What You Should Know About Prostate Cancer Surgery

Radical prostatectomy is the most widely used procedure for treating prostate cancer. In this procedure, a surgeon removes the entire prostate and some of the tissue around it.

There are three main types of radical prostatectomy:

Open prostatectomy

In this procedure, a surgeon makes a single long skin incision to remove the prostate gland and surrounding tissues. Open prostatectomy is a more traditional approach. It is less commonly used now due to how invasive this operation is.

Doctors further subdivide open prostatectomy into two types:

• Open retropubic prostatectomy: In this procedure, a surgeon makes an incision in the lower abdomen (just below the belly button) to access and remove the prostate gland.
• Open perineal prostatectomy: In this procedure, a surgeon makes an incision in your perineum (the area of skin between your scrotum and anus). This is a less common type of surgery because the lymph nodes cannot be removed during this procedure.

Laparoscopic prostatectomy

Unlike open prostatectomy, laparoscopic prostatectomy is a minimally invasive procedure. It uses small incisions and a laparoscope (a thin tube with a camera) to guide the surgeon in removing the prostate gland. The prostate is then removed through one of the small cuts.

This approach usually results in less blood loss and pain. It also has quicker recovery rates.

Robotic-assisted laparoscopic radical prostatectomy

This procedure is similar to laparoscopic prostatectomy, but it uses robotic assistance to enhance precision and control during the surgery. The surgeon is at a control panel moving robotic arms to operate through several small incisions in the abdomen.

Other types of prostatectomy

In addition to these approaches, there are other types of prostatectomy

Transurethral resection of the prostate

Transurethral resection of the prostate (TURP) isn’t a curative surgery. Doctors may recommend it to people with advanced prostate cancer to help relieve certain symptoms like trouble urinating.

Pelvic lymphadenectomy

In some cases, doctors remove lymph nodes in the pelvic area to check for the spread of cancer before performing radical prostatectomy.

Bilateral orchiectomy

This procedure removes your testicles. These organs produce testosterone, which can make prostate cancer grow. Removing testicles may help control the growth of the tumor.

Radical prostatectomy is a very effective procedure. According to a 2013 study, even people with relatively advanced prostate cancers have somewhat high rates of overall survival: 58–89% within 10 years after surgery.

Those with less advanced cancers have nearly 100% survival rates for the same period.

The main risks of prostate cancer surgery are incontinence (leakage of urine) and erectile dysfunction.

Other possible complications and side effects include:

• a reaction to anesthesia
• bleeding
• blood clots
• infection
• damage to nearby organs

Let’s discuss what happens before, during, and after prostate cancer surgery.

Before the procedure

Before the surgery, your doctors may run a few tests to check your health and plan the best course of action. You will also meet the key members of your care team.

On the day of the procedure, you may be asked to stop eating a few hours before the surgery.

During the procedure

During the procedure, you will be under general anesthesia. Once you’re fully asleep, your surgeon will perform an incision and remove the prostate or other tissues and organs, depending on the type of surgery you’re having.

They will then connect a catheter (a flexible tube) to the bladder to drain urine while the area heals.

The surgery usually takes around 2–3 hours.

After the procedure

After your operation, you will wake up in the recovery room. Once you have been checked out, you will be transported to a hospital room. Usually, people stay in the hospital for 1–2 days after the procedure.

To prepare for prostate cancer surgery, it’s important to do the following:

• carefully follow your care team’s instructions on what to do before the surgery (like when to stop eating or bathing with a special soap)
• take time off work, find care for children and pets, and make all other necessary arrangements
• pack a bag of items that you will need at the hospital, such as medications, phone chargers, headphones, and a change of clothes

Full recovery from prostate cancer surgery may take a few weeks and sometimes even months. Everyone will recover at a different pace.

During this time, you will likely feel tired. Try to gradually increase the amount you move around each day.

Learn more about the benefits of exercise with a prostate cancer diagnosis.

You’ll also have follow-up appointments. Be sure to use them as an opportunity to address any concerns you have about your recovery progress.

The cost of prostate cancer surgery can vary significantly depending on the following:

• surgery type
• your location
• your surgeon
• insurance coverage

According to a 2019 study, prices (before insurance) for radical prostatectomy vary from $10,000 to $135,000. Be sure to clarify with your insurance provider whether your procedure is covered.

Here are a few questions that people planning prostate cancer surgery frequently ask their doctors.

Is prostate cancer surgery a major surgery?

Prostate cancer surgery is considered a major surgical procedure.

What is the best surgery for prostate cancer?

Radical prostatectomy is often recommended for prostate cancer. However, the choice of treatment depends on your cancer stage, overall health, and other factors.

What is prostate cancer surgery recovery time?

Recovery time typically ranges from a few weeks to several months.

What should you expect after your prostate is removed?

After prostate removal, you may experience certain long-term side effects like erectile dysfunction and urinary incontinence. They usually improve over time.

Prostate cancer surgery is an effective treatment for prostate cancer. Radical prostatectomy is the most common type of surgery because it can potentially cure early-stage cancers.

However, it’s a major procedure that can have long-term effects on your health. Be sure to ask your doctor about the potential side effects and complications of this procedure.