Open Prostatectomy

Prostatectomy includes a number of surgical procedures to remove part or all of the prostate gland. The prostate gland is situated in the male pelvis, below the urinary bladder. It surrounds the urethra, which carries urine from the bladder to the penis.

Prostatectomy can be performed in several ways, depending on the condition involved and recommended treatment approach:

Prostate cancer

Radical prostatectomy is surgery to remove the entire prostate gland and surrounding lymph nodes as treatment for men with localized prostate cancer. A surgeon can perform a radical prostatectomy using different techniques, including:

• Robot-assisted radical prostatectomy. The surgeon makes several small incisions in your lower abdomen to remove the prostate. He or she sits at a console, using instruments attached to a computer-assisted mechanical device (robot). The robotic device allows a more precise response to movement of the surgeon's hands.
• Open radical prostatectomy. The surgeon typically makes an incision in your lower abdomen to remove the prostate (retropubic surgery).
• Laparoscopic radical prostatectomy. The surgeon makes several small incisions in your lower abdomen and inserts special tools to remove the prostate.

Enlarged prostate

Simple prostatectomy, on the other hand, is generally recommended for men with severe urinary symptoms and very enlarged prostate glands (rather than prostate cancer), and can be performed open or robotically. This enlargement of the prostate is called benign prostatic hyperplasia, or BPH. Simple prostatectomy doesn't remove the entire prostate, as in a radical prostatectomy, but instead removes just the obstructive part of the prostate that's blocking the flow of urine.

Mayo Clinic urologists use advanced endoscopic techniques to address enlarged prostate symptoms without the need for open, laparoscopic, or robotic surgery in most cases.

Why it's done

Most often, prostatectomy is done to treat localized prostate cancer. It may be used alone, or in conjunction with radiation, chemotherapy and hormone therapy. Prostatectomy to treat prostate cancer involves removing the entire prostate, seminal vesicles and some surrounding tissue, including lymph nodes.

Prostatectomy options to treat prostate cancer include open radical prostatectomy, laparoscopic radical prostatectomy and robot-assisted radical prostatectomy.

Less often, simple prostatectomy may also be used to treat a blocked urethra caused by BPH. Simple prostatectomy to treat BPH doesn't always involve removing the entire prostate. The surgery eases urinary symptoms and complications resulting from blocked urine flow, including:

• A frequent, urgent need to urinate
• Difficulty starting urination
• Slow (prolonged) urination
• Increased urination frequency at night (nocturia)
• Stopping and starting again while urinating
• The feeling you can't completely empty your bladder
• Urinary tract infections
• Inability to urinate