Surgery for Prostatitis
Types of Surgery for Prostatitis
Surgery for prostatitis may be something to consider if you have not had success with any other conventional, natural, and alternative treatments. Surgery is usually a last resort for either chronic bacterial or chronic nonbacterial prostatitis and, it is typically done only after all other treatments have failed.
If you have chronic bacterial prostatitis that has not responded to long-term antibiotic treatment and that causes you to get repeated urinary tract infections, you may need surgery to remove part of the prostate. If infected prostate stones, also called prostatic calculi, are present you may consider surgery to remove the stones. One procedure for these conditions is called a transurethral resection of the prostate (TURP). The other surgical procedure that is sometimes used for nonbacterial cases of chronic prostatitis is a minimally invasive laparoscopic prostatectomy, which is the removal of the prostate.
What Is Involved in the Procedures?
When performing TURP, the doctor will remove part of the prostate gland through the urethra using a cystoscope, which is a long, thin tube. This is performed under general or regional anesthesia and should take less than 90 minutes. After surgery you will have a catheter inserted through the penis into the bladder, and that will remain in place for about one day. You can probably leave the hospital after one to two days. Read more about the TURP procedure here
The other procedure, the minimally invasive laparoscopic surgery, involves tiny incisions, less pain, lower risk of infection, and faster recovery than traditional radical prostatectomy, which involves a larger incision and can have a long recovery period. A laparoscopic prostatectomy is usually performed under general anesthesia. About half of the men are able to regain their ability to have erections, but it may take three months to a year for this to happen. The younger you are, the more likely you are regain erectile function. Half of the men develop urinary incontinence, and older men may be more likely to be affected than younger men. More serous risks include blood clots, heart attack, stroke, and infection.
A study published in 2011 examined the effectiveness of laparoscopic prostatectomy in men with treatment-resistant CP/CPPS. The study involved six men with severe CP/CPPS. Before surgery, the median Chronic Prostatitis Symptom Index (CPSI) score was 35. Six months after having surgery, the score was 10, and 12 months after surgery the score was 7.5. The authors of the study noted that these results are preliminary and that laparoscopic radical prostatectomy is “potentially appropriate as a treatment of last resort for those patients who have failed many other options.”
What Are the Side Effects?
Prostate surgery does not always cure a bacterial infection or a case of chronic prostatitis. The procedure can even make your symptoms worse. It is possible that your surgeon may not remove the part of the prostate that is causing your symptoms. To remove all of the prostate can leave you with urinary incontinence and/or erectile dysfunction, which can greatly affect your quality of life. Surgery can also put you at risk of infection or other complications such as ejaculatory dysfunction and blood in the urine. Recovery can take several months.
Surgery is not always the best solution. Many times prostatitis stems from problems that occur elsewhere in the body and not in the prostate itself. That is why whole-body approaches that employ many different types of treatments are usually the most successful at curing prostatitis. If you are considering surgery for prostatitis, only do so once you have explored all treatment options for causes ranging from diet to psychological health to pelvic floor muscle dysfunction to allergies to stress. Also, if you have been taking antibiotics, you should look into a good daily probiotic to restore your gut health.
There are some other less invasive procedures that are not technically considered surgery including the following:
These are procedures used on men who have urinary symptoms of CP/CPPS that have not responded to other forms of treatment.
Reference for Surgery for Prostatitis:
Krongrad A, Lai S. Laparoscopic prostatectomy for severely symptomatic, treatment-refractory chronic prostatitis: preliminary observations from an ongoing Phase II clinical trial. UroToday Intl J 2011 Apr; 4(2): art 30. doi:10.3834/uij.1944-5784.2011.04.12