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Surgical Procedures for Prostate Cancer
Surgery for Early Stage Prostate Cancer
- Radical retropubic prostatectomy—An incision is made in the lower abdomen to access the pelvic area and the affected organs. In some cases, nerves that control erections can be spared. This depends on the location and extent of the cancer in the prostate. The surgery may be stopped if cancer is found in the lymph nodes. This would indicate it has spread beyond the primary site.
- Radical perineal prostatectomy—An incision is made through the perineum, the area between the scrotum and anus. The prostate is removed, but the nearby lymph nodes are spared. This method is not used as often because of damage to nerves that control erections. If lymph nodes need to be removed, another incision is made through the abdominal wall.
- Open—An incision is made through the abdominal wall. It starts at the belly button and ends near the top of the bladder at the pubic bone. Doing so exposes the organs so they can be removed through the incision.
- Laparoscopic —Tubes are inserted into small incisions in the abdomen. A lighted camera and surgical instruments can be used through the tube. Images from the laparoscope are viewed on a special monitor. Healing and recovery time for laparoscopic surgery is generally faster than open surgery
- Robot-assisted —Robotic arms are inserted through small incisions. This allows for greater range of movement than a doctor's hand.
- Nerve-sparing—The surgeon will leave the two nerve bundles that control spontaneous erections. The ability to do this depends on how close the cancer is to the nerves. It is possible to have one nerve bundle removed and still have the ability to get an erection.
Urinary incontinence, which may include:
- Stress incontinence—Urine leaks during times there is a sudden increase in pressure. Examples include sneezing or laughing.
- Urge incontinence—Bladder spasms cause a sudden urgent need to urinate. This can cause urine to leak from the bladder.
- Overflow incontinence—This causes difficulty with empyting the bladder. Urine stream may be weak or there may be dribbling. Urine builds up in the bladder and leaks out.
- Erectile dysfunction (ED)—The inability to attain or maintain an erection that is firm enough for sexual intercourse. This may be more of an issue if nerve-sparing surgery was not an option. There are several treatments available to treat ED.
Surgery for Advanced and Metastatic Prostate Cancer
- Reviewer: EBSCO Medical Review Board Mohei Abouzied, MD, FACP
- Review Date: 09/2017
- Update Date: 04/19/2017