Overview of Prostate Surgery

The prostate gland is a common source of medical problems for men. Surgery is one of the most common treatments for a variety of benign prostate problems. For prostate cancer the options may include surgery, radiation therapy, or active surveillance.

What Is the Prostate?

The prostate is a gland that is found only in men. It is located below the bladder and wraps around the urethra, the tube that carries urine from the bladder and out of the body.

The anatomy of the prostate gland is typically referred to as lobes or zones. Your surgeon may refer to areas of the prostate that will be removed during surgery either way or using both the words "lobes" and "zones."

Diagnosis

Most men are diagnosed with a prostate condition after they report symptoms commonly associated with prostate enlargement, such as difficulty urinating, difficulty starting urination, and an inability to completely empty the bladder.

If a prostate exam reveals an abnormal nodule or lab test (PSA) is high, a prostate biopsy is typically the next step. This biopsy will determine if the prostate condition is benign, or if prostate cancer is present. An MRI of your prostate may also be used to assist with the prostate biopsy.

Risks of Surgery

Every surgery has risks and prostate surgery is no different. In addition to the standard risks of surgery and the risks of anesthesia that are present for every surgery, there are risks specific to prostate procedures. These risks include, but are not limited to, erectile dysfunction and problems with urination.

Types of Surgery

There are multiple types of prostate surgery that are available to treat prostate conditions. The two most common conditions, benign prostatic hyperplasia (BPH) and prostate cancer, can be treated with surgical techniques. Some patients may opt for medication or non-surgical therapies, depending on how aggressively they and their doctor would like to treat the condition.

Prostate Surgeries

Prostate Surgeries for Cancer:

• Robotic assisted Radical Prostatectomy (most common surgery)
• Prostate Cryoablation
• Focal Prostate Ablation

Prostate Surgeries for Benign Conditions (BPH):

• Transurethral Resection of Prostate (TURP)
• Transurethral Incision of Prostate (TUIP)
• Prostate Urethral Lift (Urolift)
• Prostate Water Vapor Therapy (Rezum)
• Holmium Laser Enucleation (HoLEP)

Alternatives

For benign conditions your doctor may start with medications that relax or shrink the prostate or even consider starting a high quality saw palmetto extract supplement. Some of these medical therapies may even have to be continued after surgeries. What path is taken for treatment will depend on the size of the prostate, the severity of symptoms, and goals for treatment.

For patients with cancer, "active surveillance" is one approach, where the cancer is monitored but no intensive therapy is done. Other options beyond surgery may include radiation therapy, cryotherapy, or hormone therapy.

Life After

Most patients and their partners have many questions about recovering from prostate surgery and life after prostate surgery. It's important to talk to your doctor about all available options and side effects.