Surgery is a common treatment choice for men with prostate cancer whose disease has not spread outside the prostate. The main type of surgical procedure for prostate cancer is a radical prostatectomy.

Prostate cancer is a common disease among older men and the second-most common cancer in American males. It occurs when there is an uncontrollable growth of the cells in the prostate, a walnut-sized gland that is part of the male reproductive system. The prostate is located between the penis and the rectum below the bladder and around the urethra. Due to the location of the prostate, prostate cancer affects both the reproductive and urinary systems.

A radical prostatectomy is a surgical procedure in which a surgeon removes the entire prostate gland as well as some of the tissue around it, including the seminal vesicles. Surgeons can perform it as open surgery or as laparoscopic surgery.

Open radical prostatectomy

An open radical prostatectomy is a more traditional approach to this surgery. The surgeon makes a single long skin incision to remove the prostate and nearby tissues. There are two main ways to do this operation: radical retropubic prostatectomy and radical perineal prostatectomy.

In either procedure, patients are asleep under general anesthesia or numbed with spinal or epidural anesthesia, so that they do not feel any pain. During a retropubic prostatectomy, the surgeon makes the incision in the abdomen, from the belly button down to the pubic bone. During a perineal prostatectomy, the incision is made between the anus and scrotum (the perineum). The perineal approach is less common since it is more likely to cause erectile dysfunction. However, it is a shorter and faster procedure. During a retropubic prostatectomy, the surgeon also may remove some of the lymph nodes if cancer also affects them. 

Laparoscopic radical prostatectomy

Laparoscopic radical prostatectomy is a more modern and less invasive approach than an open prostatectomy. During this operation, the surgeon makes several small incisions and uses special long surgical tools to remove the prostate. In addition to the surgical instruments, the surgeon also inserts a small camera called a laparoscope through the incision. This allows the surgeon to see what it being done inside the patient’s body. 

There also is a second laparoscopic approach that uses a robotic interface called the da Vinci system. During the operation, the surgeon sits at a control panel in the operating room. Working through several small incisions in the patient’s abdomen, the surgeon operates by moving the system’s robotic arms.

Benefits and risks 

The removal of the prostate through a prostatectomy is an effective method to treat prostate cancer, particularly in cases in which the cancer has not metastasized, or spread to other tissues.

As in any surgery, there are possible risks and side effects. These include reactions to anesthesia, bleeding from the surgery, blood clots in the legs or lungs, damage to nearby organs, and infections at the surgery site. Men who have the surgery also are at risk of erectile dysfunction, changes in penis length, and urinary incontinence.

 

Last updated: July 17, 2020

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Prostate Cancer News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Inês holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer. Before that, she studied Cell and Molecular Biology at Universidade Nova de Lisboa and worked as a research fellow at Faculdade de Ciências e Tecnologias and Instituto Gulbenkian de Ciência. Inês currently works as a Managing Science Editor, striving to deliver the latest scientific advances to patient communities in a clear and accurate manner.
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Özge has a MSc. in Molecular Genetics from the University of Leicester and a PhD in Developmental Biology from Queen Mary University of London. She worked as a Post-doctoral Research Associate at the University of Leicester for six years in the field of Behavioural Neurology before moving into science communication. She worked as the Research Communication Officer at a London based charity for almost two years.
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Inês holds a PhD in Biomedical Sciences from the University of Lisbon, Portugal, where she specialized in blood vessel biology, blood stem cells, and cancer. Before that, she studied Cell and Molecular Biology at Universidade Nova de Lisboa and worked as a research fellow at Faculdade de Ciências e Tecnologias and Instituto Gulbenkian de Ciência. Inês currently works as a Managing Science Editor, striving to deliver the latest scientific advances to patient communities in a clear and accurate manner.
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