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Radical Prostatectomy for Prostate Cancer

Radical prostatectomy is a surgical intervention performed to remove malignant tumor (cancer) from the prostate gland. The procedure is usually performed by urologic surgeons under general anesthesia. Depending on the characteristic of the tumor, the operation can be done either by an open surgery or as a laproscopic surgery through small incisions. Robot-assisted prostatectomy is a latest method of this treatment which is performed by guiding robotic arms that hold the surgery tools.

Open Surgery – during an open surgery, incision is usually made to reach the cancer in prostate gland. Incision may be made either in the lower abdominal part or in the perineal  (perineum) area between the anus and the scrotum. Retropubic approach is the one in which the incision is made in the lower belly; in perineal approach, the incision is made in the perineum. Once having access to the prostate gland, the tumor will be removed. Sometimes, lymph nodes in the area may also be removed for analysis. The normal recovery time is generally 6 months to 1 year. But the recovery from the perineum surgery is shorter when compared to the recovery time from the retropubic approach. Separate incisions can also be made for the removal of lymph nodes for testing. This may not be necessary in few cases after the PSA test.   

Laparoscopic Surgery- In a laparoscopic surgery, the surgeon makes several small incisions in the belly. During the procedure, an illuminated instrument called laparoscope is inserted into one of the incisions. The surgeon uses specialized tools and instruments to reach and eliminate the prostate through these incisions.  

Robotic-assisted laparoscopic radical prostatectomy is a surgery which requires specially trained specialists. Through small incisions in the belly, robotic arms translate the surgeon's hand motions into finer and more particular action. Whether it is an open or laparoscopic surgery, removal of all the cancer cells is the main goal. This procedure is also done by removing the prostate and the tissues around it. Some types of tumors can also be removed by using a nerve-sparing technique.  

Side Effects and Complications  

Being a major and a complicated surgery, Radical prostatectomy involves certain complications. Heart problems, blood clots, allergic reactions, blood loss and infection of wound are some of the common complications. Patient may also experience erectile dysfunction, urinary incontinence, damage to the rectum, etc. Some prostate cancer patients may need to undergo another treatment after the surgery due to recurrent urinary problems.  

Radical Prostatectomy and Prostate Cancer  

Radical Prostatectomy shows impressive success rate in those cases where the prostate malignancy is within the prostate and has not proliferated beyond it. During this surgery, removed prostate is microscopically examined to observe if cancer has reached its edge or not. If yes, further treatments may be required. Those patients whose prostate cancer has not spread beyond their prostatic gland have nearly 85% to 90% chances of healing after Radical Prostatectomy.      

After this surgery, patients are required to stay for two to three days in hospital. They are put on a urinary catheter for few days after successful completion of surgery. Patients experience pain that gets usually controlled by medicines. However, patient’s sexual and urinary functions attain normalcy after few months of surgery. For proper healing and recuperation, patients must follow up regularly with their doctor.