Radical Prostatectomy

The prostate is a part of the male reproductive organ and is located between the bladder and the penis, in front of the rectum. It is the size of a walnut and normally weighs 15-20 grams. The main function of the prostate is to produce sperm. Normally, the prostate stops growing after between 20-25 years of age and will begin to grow again after the age of about 45. The enlarged prostate may progress into other diseases of the prostate, including prostate cancer.

3 Methods of Radical Prostatectomy

A radical prostatectomy is the removal of the prostate and there are three methods that may be used:

  1. Open radical prostatectomy (ORP)
  2. Laparoscopic radical prostatectomy
  3. Robotic-assisted laparoscopic prostatectomy or da Vinci prostatectomy

It is a surgical treatment option for prostate cancer.

  1. Your medical team will ask you about your medical history, including any previous surgeries and any allergies you have to medication.
  2. ​Please let your doctor know about all medication you are currently taking as some may need to be stopped before the procedure. Anticoagulants, including aspirin, must normally be stopped at least one week before the procedure.
  3. You will be asked to fast for eight hours before the procedure.
  1. An open prostatectomy is done with an incision made in the abdomen, under the belly button
  2. A laparoscopic prostatectomy has been developed from the open technique where five small incisions are made in the abdomen to insert a camera and surgical tools. The camera displays images onto a computer monitor, allowing the doctor to visualize the prostate. This technique is less painful than the open technique, recovery is quicker, there are fewer side effects, and the results are better than those of open surgery.
  3. ​A robotic-assisted laparoscopic prostatectomy (da Vinci prostatectomy) involves the use of a robotic arm to perform the surgery, controlled by a specialist doctor. Incisions are small and there is less pain for the patient. Recovery is quicker and the patient is more likely to be able to control their bladder and have erections after the procedure.

Your treatment plan will depend on the stage of your disease and your general health. Immediately after the procedure you will have a catheter in place to empty your bladder. You will see your doctor about one week after being discharged to have your wound checked. You will likely be recommended to avoid lifting heavy objects for a while after the procedure. Full recovery normally takes three to four weeks.

  1. Urinary and bowel incontinence
  2. Leaking urine
  3. Erectile dysfunction
  4. Infertility
  5. Blood loss
  6. The urethra may narrow due to scar tissue

After the procedure, your doctor will assess your health and your surgical wounds and provide recommendations for self-care. Your doctor will then decide if you are fit to travel, taking into consideration your health and safety.

The success of the procedure depends on the stage of the disease, the patient’s physical and mental health, and the patient’s quality of life after the procedure, including the risks of not undergoing treatment. Please talk to your doctor about all of your treatment options.

What if the procedure is not performed?

      A prostatectomy is not the right treatment option for everyone and you should discuss all risks and benefits of the procedure (and of not having the procedure) with your doctor.

  1. Radiation therapy, whether brachytherapy or external beam radiation, may be a treatment option for low- to high-risk prostate cancer.
  2. Chemotherapy has improved as a treatment option and doctors are able to manage side effects better to make the treatment less uncomfortable.
  3. Hormone therapy is an option for after surgery or as the treatment option for metastatic prostate cancer. The doctor will aim to decrease or eliminate male hormones with medication or by removing the testicles.

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