Counselling men undergoing prostatectomy

Counselling men undergoing prostatectomy

Men undergoing prostatectomy need to be advised about the following: /uni25CF Retrograde ejaculation or anejaculation . This occurs in about 65–85% of men after prostatectomy . /uni25CF Erectile dysfunction . This occurs in about 5–10% of men, usually in those whose potency is waning. /uni25CF Success rate . On the whole, men with acute and chron - ic retention do well from the symptomatic point of view . Ninety per cent of men undergoing elective operation for severe symptoms and urodynamically proven BOO do well in terms of symptoms and flow ra tes. Only about 65% of those with mild symptoms or those with weak bladder con - traction as the cause of their symptoms do well. Men who are unobstructed and have detrusor instability do not re - spond well to TURP; in fact, their storage symptoms could accentuate postoperatively . Patients who have concomitant BOO and secondary detrusor ov eractivity may need an anticholinergic drug for a few months if the y have per - sistent irritative symptoms. /uni25CF Risk of reoperation . After TURP , this is about 15% - after 8–10 years. /uni25CF Morbidity rate . Death after TURP is infrequent w (<0.5%); severe sepsis is found in about 6%; and severe haematuria requiring transfusion of more than 2 units of blood occurs in about 3%. After discharge, about 15–20% of men subsequently require antibiotic treatment for symptoms of urinary infection. /uni25CF Incontinence . Although the risk is rare and is about 1%, the risk is higher in older patients and those with a very large prostate.

1 4 Figure 84.11 The surgical approaches to the prostate. (For key see text.)