prostatektomii

Prostatektomi, or prostatectomy, is a surgical procedure to remove all or part of the prostate gland. It is most commonly performed to treat localized prostate cancer, and can also be used for benign prostatic hyperplasia (BPH) in select cases to relieve urinary obstruction. The procedure exists in several forms, including radical prostatectomy, which removes the entire prostate and seminal vesicles for cancer, and simple or subtotal prostatectomy, which removes part of the prostate to treat BPH while preserving surrounding tissue.

Approaches to prostatectomy vary. Open techniques include retropubic and perineal approaches, while minimally invasive methods include laparoscopic and robotic-assisted prostatectomy. Robotic-assisted radical prostatectomy has become widely used in many centers, offering potentially shorter recovery and enhanced precision. In cancer cases, lymph node dissection may be performed for staging. Nerve-sparing techniques aim to preserve erectile function when oncologically appropriate.

Postoperative care typically involves a catheter for about 1 to 2 weeks to allow the urinary tract to heal. Recovery of urinary continence progresses over weeks to months and is a major consideration after radical procedures. Erectile function depends on age, preoperative function, and whether nerve-sparing was possible. Complications can include urinary incontinence, erectile dysfunction, infection, bleeding, anastomotic leakage, and rare lymphocele or stricture formation.

Outcomes vary by indication and stage. For localized prostate cancer, prostatectomy can provide substantial cancer control and potential cure when margins are clear and disease is confined to the gland. For BPH, prosthetic relief of obstruction improves urinary flow and symptoms. Overall, the choice of technique depends on patient factors, tumor characteristics, and surgeon experience.