Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it. It is done to treat prostate cancer.
There are four main types or techniques of radical prostatectomy surgery. These procedures take about 3 to 4 hours:
For these procedures, you will have either general anesthesia so that you are asleep and pain free, or you will get medicine to numb the lower half of your body (spinal or epidural anesthesia).
Radical prostatectomy is most often done when the cancer has not spread beyond the prostate gland. This is called localized prostate cancer.
Your doctor may recommend one treatment for you because of what is known about your type of cancer and your risk factors. Or, your doctor may talk with you about other treatments that could be good for your cancer. These treatments may be used instead of surgery or after surgery has been performed.
Factors to consider when choosing a type of surgery include your age and other medical problems. This surgery is often done on healthy men who will live for 10 or more years after the procedure.
Risks of this procedure are:
You may have several visits with your health care provider. You will have a complete physical exam and may have other tests. Your health care provider will make sure medical problems such as diabetes, high blood pressure, and heart or lung problems are being controlled.
If you smoke, you should stop several weeks before the surgery. Your doctor or nurse can help.
Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.
During the weeks before your surgery:
On the day of your surgery:
Prepare your home for when you come home after the surgery.
Most people stay in the hospital for 1 to 4 days. After laparoscopic or robotic surgery, you may go home the day after the procedure.
You may need to stay in bed until the morning after surgery. You will be encouraged to move around as much as possible after that.
Your nurse will help you change positions in bed and show you exercises to keep blood flowing. You will also learn coughing or deep breathing to prevent pneumonia. You should do these steps every 1 to 2 hours. You may need to use a breathing device to keep your lungs clear.
After your surgery you may:
The surgery should remove all of the cancer cells. However, your doctor will watch you carefully to make sure the cancer does not come back. You should have regular checkups, including prostate specific antigen (PSA) blood tests.
Prostatectomy - radical; Radical retropubic prostatectomy; Radical perineal prostatectomy; Laparoscopic radical prostatectomy; LRP; Robotic-assisted laparoscopic prostatectomy; RALP; Pelvic lymphadenectomy
Su LM, Smith JA Jr. Laparoscopic and robotic-assisted laparoscopic radical prostatectomy and pelvic lymphadenectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 103.
Schaeffer EM, Partin AW, Lepor H, Walsh PC. Radical retropubic and perineal prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 102.
Resnick MJ, Koyama T, Fan KH, Albertsen PC, Goodman M, Hamilton AS, et al. Long-term functional outcomes after treatment for localized prostate cancer. N Engl J Med. 2013 Jan 31;368:436-45.
Updated by: Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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