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What You Need To Know About Getting a Radical Prostatectomy

What You Need To Know About Getting a Radical Prostatectomy

Prostate cancer is the most prevalent type of cancer among men. There are several treatment options for this condition. Among them, radical prostatectomies are the most commonly used.

A radical prostatectomy removes the prostate gland, along with the surrounding tissue. Doctors are more likely to recommend this procedure if the cancer cells remain within the prostate gland. This is done to prevent further spread of cancer to the other parts of the body.

Why is radical prostatectomy performed?

The ultimate goal of a radical prostatectomy is to remove prostate cancer. But there are also less common reasons why doctors recommend this procedure:

  • Bleeding from the prostate
  • Difficulty in urinating
  • Bladder stones with prostate enlargement
  • Hydronephrosis or the build-up or urine causing the kidneys to swell

It is important to get proper diagnosis from your doctor to determine if this is the right treatment for you.

What are the types of radical prostatectomy?

The prostate is located within the pelvis and surrounded by many organs. Because of this, medical professionals have developed different approaches to reach and remove the prostate. Some approaches are only minimally invasive.

The method that will work best for you is dependent on factors such as tumor site, how far it has progressed, and your overall health status.

There are three main types of radical prostatectomy surgeries:

Open or retropubic

In this approach, surgeons make the incision in the lower abdomen to remove the prostate. This also allows preserving one or both of the small nerve bundles necessary for unassisted erections, unless the cancer has already spread to the nerves.

In other rare cases, doctors may make the incision in the perineum, between the scrotum and anus. This is called the open perineal approach.


This recently developed approach involves making several small incisions using lit magnifying devices and cameras. The incision will measure around 0.1 cm. This removes the prostate without having to make a large cut, making recovery time faster.

Robot-assisted laparoscopic prostatectomy

Just like the name suggests, this method makes use of a robotic system to carry out the surgery. The surgeon controls the robotic arm from the outside and monitors the entire process using a 3-D screen.

As a preventative measure, surgeons may remove the lymph nodes, unless the cancer cells have not yet reached beyond the prostate gland. This is called a pelvic lymph node dissection.

What are the risks and complications of radical prostatectomy?

Just like any surgical procedure, a radical prostatectomy comes with its own risks and complications.

  • Urinary incontinence. This involuntary “leak” will eventually improve over time, but is more difficult to manage if you are older.
  • Erectile dysfunction. Recovery might take up to two years. The younger you are, the higher the chance that you will maintain potency.
  • Changes in penis length
  • Lymphedema or swelling of soft tissues due to fluid build-up
  • Allergic reaction to anesthesia
  • Bleeding

What happens in a radical prostatectomy procedure?

Before the surgery, an examination of your prostate gland will take place. Apart from reviewing your medical history, your doctor will have to run physical examinations, blood tests, and other diagnostic tests.

The surgical procedure itself depends on the chosen approach. Generally, the surgeon will have to make an incision to remove your prostate gland, and lymph nodes in case the cancer has spread to them.

Doctors will insert a drain to remove excess fluid from the prostate site. They will suture the incisions back together, and apply bandages.

Your medical team will monitor you after the surgery, and prescribe pain medication.

The medical team will put in a urinary catheter, which stay for around three weeks.

Depending on how the entire process went, your doctor will give you additional instructions on how to manage the pain, and how many times you should visit for assessment.

Key takeaway

Radical prostatectomies are the most widely used treatment to remove prostate cancer. Advances in diagnosis and treatment allow surgery to be less invasive. In conclusion, it is important to always consult with your doctor on the best treatment plan for you.

Learn more about Prostate Cancer here.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Treatments A-Z: Radical Prostatectomy, https://www.ucsfhealth.org/treatments/radical-prostatectomy

Accessed March 23, 2021 


Radical Prostatectomy, https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/radical-prostatectomy

Accessed March 23, 2021


Prostatectomy, https://www.mayoclinic.org/tests-procedures/prostatectomy/about/pac-20385198

Accessed March 23, 2021 


Surgery for Prostate Cancer, https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html

Accessed March 23, 2021 


Radical Prostatectomy , https://www.pcf.org/about-prostate-cancer/prostate-cancer-treatment/surgery-prostate-cancer/

Accessed March 23, 2021

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Written by Honey Buenaventura Updated May 03
Fact Checked by Hello Doctor Medical Panel