Prostatectomy

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. .  While the cost of such procedures is high, costs are declining rapidly.
 * 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).