Radical Prostatectomy is a surgery conducted to remove the prostate gland and its surrounding tissues. Additionally, nodes found around the area of the prostate are also removed if deemed necessary.
This surgery is performed under general anesthesia with the goal of eliminating prostate cancer before it spreads all over the patient’s body. This means that men with advanced cases of prostate cancer – the cancer cells have already spread beyond the prostate can less likely benefit from Radical Prostatectomy.
How is Radical Prostatectomy Conducted
This surgery can be conducted in two ways: Open Surgery and Laparoscopic Surgery
1. An Open surgery is done in two approaches, either through the “Retropubic approach” where a large slit is made in the lower abdomen which allows surgeons to get rid of lymph nodes in the prostate area or through the “Perineal Approach” where the skin between the scrotum and the anus is incised also with the goal of removing the prostate gland affected by cancer.
The Perineal Approach as compared to the Retropubic approach doesn’t permit the surgeon to remove lymph nodes in the area of the prostate which makes the Retropubic approach the most common type of Radical Prostatectomy. Being able to remove the lymph nodes for testing is a distinct advantage to the retropubic approach and is one of the key reasons why it is more popular with surgeons.
2. Laparoscopic surgery on the other hand is done by making several small incisions in the lower abdomen of the patient. A thin camera called a Laparoscope is inserted in one of the incisions and on the other incisions, specialized tools are inserted to access the prostate and it’s surrounding tissues.
This surgery is most often conducted by hand, but with the modernization of medical tools, some surgeons utilized robots, this is called the Robot Assisted Prostatectomy. Patients who underwent Laparoscopic surgery are reportedly faster to recover and have lost less blood during the entire process. But because this is relatively a new technique, no results from long term follow up treatment are available as of this time.
What are the Risk Involved
1. Erection Problems – The nerves that control man’s ability to have an erection lie next to the prostate gland. These nerves are often damaged or removed during the surgery which makes it possible that man may have problems in erection after a Radical Prostatectomy.
According to studies 80% of men suffer from this condition after the surgery but months or years later, they regain their ability to have erections. But the recovery depends on how old the patient was during the surgery, how the surgery affected the nerves and whether the man was able to have an erection before the surgery.
2. Incontinence – Studies would show that a year after the surgery, 15 to 50 percent of men report problems on passing urine. Urinary Incontinence is the involuntary loss of urine from one’s body and up to half of all those who underwent Radical Prostatectomy developed this condition.
3. Other Complications – Because Radical Prostatectomy is a major surgery, general risks would include heart problems, blood clots, allergic reaction to anesthesia, infections and blood loss
