Surgery for Prostate Cancer
Removing the entire prostate gland and seminal vesicles through surgery, known as a radical prostatectomy, is an option for men with low, intermediate, or high-risk cancer that has not widely spread.
What are the Types of Surgery?
Open radical prostatectomy has been the traditional way of surgically removing the prostate. In this procedure, the surgeon makes an incision in the lower abdomen, or through the perineum (between the scrotum and anus).
Today, robot-assisted laparoscopic radical prostatectomy is more common in the U.S., with more than 90% of radical prostatectomies performed robotically. Small incisions, often five in total, are made in the abdomen. The robotic arms are connected to trocars (tubelike devices) that are inserted through the incisions. The surgeon controls the robot’s arms, which control a camera and surgical instruments.
Compared with open surgery, robot-assisted surgery may have less bleeding, a bit less pain, fewer short-term complications, and equivalent cancer cure rates. Recovery of urinary and sexual function depends more on the extent of the cancer, surgeon’s skill, and patient baseline function, rather than the method of surgery.
What Happens After Surgery?
Whether open or laparoscopic/robotic surgery is chosen, patients typically go home after an overnight stay in the hospital with a bladder catheter to help drain urine for 7 to 14 days. Increasingly, select patients are being discharged on the same day as their robotic procedure, with safe results.
After surgery, a pathologist will examine the cells under a microscope and determine a final grade (how aggressive your cancer is) and whether the sampled lymph nodes have prostate cancer in them (how far it has spread).
Ask for a copy of your pathology report and talk with your doctor about what it means. If it appears that some cancer was left behind (called positive margins), or if the cancer is more aggressive than what was seen in your initial biopsy, you may need more treatment.
About 6 to 8 weeks after surgery, your PSA will be checked. Based on your PSA and pathology report, you and your doctor will decide whether more treatment is needed with radiation therapy and/or hormone therapy.
Last Reviewed: 12/2023
