If the prostate is greatly enlarged, if the bladder has been damaged and must be repaired, or if the patient has other complications prohibiting transurethral surgery, an open surgical procedure called a prostatectomy (removal of the prostate) may be necessary. With this procedure, the patient is anesthetized and the surgeon makes an external incision, either in the lower abdomen or in the perineum (the area between the rectum and the scrotum), depending upon the location of the enlarged portion of the prostate. The surgeon then removes the enlarged prostate tissue from inside the gland. An open prostatectomy in which the surgeon accesses the prostate from the abdomen is called
suprapubic (surgery from on top or above); surgery through the perineum is called retropubic (surgery from the back or from behind). 
Sometimes incontinence surgery takes place via an incision through the abdomen. Two standard suspension procedures that require abdominal incisions are the Marshall Marchetti Krantz procedure and the Burch procedure. The Marshall Marchetti Krantz (MMK) procedure is still offered in many medical centers throughout the United States, but it is no longer a favored technique. This is because the sutures (stitches) in the procedure are placed around the urethra, creating the potential for obstruction; in addition, the surgical entryway limits the physician's ability to correct cystocele (herniation of the bladder into the vagina). During the MMK procedure, the bladder neck and urethra are separated from the back surface of the pubic bone. Sutures are placed on either side of the urethra and bladder neck, which are then elevated to a higher position. The free ends of the sutures are anchored to the surrounding cartilage and pubic bone. The Burch procedure, also known as Burch colposuspension (vaginal suspension), often is performed when the abdomen is already open for another purpose, such as abdominal hysterectomy (removal of the uterus). During the suspension procedure, the sutures are placed laterally (sideways), which avoids urethral obstruction and allows the physician to repair any small cystoceles that may be present. The bladder neck and urethra are separated from the back surface of the pubic bone. The bladder neck then is elevated by means of lateral sutures that pass through the vagina and Cooper's (pubic) ligaments. The vaginal wall and ligaments are brought together without tension, and the sutures are tied.
Is the most invasive procedure for removing kidney stones. Because it is so traumatic, most kidneys can withstand no more than two such operations. Deep anesthesia is required, after which the surgeon makes a large (10-20 centimeter) incision in the patient's back or abdomen, depending upon where the stone is located. Either the ureter or the kidney isopened and the stone extracted. Most patients require prolonged hospitalization afterward, and recovery may take up to two months.
All drugs--even those sold over-the-counter--have side effects. Patients should always consult a doctor before using any drug for an extended time.Aspirin and ibuprofen are easy to obtain and may be a first line of defense against mild discomfort. However, they may make symptoms worse in some patients. Over-the-counter forms of phenazopyridine hydrochloride (Azo-Standard, Prodium, and Uristat) may provide some relief from urinary pain, urgency, frequency, and burning. Higher doses of the drug are available by prescription as Prodium and Pyridium.
- Orchiectomy
- The surgical removal of one or both of the testicles.
Inflammation of a testicle.
A condition characterized by involuntary bladder muscle contractions during the bladder filling phase which the patient cannot suppress.
Leakage of small amounts of urine from a bladder that is always full.
Oxybutynin is an anticholinergic drug medication that also directly relaxes bladder smooth muscle. It is prescribed for neurogenic bladder patients, and patients who have symptoms of bladder instability with voiding: that is, patients with
urge incontinence, frequency, urinary leakage, or painful urination. The typical dosage is 2.5-5.0 mg to be taken orally 3 to 4 times/day). Oxybutynin's notable side effects are dry mouth, dry skin, visual blurring, nausea and constipation.