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Surgery

Surgery is the most common treatment for prostate cancer for men under 70 whose cancer is confined to the prostate. Doctors aim to remove all of the cancer and maintain the best possible urinary functions for the patient with little or no impact on sexual function.

More than 75 percent of men who undergo surgery never experience a recurrence of prostate cancer.

The removal of the entire prostate is a procedure called a radical prostatectomy. If the prostate is removed, semen can no longer be ejaculated. Whether or not a man can achieve an erection will depend on the degree to which the nerves can be spared.

There are five types of prostatectomies:

Retropubic Surgery –

The doctor will operate through an incision below the navel to remove the prostate and, if suspected of possible spread into the pelvic region, nearby lymph nodes too.

Perineal Surgery –

The doctor will operate through an incision in the skin between the scrotum and the anus. This procedure minimizes bleeding but can carry a greater risk of rectal injury.

Laproscopic Surgery –

The doctor inserts a thin tube-like instrument through the navel to remove the prostate with several other small incisions in the abdomen through which surgical instruments are passed. Hospital stays are often times minimal with this procedure.

Nerve-Sparing Prostatectomy –

A technique where the doctor cuts the edges of the prostate while making every effort to spare the nerves to allow for erectile function after surgery. However, a doctor will not know if the nerves can be spared until surgery has begun because sometimes the cancer will have invaded the nerves around the prostate. Depending on the situation, the doctor may be able to graft nerves from other parts of the body.

Robotic Surgery –

Robotically assisted surgery is where a doctor uses a machine to control tiny surgical instruments with great precision.  The procedure increases accuracy, but as with all surgery, the level of experience of the surgeon is a critical factor to consider. The robotic-assisted prostatectomy is the most widely used form of prostate cancer treatment of localized prostate cancer in the United States as it offers a number of advantages over other types of surgery including:

  • Less post-operative pain and discomfort
  • Faster recovery time
  • Reduced blood loss
  • Earlier return to urinary continence
  • Strong post-operative return to sexual functioning
  • Less scarring
  • Less risk of infection

Watch one of our experts discuss prostate cancer surgery below.