If prostate cancer has not spread outside the prostate gland, surgery is a common choice for curing it. For prostate cancer, the main type of surgery is radical prostatectomy. The entire prostate gland and some of the tissue around it including the seminal vesicles are removed by the surgeon in this operation. There are different ways in which a radical prostatectomy can be done by a urologist.
Open approaches to radical prostatectomy
The surgeon operates through a single long incision for removing the prostate and nearby tissues in the more traditional approach to doing a prostatectomy. In comparison to the past, this type of surgery, which is sometimes referred to as an open approach, is now done less often. This operation is done in two main ways.
Radical retropubic prostatectomy
In your lower abdomen, the surgeon makes an incision from the belly button down to the pubic bone during this operation. When the surgery is done, you may be given spinal or epidural anaesthesia that numbs the lower half of the body or general anaesthesia which makes you fall asleep. The surgeon may also remove some of the nearby lymph nodes at this time if there is a chance that cancer has spread to them. For checking whether there are cancer cells in the lymph nodes, they are sent to the lab and in some cases, they may check the lymph nodes during the surgery. The surgeon might not continue with the surgery if cancer cells are found in any of the nodes. The reason behind this is cancer cannot be cured by surgery and serious side effects could develop if the prostate is removed.
Radical perineal prostatectomy
An incision is made in the skin between the anus and scrotum by the surgeon in this operation. As it leads to erection problems and the nearby lymph nodes can’t be removed, this approach is used less often. If erection problem isn’t an issue for you and there is no need to remove lymph nodes, you can go for this option because it is often a shorter operation. If you have other medical conditions making retropubic surgery difficult for you, this approach might be used on the advice of the prostate specialist. There may be less pain and an easier recovery afterwards in the case of the perineal operation, which usually takes less time than the retropubic operation.
When you are still under anaesthesia after the surgery, to help in passing out of urine, a catheter will be put in your penis. For 1 to 2 weeks, the catheter will usually stay in place while you heal. When the catheter is removed, you will be able to urinate on your own. After the surgery, you will probably have to stay in the hospital for a few days. For several weeks, your activities will be limited.
Laparoscopic approaches are often taken towards radical prostatectomy.