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Radical prostatectomy involves surgical removal of the prostate gland and
sometimes the surrounding tissue. Physicians began using this major surgical
procedure more than 40 years ago. It requires a three- to five-day hospital
stay, and a lengthy recovery period of three to five weeks. Some patients do
not return to routine activities for eight weeks.
There are two types of radical prostatectomy:
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The perineal approach involves an incision between the scrotum and the rectum
to remove the prostate, as well as an additional incision in the abdomen if a
doctor wishes to remove lymph nodes. |
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With the retropubic approach, an incision is made in the lower abdomen to
remove the prostate and lymph nodes. This procedure sometimes enables a surgeon
to avoid removing the nerves that control erections and bladder function. This
technique is commonly referred to as nerve-sparing surgery. It can lower, but
not eliminate, the chance of impotence or incontinence after surgery. |
While surgery can be effective in treating prostate cancer, some men choose it
because they think it “gets the cancer out.” According to a Journal of Urology
study, 47 percent of men undergoing radical prostatectomy (surgery) had cancer
cells remaining in the body following surgery for localized prostate cancer.11
In addition, there may be complications with surgery that significantly impact
quality of life. Up to 10 percent of surgical patients have urinary
incontinence4 (lack of bladder control), and up to 79.6 percent of
patients experience impotence5 (lack of ability to maintain an
erection).
While nerve sparing surgery may lower the risk of impotence, the potential for
other major surgical complications still exists, and the procedure can be
somewhat risky since the cancer often invades the neurovascular bundles.
Surgical outcomes also are dependent on the experience and skill of the
physician.
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