Surgery for prostate cancer

Surgery for prostate cancer, which is called radical prostatectomy, involves the removal of the entire prostate gland and some surrounding tissues. The seminal vesicles, which produce fluid that is part of the makeup of semen, are also removed.

Prostate removal through radical prostatectomy is an attempt to cure prostate cancer, and is generally presented as an option when the cancer is believed to be confined to the prostate gland.

There are four main types that are performed today:

• Radical retropubic prostatectomy
• Radical perineal prostatectomy
• Laparoscopic radical prostatectomy
• Robotic-assisted laparoscopic radical prostatectomy

Are there risks?

Every approach has certain risks and potential side effects. The main risks after any surgery, including radical prostatectomy, are complications from anesthesia, heart attack, stroke, blood clots, and infection. Bleeding is another risk, and some men may require a blood transfusion.

The two main side effects that can possibly occur are urinary incontinence (the inability for a man to control urination) and impotence (the inability for a man to get or maintain a natural erection for intercourse). These side effects can also occur with other treatments for prostate cancer. Other factors, such as the age of your loved one, whether he currently has any urinary or erectile problems, and the skill of the surgeon may also contribute to these side effects.

Rates of impotency vary widely. With nerve-sparing surgery, impotence rates have been reported as low as 25% to 30% for men under the age of 60, and only 10% for men under the age of 50, according to the American Cancer Society. They advise that some doctors have reporter higher rates of impotence. It is also very important to understand how a doctor defines the word impotence (this is a good question to ask your doctor).

Expect that your man will probably experience some level of incontinence right after radical prostatectomy. But this is expected to lessen within a few months, until it is hopefully no longer a problem.

According to a study of 901 men aged 55 to 74 (as reported by the American Cancer Society), five years after surgery 15% of men had no bladder control or frequent "leaks" or "dribbling" (16% of men leaked at least twice a day). It was also reported that 29% of men wore pads to control wetness, but these men were in different groups in the study so these percentages may be inflated.

To learn more about what to expect after surgery, read the articles in our helpful tips section.

Other problems that can occur following radical prostatectomy may include bladder irritation, bladder infection, and gastrointestinal (digestive) problems.

Find the surgeon with the "best hands"

We cannot stress enough that the skill and experience of the surgeon are paramount for success with any surgical approach for prostate cancer. Please do your homework to make sure that you choose the best surgeon! Your choice of surgeon will be the most important factor in preventing long-term (or even permanent) incontinence and impotence.

Always discuss everything you read on this web site with a qualified medical professional.

Updated 7/11

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