Plastic Surgery Circulatory Surgery Digestive Surgery Muscular Surgery Reproductive Surgery |
Description - Video - After Surgery Radical retropubic prostatectomy can be performed in several different ways with several possible associated procedures. The most common approach is to make an incision in the skin between the umbilicus and the top of the pubic bone. The pelvis is then explored and the important structures such as the urinary bladder, prostate, urethra, blood vessels, and nerves are identified. The prostate is removed from the urethra below and the bladder above, and the bladder and urethra are reconnected. The blood vessels leading to and from the prostate are then divided and tied off. Recovery typically is rapid; individuals are usually able to walk and eat within 24 hours after surgery. A catheter through the penis into the bladder is typically required for at least a week after surgery. A surgical drain is often left in the pelvis for several days to allow drainage of blood and other fluid. The most common serious complications of radical retropubic prostatectomy are loss of urinary control and impotence. As many as forty percent of men undergoing prostatectomy may be left with some degree of urinary incontinence, usually in the form of leakage with sneezing, etc. (stress incontinence) but this is highly surgeon-dependent. Impotence is most common when nerve-sparing techniques are not used. Although erection and ejaculation are affected, penile sensation and the ability to achieve orgasm remain intact. Therefore, use of medications such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) may restore some degree of potency. Continence and potency may improve depending on the amount of trauma and the patient's age at the time of the procedure, but progress is frequently slow. Potency is greatly affected by the psychological attitude of the patient. The sensation of orgasm may be altered and no semen is produced, but there may be a few drops of fluid from the bulbourethral glands. Marital counseling focusing on the changes may be effective in restoring potency or maintaining a satisfactory spousal relationship if impotence continues. |
