Prostatectomy

Question 1

What is the difference between a simple

prostatectomy and a radical prostatectomy?

Answer 1

A simple prostatectomy is performed when the benign prostatic
hypertrophy or adenoma is too big to be resected by a
transurethral approach. In this operation, the peripheral
prostate and associated structures remain. In a radical
prostatectomy, the entire prostate, pelvic nodes, ejaculatory
ducts, seminal vesicles, and a portion of the bladder neck are
removed. Radical prostatectomies are performed due to cancer
of the prostate.
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1142-
1143.

Question 2

Why can urine output not be used to assess
adequate renal perfusion during an open radical
prostatectomy?

Answer 2

Because the continuity of the urethra is disrupted during surgery
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1143.

Question 3

At what point during an open radical prostatectomy

does the most blood loss occur?

Answer 3

Most blood loss occurs during the control of the dorsal venous
complex.
Jaffe RA, Schmiesing CA, Golianu B. Anesthesiologist’s
Manual of Surgical Procedures. 5th ed. Philadelphia, PA:
Wolters Kluwer Health, 2014: 887.

Question 4

1.What is the most common complication during an
open radical prostatectomy? 2. With what approach
does it occur more often?

Answer 4

1. Hemorrhage 2. Retropubic approach
   Longnecker DE, Newman MF, Brown DL, Zapol WM.
   Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1143.

Question 5

What is the most common long-term complication of

a retropubic radical prostatectomy?

Answer 5

Sexual dysfunction
Longnecker DE, Newman MF, Brown DL, Zapol WM.
Anesthesiology. 2nd ed. New York: McGraw-Hill; 2012: 1143.