A prostatectomy is the surgical removal of all or part of the prostate gland. The primary reason why a prostatectomy might be performed is to remove cancer cells from the prostate. A prostatectomy requires anesthesia and a short hospital stay and once released, a catheter will need to be worn at home while you are recuperating. Because the nerves that control a man’s erection reside next to the prostate gland, it is important to understand before a prostatectomy is performed, that they are sometimes damaged or removed during the surgical procedure. This can affect a man’s ability to have an erection; however, for most men, the ability to obtain an erection eventually is regained. Incontinence—which is treatable—can also be a side effect of a prostatectomy. It is important to discuss all of the risks and benefits associated with a prostatectomy prior to undergoing the surgical procedure.
There are a variety of prostatectomy procedures performed today depending on the severity of the cancer and the overall condition of the prostate:
- A suprapubic/retropubic prostatectomy is a partial removal of obstructing prostatic tissue that is performed through an incision just below the belly button. Suprapubic prostatectomy requires incising the bladder to remove the obstructing tissue while a retropubic approach involves incising the prostatic capsule to remove the obstructing tissue. Both approaches utilize an abdominal incision.
- A radical retropubic prostatectomy is the complete removal of the prostate through an abdominal incision. Physicians will usually opt for this procedure so that the lymph nodes can be sampled at the time of the operation. In addition, sparing the nerves around the prostate is easier to do via this method.
- A perineal prostatectomy is when a perineal (the area between the anus and the scrotum) incision is utilized to remove the prostate. This procedure is performed typically to remove prostate cancer in the early stages and is marked by less blood loss and an easier recovery time because the incision does not involve muscle or any other vital tissue.
- The Da Vinci Robotic prostatectomy method is a robotic-assisted procedure to remove cancer infected tissue from the prostate gland. It is minimally invasive and is quickly becoming the number one choice for urologists looking for alternative prostate cancer treatments. The procedure has allowed physicians to achieve excellent results in the removal of cancer and compared to other treatments, has shown men to have a faster return of sexual function as well as a decrease in urinary incontinence.