Open Prostatectomy for Benign Prostatic Enlargement


Email Raji.Kooner@svha.org.au or call 02 8382 6980 for a confidential appointment.

So, they’re really the major treatments for BPH.

The other treatment is open prostatectomy, as opposed to an open radical prostatectomy for prostate cancer, it’s an open prostatectomy.

This is sometimes used if patients have a very large prostate, or they have other pathology in the bladder such as a diverticula, an outpocketing, or a big bladder stone.

It’s a fairly big operation with a long recovery time1, and often you can get a lot of blood loss with this with an incision in the lower abdomen.

I’ve not had to do this for approximately ten years because the holmium laser allows us to do very large prostates in a similar fashion.

So basically, an open prostatectomy enucleates the adenoma, the abnormal part of the prostate which has grown, and we find the plane between this and the capsule, and shell out the prostate2.

The holmium laser does the same thing, but endoscopically, through the eye of the penis, it shells that area out.

So, this is a treatment now that can be used for larger patients, for larger prostates, and for patients who previously had to have open prostatectomy, they can now have an endoscopic treatment.

References

1. Surgery for Prostate Cancer - American Cancer Society - https://www.cancer.org/cancer/types/prostate-cancer/treating/surgery.html
2. Mohit Khera, Brian J Miles, Bradley Fields Schwartz, et al - Simple Prostatectomy: Overview, Preparation, Technique - https://emedicine.medscape.com/article/445996-overview