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Prostate: your prostate operation  

Why is the operation needed?

You have developed enlargement of your prostate, which cannot shrink by itself or with drugs. This enlarged tissue needs to be removed to allow your urine to flow normally from your bladder to your penis. If the obstruction continues, it can damage your bladder and possibly your kidneys. It may block off the urine completely and cause considerable pain. This emergency situation is called acute retention.

What will the operation do to your stream?

It will give you a good stream with full control, which you probably have not had for years. You will soon be able to pass urine normally without dribbling and will not have to get up more than once to urinate during the night.

How is the operation performed?

This is usually done through the penis. The urologist passes an instrument about as wide as a pencil through the urethra to cut away the enlarged prostate. This instrument (a resectoscope) has a loop of wire at its tip, which can cut tissue. It has a miniature telescope or camera and light to allow the surgeon to see clearly to slice and 'nibble' away pieces of the prostate from inside the urethra, thus making it nice and wide.

What anaesthetic will I have?

Usually a local anaesthetic is used-you will be made numb from the waist down for about 4 hours. This is done by giving a spinal injection. Sometimes a general anaesthetic may be necessary.

What happens after the operation?

A catheter is left in the urethra to drain the bladder for about 1 day. There is usually some blood loss for a few days. Taking the catheter out is simple and painless. You are in hospital for about 4 days. Although it tends to burn and be erratic at first, your urine stream will soon become strong and controlled.

What are the chances of becoming incontinent?

This is rare. Usually after 2 days of incontinence you begin to return to normal.

What about my sex life?

In most people the sexual desire and ability remains. Getting an erection soon returns and satisfactory intercourse is possible about 2 months later. You will have an orgasm, but you do not ejaculate fluid (semen) outwards. It goes back up into the bladder. This is quite harmless, and the fluid passes out later in the urine.

Can I become impotent?

This is most unusual-less than 1 in 10 men have a problem. If you have had a problem before the operation, it is unlikely to improve it.

What happens after I leave hospital?

Like after any operation, you make steady and good progress, with gradual improvement of your urination. Sometimes infection and bleeding can cause minor setbacks. You should take it very easy for 2 weeks, but should be well enough to return to work in about 4 weeks.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia