View source for Prostatectomy

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==Overview==

A '''prostatectomy''' is the [[surgical]] removal of all or part of the [[prostate gland]]. Abnormalities of the prostate, such as a [[tumour]], or if the gland itself becomes enlarged for any reason, can restrict the normal flow of [[urine]] along the [[urethra]].  

There are several forms of the operation:

* '''[[Transurethral resection of the prostate]]''' (TURP): a [[cystoscope]] is passed up the urethra to the prostate, where the surrounding prostate tissue is excised. This is a common operation for [[benign prostatic hyperplasia]] (BPH) and outcomes are excellent for a high percentage of  these patients (80-90%). A more refined and safer operation is by means of a holmium high powered "red" laser. This technique has been well documented as being the only laser operation that is of higher standard than the "old" TURP operation.
* '''open prostatectomy''': A surgical procedure involving a skin incision and enucleation of the prostatic adenoma, through the prostatic capsule (RPP-retropubic prostatectomy) or through the bladder (SPP-suprapubic prostatectomy). Reserved for extremely large prostates.
* '''[[Laparoscopic]]''':  a laparoscopic or four small incisions are made in the abdomen, and the entire prostate is removed sparing nerves more easily damaged by a retropubic or suprapubic approach.  Laparoscopic prostatectomy has more advantages than the radical perineal or retropubic operation and is more economical than the robot assisted technique.   
* '''Robotic-assisted prostatectomy''':  Laparoscopic robotic arms are controlled by a surgeon.  The robot gives the surgeon much more dexterity than conventional laparoscopy while offering the same advantages over open prostatectomy: much smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.<ref name="sciencedaily"> Center for the Advancement of Health; August 29, 2005; Robot-assisted Prostate Surgery Has Possible Benefits, High Cost 
[http://www.sciencedaily.com/releases/2005/08/050829073446.htm]</ref>.  While the cost of such procedures is high, costs are declining rapidly <ref name="liebertonline"> Cost Analysis of Radical Retropubic, Perineal, and Robotic Prostatectomy; Scott V. Burgess, Fatih Atug, Erik P. Castle, Rodney Davis, Raju Thomas; Journal of Endourology 2006 20:10, 827-830 [http://www.liebertonline.com/doi/abs/10.1089/end.2006.20.827?cookieSet=1&journalCode=end]</ref>.
* '''[[Radical perineal prostatectomy]]''': an [[incision]] is made in the [[perineum]], midway between [[rectum]] and [[scrotum]], and the prostate is removed. Radical prostatectomy is one of the key treatments for [[prostate cancer]]. 
* '''[[Radical retropubic prostatectomy]]''': an incision is made in the lower [[abdomen]], and the prostate removed, by going behind the [[pubic bone]] (retropubic).  Radical prostatectomy is one of the key treatments for [[prostate cancer]]. 

* ''' Transurethral plasmakinetic vaporization prostatectomy (TUPVP).

==External links==
 
* [http://www.prostate-answers.com/surgery-prostate.html Prostate Cancer Treatment Guide]


[[Category:Urology]]
[[Category:Oncology]]
[[Category:Surgical procedures]]
[[Category:Surgery]]

==References==
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{{Urogenital surgical procedures}}
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