Types of Surgery

Radical retro-pubic prostatectomy: The doctor removes the entire prostate and nearby lymph nodes through an incision (cut) in the abdomen.

Radical perineal prostatectomy: The doctor removes the entire prostate through a cut between the scrotum and the anus. Nearby lymph nodes may be removed through a separate cut in the abdomen.

Laparoscopic prostatectomy: The doctor removes the entire prostate and nearby lymph nodes through small incisions, rather than a single long cut in the abdomen. A thin, lighted tube (a laparoscope) is used to help remove the prostate.

Transurethral resection of the prostate (TURP): The doctor removes part of the prostate with a long, thin device that is inserted through the urethra. The cancer is cut from the prostate. TURP may not remove all of the cancer. However, it can remove tissue that blocks the flow of urine.

Cryotherapy (or cryosurgery): Cryotherapy, also known as cryosurgery, eradicates prostate cancer by freezing prostate cells. The doctor inserts the cryo needles into the prostate gland through the area between the scrotum and anus. The needles produce very cold temperatures. The latest generation of cryotherapy uses ultra-thin needles to produce iceballs of extreme sub-zero temperatures. The doctor uses ultrasound to guide the insertion of the cryo needles and monitor the freezing process, which destroys the entire prostate, including cancerous tissue.

Pelvic lymphadenectomy: This is routinely done during prostatectomy. The doctor removes lymph nodes in the pelvis to see if cancer has spread to them. If there are cancer cells in the lymph nodes, the disease may have spread to other parts of the body. In this case, the doctor may suggest other types of treatment.

Risks and Benefits of Surgery

The time it takes to heal after surgery is different for each man and depends on the type of surgery he has had. You may be uncomfortable for the first few days. However, medicine can help control the pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain relief.

After surgery, the urethra needs time to heal. You will have a catheter. A catheter is a tube put through the urethra into the bladder to drain urine. You will have the catheter for five days to three weeks. Your nurse or doctor will show you how to care for it.

Surgery may cause short-term problems, such as incontinence. After surgery, some men may lose control of the flow of urine. Most men regain bladder control after a few weeks.

Some men may become impotent. Nerve-sparing surgery is an attempt to avoid the problem of impotence. If a man can have nerve-sparing surgery and the operation is a success, impotence may not last. In some cases, men become permanently impotent. You can talk with your doctor about medicine and other ways to help manage the sexual effects of cancer treatment.

If your prostate is removed, you will no longer produce semen. You will have dry orgasms. If you wish to father children, you may consider sperm banking or a sperm retrieval procedure.