radical prostatectomy is surgery to remove the prostate gland and some of the
tissue near it. It is done to treat prostate cancer that has not spread out
of the prostate.
The prostate gland is a small, walnut-shaped
organ. It lies just below a man's bladder. It surrounds the urethra. That's the tube
that carries urine from the bladder out of the body through the penis. The
prostate gland makes most of the fluid in semen.
When you find out that you have cancer, you may feel many emotions and need help coping. It may help to talk
with your family, friends, or a therapist about your feelings. You also can do
things at home to make yourself feel better while you go through treatment.
Call the Canadian Cancer Society (1-888-939-3333) or visit its website at
www.cancer.ca to learn more.
There are three main
types of this surgery. You and your doctor can choose which type is
right for you.
During surgery, the nerves that run along the sides
of the prostate may be damaged or removed. These nerves affect whether a man can have an erection. In some cases, the doctor may be able to avoid damage to
these nerves. This is called nerve-sparing surgery. It makes
it more likely that a man can still have an erection after
The doctor makes
a 7 to 10 centimetre cut (incision) in the skin between the belly button and the
pubic bone. This is done to remove the prostate and other tissue. Nerve-sparing is possible
with this approach. This is the most common type of radical
The doctor makes a cut between the scrotum and anus. The prostate and other tissue are then removed.
This surgery does not take as long as a retropubic surgery. And it may cause
less pain. But nerve-sparing is hard to do with this approach.
So this surgery is not done as often as a retropubic prostatectomy.
puts a lighted tube, or scope, and other tools
through a few small cuts in the lower belly. Nerve-sparing is possible
with this approach. This surgery may also be done with the help of a robot (robotic-assisted). Robotic arms translate the
surgeon's hand motions into finer and more precise action.
You will likely stay in the hospital for 1 to 3 days after surgery.
Most men can go back to work or their usual routine in about
3 to 5 weeks. But it can take 6 to 8 weeks to fully recover.
After your surgery, you will need to have routine checks with
your doctor. This includes having blood tests to measure your PSA level. PSA is
a substance that can help show if your cancer has come back. PSA tests are
usually done every 3 to 6 months for the first 3 years. After that they are done less often.
You may not need any more cancer treatment after surgery. But in some cases, you may need radiation
or hormone therapy.
Whether you can
have an erection after surgery will depend on:
If the doctor removes the nerves, you will need to use medicine or other treatment to
have erections from now on. If your nerves are
still in place, you may not need long-term medicines or treatments. As a rule, the younger you are, the better your chances that you
will still be able to get an erection. Even if your nerves are not damaged, it
will probably take 3 to 12 months after surgery before you will be able to have an erection on your own. During this time, you can use medicine or other
treatments to get an erection.
If you have this surgery, you won't be able to have children. That's because the surgery
cuts the connection between the testicles and the penis. If this is a concern, talk to your doctor. You may be able to save your
sperm before the surgery.
surgery, some men may not be able to control when they pass urine. Or
they may leak urine. This is called urinary incontinence. It may go away within
weeks or months after surgery. Or it may never go away. Some men will have
leakage only once in a while. But other men may find it hard to control their
urine all the time. Doctors can't say who will have problems and who will not. And they can't tell how long
after surgery the problem may last. Medicine and exercises to strengthen
the muscles that control the bladder can often help.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line
if you are having problems. It's also a good idea to know your test results and
keep a list of the medicines you take.
Go to http://www.healthwise.net/ed
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Current as of:
July 26, 2016
Adam Husney, MD - Family Medicine
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