Prostatectomy

Last revised by Dr Daniel J Bell on 19 Jun 2020

Prostatectomy is a common procedure to remove the prostate gland, most often for prostate adenocarcinoma, although occasionally performed for benign prostatic hyperplasia. When performed for tumor, it is only indicated for tumors that are confined to the prostate.

There are two main types of prostatectomy, radical removes the entire prostate, whilst simple just removes the obstructing component, i.e. the benign prostatic hyperplasia within the transition zone:

  • radical prostatectomy (cancer surgery)
    • open radical retropubic prostatectomy (RRP)
    • laparoscopic radical prostatectomy (LRP)
      • robot-assisted laparoscopic prostatectomy (RALP)
    • radical perineal prostatectomy (RPP)
  • simple prostatectomy (for benign prostatic hyperplasia)
    • open retropubic
    • open suprapubic
    • robot-assisted laparoscopic

Complications

  • early
    • pelvic hematoma
    • anastomotic leak
      • not with simple prostatectomy, which does not have a vesicourethral anastomosis
    • nerve injury
    • rectal injury (rare)
    • ureteral injury (rare)
  • remote
    • bladder neck stricture
    • incontinence
    • impotence (less common with modern nerve-sparing technique)

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Cases and figures

  • Case 1: urinoma postprostatectomy
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  • Case 2: lymphocele postprostatectomy
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