In some circumstances where a man’s prostate is very large and there is a need to undertake surgery, although it is not appropriate for a TURP to be performed, an open or laparoscopic (keyhole) prostatectomy may be carried out. This involves either the open procedure surgery through incisions in the abdomen or, in the case of laparoscopic surgery, the introduction of the surgical instruments through small incisions to the side of the abdomen.
The procedure then involves the surgical removal of the blockage/part of the prostate. You are likely to be in hospital for about a week under the open surgery process and 4 days under the laparoscopic method. Similar to a TURP, a catheter will be inserted to drain the urine.
Side effects are similar to a TURP in that retrograde ejaculation is likely in many men and, in a minority of men, there are risks of incontinence as well as impotency. In addition, there can be a risk of blood loss, although this is less with laparoscopic procedure, which also enables a more nerve sparing approach and reducing the risk of impotence in some men. The procedures are described in greater detail in the following sections, although please note that the procedures described below involve the complete removal of the prostate (radical) as distinct from the removal of only part of the prostate (in the case of BPH).
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