The prostate is a walnut-sized gland aloof below the bladder. It wraps about the urethra, the tube which takes urine from the bladder. The job of the prostate is to add aqueous and nutrients to the semen.
The best accepted operation for abatement of the prostate is abolitionist retropubic prostatectomy. Patients abhorrence actuality larboard amoral and impotent, but with what’s alleged nerve-sparing surgery, best adolescent men with aboriginal cancers won’t be affected.
The aboriginal footfall already the accommodating is on the operating table is to abandoned the bladder, and the catheter we use to backpack out this assignment stays in abode for best of the operation.
The aboriginal cavity is fabricated through the bark and fat layers from aloof below the axis to the pubic bone. We again cut accessible the coarse sheath below to acquisition the continued ‘six-pack’ anatomy which run forth the advanced of the abdomen.
These are pulled afar with retractors and now we acquisition the float and, squashed beneath, the prostate. Our assignment is to abstract the prostate from the surrounding structures – the rectum, bladder, nerves, veins and urethra.
The aboriginal accommodation is whether to abolish the bounded lymph glands. For low to mid-grade cancers with a low PSA level, these are larboard complete because the adventitious of blight actuality is beneath than 1 per cent.
If we were to acquisition annihilative nodes in patients with college brand blight in theatre, we don’t advance with surgery. The accommodating is bigger advised with hormone analysis to abolish the blight both in and alfresco the prostate.
WE NEXT abstract the prostate from the ligaments that attach it to the pelvic attic muscles, again stitch over (to anticipate claret loss) afore acid the agglomeration of veins alleged the after attitude complex, which runs forth the urethra and over the prostate.
Once we’ve broken the prostate from the rectum we can acclaim ambit abreast the neurovascular bundles – the fretfulness amenable for giving a man an erection, which we will appetite to preserve.
We now bisect the urethra at the point it joins the prostate. Afar from its accompany to the bladder, the prostate is now chargeless from all surrounding organs.
The close of the float merges with the prostate, and afore activity added we accept to abstract the catheter bag we anesthetized into the agency at the outset. With that done, we cut about the close of the float with scissors to abstract the prostate.
At this stage, we’ll charge to do a vasectomy to abbreviate the spermcarrying bond that runs through the prostate, and to carapace out the seminal vesicles which abundance some of the seminal aqueous and are absorbed to the prostate
Once the prostate is absolutely alone it is beatific for testing, and we again adjustment the aperture in the float to accommodate a sound, leakfree accompany to the urine tube.
Providing there are no leaks, a new catheter is fitted, and a arising tube is additionally larboard in abode – an aperture for any exceptionable fluids that ability accrue in the operation site. Again the beef layers are stitched and the bark is bankrupt with clips. Within a ages of surgery, the PSA should go bottomward to zero.
Radical prostatectomy costs the NHS £5,500. Privately, including a four-night hospital stay, it will amount about £8,000.
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