What is a radical retropubic prostatectomy?

A radical retropubic prostatectomy is surgery to remove the prostate gland. Some of the tissue around the gland is also removed. It is done to treat prostate cancer that has not spread out of the prostate. The doctor will make a 7 to 10 centimetre cut (incision) in your lower belly. The cut is between the navel and the pubic bone.

You will probably stay in the hospital for 1 to 3 days after surgery. Most men can go back to work or their usual activities 3 to 5 weeks after surgery. But it can take 6 to 8 weeks to fully recover.

After surgery, your body will need time to heal. It may take several weeks or more for you to regain control of your urine. And it may take 6 months or more for you to be able to have erections again. But with time, most men regain urine control and much of their previous sexual function. If not, medicines or other treatments may help.

After your surgery, you won't be able to ejaculate sperm. If you want to be able to father children after your surgery, talk to your doctor about your options. You may be able to save your sperm before the surgery.

When you find out that you have cancer, you may feel many emotions and may need some help coping. Seek out family, friends, and counsellors for support. You also can do things at home to help you feel better while you go through treatment. Your doctor can guide you to many local resources for support and more information. Call the Canadian Cancer Society (1-888-939-3333) or visit its website at www.cancer.ca for more information.

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 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.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your surgery.

Preparing for surgery

• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
• If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
• Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
• If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
• The surgery will take 2 to 4 hours.
• You will have a tube that drains urine from your bladder. This is called a urinary catheter. It is usually left in place for 1 to 2 weeks.
• You will have a tube coming out of your lower belly. This drains fluids that can build up after surgery. It is usually removed in the days after surgery.

Going home

• Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
• You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

• You have questions or concerns.
• You don't understand how to prepare for your surgery.
• You become ill before the surgery (such as fever, flu, or a cold).
• You need to reschedule or have changed your mind about having the surgery.