In patients who have enlarged prostate gland or benign prostatic hyperplasia, open prostatectomy, which is a traditional open surgery is performed to remove the prostate gland. The prostate gland is made from muscle cells along with dense fibrous capsules in the surrounding. The prostate gland, a vital organ in men reproductive system, produces a fluid that will become mixed with the sperm to make the semen.

As the men grow old, the size of the prostate changes, from a pea size at birth to walnut size when men reach puberty, and it will remain the same till mid-forties. During this time, the number of cells in men gets increased, and that causes the prostate to become enlarged; a condition which is called hyperplasia.  While the men’s cells in the prostate become proliferated, especially in older men, several symptoms may appear which include the followings: 

• Straining in the urination.
• Patients may get hesitant to urinate.
• Urinary leakage or dripping after urination.
• Weak urinary flow.

The leading cause of developing (BPH) is still not fully understood, but the research suggests that a change of hormone can be a significant contributor.

If patients are exhibiting mild to severe symptoms, like recurrent urinary tract infections, bladder stones, blood in the urine, or kidney problems due to an enlarged prostate, surgery is mostly recommended. Moreover, 2–3% of patients who have been diagnosed with (BPH), the best choice of treatment would be open prostatectomy. Generally, the doctor advises open prostatectomy only when the prostate is too large, about 80- 100 (g), and when he or she cannot perform a transurethral resection of the prostate (another surgical procedure to remove small prostate). Below, some of the reasons for performing open prostatectomy will be indicated:

• Urinary tract infection (UTI).
• Acute urinary retention (an involuntarily pass of urine).
• Bladder outlet obstruction (BOO) – a blockage at the neck of the bladder-.
• Gross hematuria (presence visible blood in the urine).

There are two different approaches for performing open prostatectomy, the Retropubic or Suprapubic approach. Furthermore, to reduce any risk of blood loss and complications, regional anesthesia would be recommended. In other cases, general anesthesia is recommended to make a small incision in a way that the surgeon can see the whole prostate. To help with magnification; the surgeon will use a medical device for the enhancement of his or her view. The surgeon will remove the prostate from the urethra and bladder when it is exposed. Afterward, all the cancerous tissue will be cut without damaging surrounding tissue, and the incision site will be closed.

• Patients may have Urgency and Urge Incontinence (an inability to hold the bladder with possible urinary leakage).
• It may be possible that 3–5% of patients have erectile dysfunction.
• Retrograde ejaculation (a condition that causes semen to travel backward into the bladder).

• Patients should avoid any strenuous activities.
• The shower is permitted, but swimming is prohibited.
• In some cases, patients should stay at the hospital for three days.
• The catheter will be removed when the surgeon decides that the bladder has healed.

Historians have regarded Iran as one of the ancient countries in the world. People of Persia had a keen mind in understanding the causes of various diseases and hence finding the most effective treatments. Therefore, patients who want to travel to Iran can know that they are entering into a land that has a rich and versatile background in medicine.

Furthermore, patients who want to travel to Iran to continue their medical treatments can rely on the superb health services in all major cities in Iran. Big cities in Iran, such as, Tehran, Tabriz, Mashhad, and Esfehan, have sub-special hospitals with the state of the art technologies and equipment which have attracted many patients from neighboring counties. When patients are referred to one of the hospitals in Iran, they can feel assured that professional doctors or surgeons will diagnose their treatment, and their recovery will be looked after with the help of well-trained paramedics.