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If you've been diagnosed with prostate cancer, a prostatectomy is a form of surgery to treat it. Find out more about what it is and what to expect.
Prostate cancer is very common in the UK; almost 42,000 men are diagnosed with the disease every year1. For many men with prostate cancer, surgery to remove the prostate gland forms part of their treatment to try and get rid of the tumour. Surgery to remove the prostate gland is called a radical prostatectomy.
Who is this surgery suitable for?
Surgery will only be recommended for some men with prostate cancer. Every man’s treatment is unique, based on the type, grade and stage of their cancer along with other factors such as age and overall level of health2.
Generally speaking, surgery is only an option for men with localised prostate cancer, which means the tumour is contained entirely within the prostate gland and has not spread. As it is a major operation it is only suitable for men who are otherwise healthy. If you’re aged over 75, you have other health problems or you’re overweight, prostate surgery may not be suitable2.
What’s involved in a prostatectomy?
The aim of a prostatectomy is to remove the entire prostate gland along with all of the cancerous cells within it. During the operation, the surgeon removes the prostate gland itself along with surrounding tissues, lymph nodes and the tubes that carry semen. They then reattach the urethra to the bladder3.
The operation might be open, or it might be done using keyhole surgery. Open surgery involves the surgeon making one larger incision in your tummy and removing the prostate through the opening. Keyhole surgery requires a highly specialist surgeon to make a series of tiny incisions and operating using a long instrument called a laparoscope. This can be done by hand or with the help of robotic equipment.
Will I have to stay in hospital?
A prostatectomy is major surgery which usually takes two to four hours and is performed under general anaesthetic. That means you will have to stay in hospital for at least one night after your operation so that medical staff can monitor you post-surgery. Some men can go home the next day while others may need to stay in hospital for up to a week2.
While you’re in hospital you’ll be encouraged to eat and drink normally and get up and move around as soon as you feel well enough. You may need to have daily injections for up to a month after the operation, but a nurse will show you how to do this for yourself.
What are the risks and side-effects?
As with any major operation, there are risks involved in having a prostatectomy and your surgeon will discuss these with you beforehand. The risks associated with surgery include:
- Bleeding, which might mean you need a blood transfusion
- Injury to nearby vital organs such as the bowel
- Blood clots
There are two bundles of nerves attached to the prostate, and it’s these nerves which are responsible for controlling erections. During surgery, it’s possible that these nerves might get damaged, which leads to issues with getting and sustaining an erection. Your surgeon will do everything they can not to damage these nerves. However, if the cancer has spread too close to them then they might have no choice but to remove them.3
You might also experience problems urinating after your surgery, which are usually in the form of mild leakage. Some men experience a lack of bladder control, but there are ways to manage and treat these side effects. Pelvic floor exercises help lots of men with urinary problems, and there are also plenty of products available to help manage urine leakage4.
Any other questions?
If you have any questions about prostate cancer and prostatectomies, you can read this Q&A with three of our leading specialists. Diagnosis and treatment of prostate cancer is advancing all the time, with new techniques such as prostate mapping becoming available to improve care for men with prostate cancer.
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