Prostatectomy
A surgical approach toward the treatment of prostate cancer can be used to remove all or part of the prostate. Typically, men with early-stage disease or cancer that is confined to the prostate will undergo radical prostatectomy, which is surgical removal of the entire prostate gland plus some surrounding tissue.
In the most common type of prostatectomy, known as radical retropubic prostatectomy, an incision is made in the abdomen and the prostate is cut out from behind the pubic bone. After removing the prostate, the surgeon stitches the urethra directly to the bladder so urine is able to flow.
Because it typically takes a few days for the body to get used to this new setup, the surgeon will insert a catheter, or tube, into the bladder. With this in place, urine flows automatically out of the bladder, down the urethra, and into a collection bag without the need for conscious control of the sphincter. The catheter is usually kept in place for about a week to 10 days.
My Take
If you’re in good health, the short-term risks of this surgery are low. The hospital stay is usually 2 to 3 days. You’re usually able to go back to work in about one month. You shouldn’t have severe pain with this surgery. Most men regain bladder control a few weeks to several months after the surgery.
The main advantage of surgery is that it offers the most certain treatment. That is, if all of the cancer is removed during surgery, you are probably cured. Also, the surgery provides your doctor with accurate information about how advanced your cancer is, since the nearby lymph nodes are taken out along with the tumor.
Potential Complications
Surgery does have risks and complications. You could lose a lot of blood during this surgery. Before the surgery, you might want to save about 2 units of your own blood in case you need a transfusion. The main risks of this surgery are incontinence (lack of bladder control) and impotence (loss of the ability to get or keep an erection long enough to have sex). Fortunately, only a very low percentage of men have severe incontinence after radical prostatectomy. Up to 35% of men have a little accidental leakage of urine during heavy lifting, coughing or laughing.
The chance of impotence decreases if the surgeon is able to avoid cutting the nerves. This may not be possible if the tumor is large. Your age and degree of sexual function before the surgery are also important factors. If you’re under 50 years old when you have this surgery, you’re likely to regain sexual function. If you’re older than 70, you’re more likely to lose sexual function. Remember, even if the nerves are cut, feeling in your penis and orgasm remains normal. Only the ability to get a rigid penis for sexual intercourse is lost. However, there are medicines and devices that can help make the penis rigid.