Open Prostatectomy in India

What To Expect After Open Prostatectomy?

After an open prostatectomy, you can expect the following:

• Pain and soreness in your lower abdomen. You may need to take pain medications for a few days or weeks.
• Swelling in your lower abdomen may last weeks or even months.
• Urinary incontinence (inability to control urine) for some time after surgery, but this should gradually improve over time with dedicated pelvic floor exercises such as Kegel exercises and bladder training regimens prescribed by your doctor or physical therapist.
• Erectile dysfunction (inability to have an erection) may be temporary for some patients, but possibly permanent for others depending on the extent of nerve damage during the procedure and individual patient anatomy/biology changes due to age, etc.

What Are The Benefits Of Open Prostatectomy?

The following are the benefits of open prostatectomy:-

• Preservation of nerve tissue: Open prostatectomy allows for better preservation of the nerves responsible for ejaculation, as well as those which control continence. This minimises any potential damage to the surrounding tissues and helps reduce the risk of erectile dysfunction and incontinence following surgery.
• Accuracy in assessing the cancer extent: Open prostatectomy allows for better visualisation of the area, which makes it possible for surgeons to accurately assess how far cancer has spread or if there is any evidence of spread beyond the organ.
• Lesser risk of infection and complications: The open nature of the procedure allows for fewer chances that compromising tissue cleanliness or missing any affected areas which could lead to further complications or infections post-surgery.
• Reduced risk of recurrence: With a greater ability to remove cancerous tissue, open prostatectomies result in fewer instances in which residual cells are left behind, lowering one’s risk for recurrence and metastasis downstream.

What Are The Side Effects Of Open Prostatectomy?

The side effects of open prostatectomy may include:

• Urine leakage: Open prostatectomy may result in urine leakage due to damage done to the muscles, nerves, and tissues around the bladder neck or urethra as a result of the surgery.
• Urinary urgency/frequency: Damage done to the muscles, nerves, and tissues around the bladder neck or urethra may cause an increase in urinary frequency and urgency.
• Diversion colitis: Diversion colitis is an inflammatory condition of the colon that can occur after an open prostatectomy, which may lead to diarrhoea and cramping abdominal pain.
• Erectile dysfunction: Open prostatectomy may damage blood vessels, muscles, and nerves involved in achieving and maintaining an erection, resulting in erectile dysfunction.
• Hernia formation: Surgical incisions made during an open prostatectomy may weaken abdominal wall structures leading to hernia formation at incision sites over time.

What Not To Do After Open Prostatectomy?

Things you should not do after the open prostatectomy are:

• Don’t lift heavy objects: Lifting heavy objects after an open prostatectomy can put extra strain on the surgical incision, which can lead to increased bleeding and cause infection.
• Don’t strain while urinating: Straining while urinating may put additional pressure on the bladder and cause irritation or complicated complications, such as a urinary tract infection.
• Don’t ignore pain: Pain is not normal after an open prostatectomy and should be reported to your doctor immediately in case it signals a serious complication, such as an infection or hernia.
• Don’t swim in public pools or hot tubs: Public pools and hot tubs are prime breeding grounds for bacteria that could cause an infection at the surgical incision site, so swimming should be avoided until cleared by your doctor.
• Don’t sit for too long: It is important to get up and move around regularly after an open prostatectomy to reduce the risk of blood clots forming due to prolonged immobility of your legs and feet.

What Happens If Open Prostatectomy Is Not Done On Time?

• If a patient does not undergo an open prostatectomy on time, it could result in further progression of the disease and cause more complications.
• An enlarged prostate can cause urinary retention, meaning difficulty or inability to pass urine. The longer the open prostatectomy is delayed, the longer the patient must suffer from this symptom which can be very uncomfortable and distressing.
• Delay of open prostatectomy could result in further expansion of the organ, which means more complex surgery involving more tissue removal which would ultimately reduce the quality of life and lifestyle due to the need for a long recovery period with a greater risk of infection or post-surgery complications.
• Additionally, the delay means that cancerous cells have time to spread outside the organ causing metastasis which can be difficult to control and increase mortality rates drastically.

Are There Any Alternatives For Open Prostatectomy?

Yes, there are several alternatives to open prostatectomy. Depending on the exact condition or need, different treatments may be recommended. These include:

• Transurethral resection of the prostate (TURP): A minimally invasive procedure when excess tissue is removed from the urethra to help relieve bladder obstruction caused by an enlarged prostate.
• Robotic-assisted laparoscopic prostatectomy (RALP): A newer form of surgery which is less invasive, uses tiny incisions, and is a robotic device for more precision when removing parts of the gland.
• HIFU (High-Intensity Focused Ultrasound): This non-invasive form of treatment uses ultrasound waves to destroy cancerous tissues within the prostate.
• Cryotherapy: Another non-invasive procedure which freezes and destroys cancer cells in or around the prostate using liquid nitrogen or argon gas through tiny needles inserted into the area around the organ.

Recovery After Open Prostatectomy

The recovery time from open prostatectomy surgery typically takes around 4 to 6 weeks.

Patients need to follow their surgeon’s post-operative instructions and attend regular follow-up appointments to ensure a smooth recovery.

During this period, a patient should expect some pain and swelling, along with activity restrictions advised by their doctor.

Post-treatment guidelines for Open prostatectomy:

• Follow the wound care instructions provided by your healthcare provider: This includes cleaning the wound, changing dressings and keeping the area dry.
• Monitor for any signs of infection: Signs of infection can include increased pain, redness, discharge from the incision site or fever.
• Avoid strenuous activities or lifting heavy objects for 6-8 weeks after surgery: This will help prevent stressing and tearing open the incision site, which could cause infection and damage to surrounding tissue.
• Maintain healthy eating habits: Eat a balanced diet with plenty of fruits, vegetables and proteins to help with post-operative healing.
• Follow up regularly with your physician: Keep up with scheduled appointments to monitor your recovery and review further treatment options as needed.
• Get plenty of rest throughout recovery: Allow your body to rebuild itself after surgery by getting adequate rest in order to facilitate healing processes like tissue regeneration and cell repair.