Typically, men who are 75 years old or younger, and have a life expectancy of at least 10 years are appropriate candidates for a radical prostatectomy.
How it Works
There are three different methods: Open prostatectomy, laparoscopic prostatectomy, and robotic-assisted prostatectomy.
Open prostatectomy: This surgical method involves a large lower-abdominal incision. It is the most invasive surgical method to remove the prostate. Like any open surgery, recovery time is longer, the risk for complications is greater, and pain is more intense, when compared to less invasive surgeries.
Laparoscopic prostatectomy: To remove the prostate laparoscopically, the surgeon will make several small incisions across the abdomen. These tiny incisions are where the surgical tools and camera are inserted. The camera allows the surgeon to visualize the prostate. This method is less invasive than an open prostatectomy, therefore reducing pain and recovery time.
Robotic-assisted prostatectomy: When prostate cancer is in the early stages, robotic-assisted prostatectomy is an excellent option for removing the prostate. This minimally-invasive procedure has been associated with decreased blood loss, lower risk of infection and other complications, decreased pain, and faster healing. The procedure is similar to laparoscopy, but the surgeon operates the robotic instruments and camera at a distance. Steady, precise movements, and improved visualization from the 3-D camera increase the likelihood that sexual functioning and urinary control will be preserved.
What to Expect
In general, there are many similarities between the laparoscopic and robotic-assisted prostatectomies. Both are minimally invasive, but require general anesthesia. Small incisions are made into the abdomen so the surgical instruments can be inserted. The abdomen will then be inflated with air, improving visualization and allowing more room for the instruments. The surgeon will operate the instruments, either at the bedside, or from a separate location. After the prostate is removed, the incisions are stitched closed.
Recovery will depend on the patient’s age, overall health, and type of surgery performed. Some patients may even be able to return home the same day. On average, normal activity levels can be resumed in six weeks.
A catheter to collect urine will likely be in place for a week or two following surgery. In some cases, a urethral or suprapubic drain may also be inserted. Leaking of urine is common after the catheter is removed; it may take weeks (or months) for urinary function to return to normal. Unfortunately, a permanent change in urinary control could occur.
Sexual functioning could also be permanently affected during a prostatectomy, although the risk is much less if robotic-assisted prostatectomy is performed. Even so, it may take 6 to 24 months to regain baseline sexual functioning.