Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it to treat prostate cancer.
There are four main types of radical prostatectomy surgery. These procedures take about 3 to 4 hours:
For these procedures, you will be asleep (under general anesthesia) or receive 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.
Sometimes, 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 two or more treatments that could be good for your cancer.
Your doctor must also think about your age and other medical problems you have. Healthy men who will probably live for 10 or more years often have this procedure.
Risks for any surgery are:
Risks of this procedure are:
You will have many visits with your health care provider and tests before your surgery, including a complete physical exam. 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.
You may stay in the hospital for 1 to 4 days. After laparoscopic or robotic surgery, you may go home the day after surgery.
You may need to stay in bed until the morning after surgery. Afterwards, you will be encouraged to move around as much as possible.
Your nurse will help you change positions in bed, show you exercises to keep blood flowing, and recommend coughing or deep breathing to prevent pneumonia. You should do these every 3 to 4 hours. You may need to use a breathing device to keep your lungs clear.
You may also:
The surgery should remove all of the cancer cells, but 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.
Updated by: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School.
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