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Radical prostatectomy
Radical prostatectomy is major surgery that removes the entire prostate gland plus some surrounding tissue. The surgery is performed to remove the cancer entirely as well as to prevent its spread to other parts of the body. The surgeon may decide that the pelvic lymph nodes to be sampled for a biopsy. Radical prostatectomy is performed under general or regional anesthesia.
This surgery can be radical retropubic prostatectomy, radical perineal prostatectomy, laparoscopic radical prostatectomy (LRP) or transurethral resection of the prostate (TURP).
In retropubic prostatectomy, the surgeon makes an incision in the lower abdomen to remove the prostate gland. Lymph nodes around the prostate might also be removed depending on whether the cancer has spread to these parts.
In perineal prostatectomy, the incision is made in the perineum or the skin between anus and scrotum. This procedure is use less often because the lymph nodes cannot be removed and there is a high probability that the nerves will be affected.
LRP, on the other hand, involves the use of several smaller incisions and specialized instruments. This highly complex procedure is known for its high precision and control. In the hands of experienced surgeons, it becomes an advantageous option compared with retropubic and perineal prostatectomy.
TURP, meanwhile, makes use of an instrument called a resectoscope which is passed through the end of the penis into the urethra at the level of the prostate. The electricity that passes through the instrument cuts or vaporizes the issue in the prostate. TURP is done to relieve symptoms and is also used for benign prostatic hyperplasia.
Risks of radical prostatectomy
The risks after this procedure are similar to those of any major surgery. They may include:
- Impotence
- Heart attack
- Stroke
- Blood clots in the legs
- Infection at the incision site
- Post-operative bleeding
- Death (very rare)
Recovery time for radical prostatectomy
Since a radical prostatectomy is major surgery, patients may require blood transfusion.
After operation, patients typically need 2-4 days of hospitalization. Full recovery can take up to 12 weeks.
Side effects of radical prostatectomy
A traditional radical prostatectomy is undertaken using wide margins around the prostate,
damaging the nerves which control the blood supply to the penis. By consequence, among side effects,
impotence is nearly guaranteed (51 - 96% impotence rates have been shown). Incontinence is also a very realistic side effects.
Conclusion related to selection criteria
Because of this radical prostatectomy's are not popular among possible prostate cancer treatment options, and usually only seen as a last resort.
It is recommended only for men in good general condition who can withstand long anesthesia and have a life expectancy of ten years or more.
Success and effectiveness of radical prostatectomy
Radical prostatectomy's have the highest success rate among all prostate cancer treatment options, due to the fact that it calls for the complete removal of the prostate.
Success rates for a radical prostatectomy can range from 30 - 98%. Studies have shown success rates between 76 - 98% for low-risk disease;
60 - 76% for moderate risks disease; and 30 - 76% for high risks disease.
The experience of the surgeon performing the surgery is an important fact, i.e.
surgeons have greater success and lower complications rates if they routinely perform the procedure.
Latest News
NCCN updates recommend the value of active surveillance
A recent study at Memorial Sloan-Kettering Cancer Center revealed that inexperienced surgeons treat many
prostate cancer patients in United States. This lack of high-volume experience induces increased complications
such as incontinence and impotence, and possible cancer recurrence.
[ read full article ]
Proliferation of minimally invasive surgery vs open radical prostatectomy
Over the past seven to eight years there has been noted a proliferation of minimally invasive surgery (MIS) techniques for the
treatment of urologic malignancies. This evolution is no better demonstrated than the radical prostatectomy procedure for
patients with prostate cancer.
[ read full article ]
Comparative effectiveness of minimally invasive vs open radical prostatectomy
Statistics show that minimally invasive radical prostatectomy (MIRP) for prostate cancer (CaP) is the most
common treatment modality for localized CaP in the United States. The popularity of this treatment in part is
due to marketing and patient driven desire for the procedure.
[ read full article ]
Surgery improves survival for prostate cancer patients younger than 50
According to a new study from Henry Ford Hospital, for men younger than 50 with prostate cancer, undergoing a
radical prostatectomy can greatly increase their chances for long-term survival.
[ read full article ]
Traditional or robotic prostate surgery?
Men diagnosed with prostate cancer in their 40s and 50s are often steered toward surgery (called a radical
prostatectomy), since it's thought to offer the best chance for long-term survival. What's more, removing the
prostate and examining it in a lab is the only way to know for sure how much cancer was there and how likely
it is to return.
[ read full article ]
Update on watchful waiting versus radical prostatectomy
In 2005, the Scandinavian Prostate Cancer Group Study 4 (SPCG-4) reported that radical prostatectomy improved
prostate cancer survival compared with watchful waiting after a median of 8.2 years of follow-up.
[ read full article ]
New Method of Robotic AIR Prostatectomy Shows Multiple Benefits
A new robotic surgical technique developed at The Cancer Institute of New Jersey (CINJ) for the
removal of all or part of the prostate gland is showing what investigators call a “dramatic improvement” in a
male’s sexual potency rate.
[ read full article ]
Treatments after prostate surgery reported in the Journal of Urology
Although primary prostate surgery or radiotherapy is successful in many cases of prostate cancer, some patients
will suffer a recurrence of the disease, which is most often first detected by a measurable PSA blood test. This
so-called biochemical recurrence affects 30% to 40% of patients after surgery.
[ read full article ]
Satisfaction and regret after radical prostatectomy procedures studied
New study published in European Urology
have shown that approximately 16% of patients with localised prostate cancer regret their treatment choice.
European Urology (http://www.europeanurology.com), the official journal of the European Association of Urology,
will be publishing an article
[ read full article ]
Pelvic Floor Exercises For Men Facing Prostate Surgery: The Sooner The Better
Men about to undergo prostate cancer surgery should begin a program of pelvic floor muscle exercises (also
known as kegel exercises) before surgery, and continue afterwards. That’s the new recommendation from the Expert
Committees on the Adult Conservative Management of Incontinence at the International Consultation on Incontinence,
Paris, 2008.
[ read full article ]
Sexual Life After Prostate Removal
One of the most feared side effects of therapy for prostate cancer is the impact on sexual health. According to
National Cancer Institute in US, about 219.000 men have been diagnosed prostate cancer every year and almost a
half of those men had prostate removal.
[ read full article ]
Prostate surgery need not mean loss of potency
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[ read more articles ]
NOTE: Issues on this site regarding prostate cancer and treatment options, are provided for
information only, and are not meant to substitute for the advice of your own physician or other medical professional.
Prostate-Report.org does not endorse any specific product, service or treatment.
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