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Prostate Cancer Surgery - Prostatectomy

Approximately 75 percent of men who undergo surgery never experience a recurrence of prostate cancer.

Radical prostatectomy, involves removing the prostate and some surrounding tissue. There are two approaches to radical prostatectomy:

• Retropubic, where the surgeon operates through an incision in the abdomen.
• Perineal, where the surgeon operates through an incision in the skin between the scrotum and the anus.

Nerve-sparing surgery is done through the abdominal, or retropubic approach.

These procedures usually take 2-4 hours under general anesthesia, and require a 3-5 day hospital stay, followed by 3-5 weeks of recovery time.

Surgery always has risks, and this type of surgery can cause significant side effects.

Incontinence is common following surgery, but most men recover within a few weeks or months. As many as 35 percent of men have permanent, mild but treatable stress incontinence, such as passing a little urine while coughing.

Erectile dysfunction (ED) is more common and more difficult to treat. The nerves located along the side of the prostate control erections. Sometimes they need to be removed to catch all of the cancer. They can be partially removed or damaged during surgery.

Nerve-sparing surgical techniques can improve the odds of recovering erections, from around 30 percent for men under 60 with one nerve spared, to about 76 percent for men under 60 with both nerves spared. Even if one nerve is sacrificed, one may be able to regain potency over time with the remaining nerve. Some patients regain potency over time with the use of ED drugs or medical devices. Sometimes patients are given ED drugs in advance of surgery, to support the system.

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