Summary The radical prostatectomy surgery involves the following: - The incision for the procedure depends on the type of surgery. During an open surgery, the incision is made either in the lower abdomen or the perineum, while laparoscopic surgery makes use of small multiple incisions. - If lymph nodes have to be removed, they may be removed via a lower abdominal incision or through the laparoscopic method. - As the tissues around the prostate are separated, care is taken to prevent bleeding from the dorsal venous plexus in front of the prostate. - The prostate is separated from its surrounding tissue and ligaments. - The neurovascular bundles are identified. Sometimes, neurovascular bundles on both sides are preserved, while in other cases the bundle on one side may have to be sacrificed. Preservation of neurovascular bundles may not be necessary in older men who already have problems with erection. Similarly, the bundles are not preserved if they are also affected by the cancer. - The seminal vesicles and vas deferens are also separated and removed - The prostate is cut out along with its urethra, but without disturbing the external urethral sphincter. The cut ends of bladder neck and the urethra are stitched together. - A drain is placed in the pelvic region to drain out any fluid that may accumulate. A catheter is passed through the urethra to drain urine from the bladder till healing of the surgical wound is complete. The procedure can take 2 to 4 hours depending on the complexity of the procedure.
Type of Anesthesia - Radical prostatectomy is done under general anesthesia and sometimes under epidural anesthesia.
Indications - Localized Prostate Cancer without metastasis (when prostate cancer is limited to the gland) - None remarkable surgical risks - Life expectancy longer than the physical progress of cancer disease(at least 10y)