to clear your bladder of urine and blood.
  • अपने डॉक्टर से पूछें कि कब नहाना, स्नान करना या पानी में भिगोना सुरक्षित है।
  • Wash the incision gently with mild soap and water.
  • Do not drive unless your doctor has given you permission to do so. You may need to wait up to one month.
  • सर्जरी के छह सप्ताह बाद जोरदार व्यायाम से बचें।
  • Resume यौन गतिविधि when able.
  • Avoid caffeine, alcohol, spicy foods, or any other food or drink that might aggravate your stomach, intestines, bladder, or urinary tract.
  • अपने डॉक्टर के निर्देशों का पालन अवश्य करें।

Complete healing from surgery usually occurs within six weeks.

अपने डॉक्टर को बुलाओ

अस्पताल छोड़ने के बाद, निम्न में से कोई भी होने पर अपने डॉक्टर को फोन करें:

  • बुखार और ठंड लगने सहित संक्रमण के लक्षण
  • लालिमा, सूजन, दर्द बढ़ना, अत्यधिक रक्तस्राव, या चीरा स्थल से कोई स्राव
  • मतली और / या उल्टी जिसे आप सर्जरी के बाद दी गई दवाओं से नियंत्रित नहीं कर सकते हैं, या जो अस्पताल से छुट्टी के बाद दो दिनों से अधिक समय तक बनी रहती है
  • दर्द जिसे आप दी गई दवाइयों से नियंत्रित नहीं कर सकते
  • दर्द, जलन, अत्यावश्यकता या बार-बार पेशाब आना, या पेशाब में लगातार खून आना
  • Poor drainage from Foley catheter
  • पेट में सूजन या दर्द
  • Cough, shortness of breath, or chest pain,
  • सिरदर्द, मांसपेशियों में दर्द, चक्कर आना, या सामान्य बीमार महसूस करना
  • कब्ज़
  • नए, अस्पष्टीकृत लक्षण
  • Drainage from your incision

आपातकालीन स्थिति में तुरंत चिकित्सा सहायता के लिए कॉल करें।

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