What is radical prostatectomy?

Radical prostatectomy is an operation to remove the prostate gland, with the aim of treating prostate cancer and preventing it from spreading to other parts of the body.  The prostate gland produces part of the semen and is found underneath the bladder. It surrounds the urethra (the tube that carries urine from the bladder out of the body).

Radical prostatectomy is generally done under general anaesthesia, which means you will be asleep during the operation and feel no pain.  It generally requires a hospital stay of between two to five days.

Your surgeon will explain the benefits and risks of having a radical prostatectomy and will also discuss any alternatives treatment options. 

About the operation

During a radical prostatectomy, your surgeon will make an incision in your abdomen and the prostate and surrounding tissue is removed.  The incision is closed using either stitches or clips.

Alternatively your surgeon may perform a laparoscopic (also known as “keyhole”) radical prostatectomy which involves removing the prostate through five or six small incisions.  A camera and light source is inserted through one of incisions so your surgeon can see the prostate gland and the instruments used to perform the operation are inserted through the other incisions.

The potential benefits of laparoscopic prostatectomy are reduced pain and blood loss, and the functional and cancer outcomes are comparable with open surgery.  Length of stay in hospital is generally 1-2 days compared to 5-7 days for open surgery and recovery times are also usually shorter.   

Both open and laparoscopic radical prostatectomy operations last between two or three hours.  Following the operation a catheter will be left in place to drain urine from your bladder into a bag.  This is normally removed about two weeks after surgery.   Your surgeon will also send the tissue they have removed to the laboratory for analysis.

Radical prostatectomy is a commonly performed operation and for most people the benefits outweigh the disadvantages.  However, like all surgery there is a risk of complications.  The main complications specific to radical prostatectomy include:

  • Bleeding, requiring a blood transfusion
  • Urinary tract infection. The risk of infection is higher for the first few weeks. It’s important you complete your course of antibiotics to reduce the risk of infection.
  • Stress incontinence (when urine leaks because you coughed, sneezed or made a sudden movement).
  • Erectile dysfunction (impotence). It’s possible you may not be able to get or maintain an erection after treatment.
  • Further treatment may be required if the cancer tissue is not completely destroyed

The chance of complications depends on the exact type of procedure you are having and other factors such as your general health. Ask your surgeon to explain how any risks apply to you.

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