Open Prostatectomy. An information guide

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1 TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Open Prostatectomy An information guide

2 en Prostatectomy Open Prostatectomy pen prostatectomy is the surgical removal of a large nonrous prostate through an incision, generally in the lower men. An The open operation prostatectomy can also is be the carried surgical out removal through of an a large on between noncancerous the base prostate of the through penis an and incision, the rectum. generally in the lower heter abdomen. would be The placed operation into the can bladder also be through carried out the through penis an incision between the base of the penis and the rectum. an additional catheter or drain may be placed into the er through A catheter the would abdominal be placed skin. into These the bladder catheters through are there penis and low an the additional bladder to catheter be irrigated or drain / flushed may be to placed ensure into the the bladder er drains through whilst the abdominal healing occurs. skin. These catheters are there to allow the bladder to be irrigated / flushed to ensure the bladder drains whilst healing occurs. t is the prostate gland? rostate What gland is the is prostate made up gland? of three lobes of tissue, which a ring The around prostate the gland top is made part of up the of three urethra lobes (water of tissue, pipe) which at form a ladder ring outlet. around the The top prostate part of makes the urethra the milky (water fluid, pipe) at which the bladder s the outlet. sperm. The When prostate the makes prostate the milky becomes fluid, enlarged which carries it can the sperm. several When difficulties. the prostate Most becomes significantly enlarged an enlarged it can cause prostate several nterfere difficulties. with the Most flow significantly of urine and enlarged can lead prostate to retention will interfere of with the flow of urine and can lead to retention of urine.. 2 2

3 What are the alternatives? If you feel that your urinary stream does not trouble you and you are only getting up once or twice at night, you may feel that you would want to wait before opting for surgery. However if you are upset by the symptoms and have tried other forms of treatment, surgery would be sensible. Open prostatectomy is used for men who have very enlarged nonmalignant prostate. These large prostates cannot be removed through the standard way (passing instruments through the penis and coring out the prostate) as it would take too long, and would increase anaesthetic and bleeding risks. The other indications for your surgeon choosing this method would be if you have a bladder stone or diverticulas. Why do I need an operation? This operation offers the highest chance of relief of your urinary symptoms. What are the risks? This operation can be carried out under a general anaesthetic or a spinal anaesthetic. General anaesthetic has a very small risk of complications to your heart and lungs. Further risks include the risks of bleeding, for which you may need a transfusion and a risk of infection. However before the operation you will attend the preoperative assessment clinic where tests will be carried out. The results of these will ensure that the operation is carried out in the safest way possible for you. Having an open prostatectomy may also put you at a small risk of urinary incontinence, stricture and impotence. Should these occur, there are possible corrective treatments that could be used once you have made full recovery from the initial surgery. 3

4 Before your operation you will be asked to attend a pre-operative clinic if you are taking anti-coagulants (Warfarin, Aspirin or Sinthrome) please inform the pre-op assessment staff you will be advised when to stop eating and drinking before your operation but it is usually about 6 hours before for food and 3 hours for drinking you may be asked to sign your consent form after being fully informed about the procedure. What happens on your admission day? you will be asked relevant information by the nurse and a doctor you may be seen by an anaesthetist your operation will be explained to you and you will be asked to sign a consent form, if you have not already done this in clinic. What happens after your operation? you may require oxygen following your operation you may have an intravenous line (drip) that will remain in place until you are eating and drinking normally you may require a blood transfusion you may experience some pain and discomfort after surgery. We advise that you keep a supply of painkillers at home you will have a catheter in your bladder on return from theatre. The tube lies inside your bladder and drains your urine into a bag you may have a second catheter/drain through your abdomen to drain any excess blood from your operation 4

5 bladder irrigation may be in progress on your return from theatre. Irrigation involves fluid which will wash out your bladder to prevent clot formation as some bleeding can be expected after the procedure the catheters may remain in your bladder for about 3 10 days. When are you ready to go home? open prostatectomy requires several days stay in hospital. You may go home with a urinary catheter in place your doctor and the nurse will discuss with you when they are happy for you to go home you may have been asked to stop taking some medication prior to your operation. If so, please ask your hospital doctor about restarting these when you return home you may pass some blood or small clots for days after the operation. This is not unusual, increasing your fluid intake will help wash away the blood if the catheter fails to drain into the collection bag and you feel uncomfortable with a strong need to pass water, you should attend accident and emergency or contact your GP at first discomfort in the wound area will prevent you from harming yourself. You should avoid vigorous activity, which may put strain on the surgical wound site. However you should be able to return to light work after four to eight weeks sexual activity can recommence when it feels comfortable to do so if you require a fit note to cover your hospital stay, please ask the nurses on the ward. Any further fit notes can be obtained from your GP 5

6 you may be given antibiotics but you must ensure you complete the course. If you are worried or have problems after your discharge, contact your GP or telephone the ward for advice. In an emergency, go to the nearest Accident & Emergency department. 6

7 7

8 If English is not your frst language and you need help, please contact the Ethnic Health Team on Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu For general enquiries please contact the Patient Advice and Liaison Service (PALS) on For enquiries regarding clinic appointments, clinical care and treatment please contact and the Switchboard Operator will put you through to the correct department / service Date of publication: November 2006 Date of review: March 2014 Date of next review: March 2017 Ref: PI_SU_285 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests

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