Operative note 40 Advanced ADVANCED (rare, examinable)
Open simple prostatectomy
What it does: shell the adenoma out, big prostate.
Freyer, through the bladder
- Open the bladder.
- Cut round the adenoma base. Spare the orifices.
- Plane at 6 o'clock. Finger sweeps round.
- Scissors at the apex, close to the adenoma. The sphincter is mm away.
Millin, behind the pubis
- Dorsal vein stitched first.
- Capsule cut below the bladder neck.
- Enucleate from behind.
- 2026 update: Rare now. HoLEP or robotic does this.
- 2026 update: The finger plane IS the HoLEP plane. One concept.
From the UroRef Operative Quick Guide.