Prostatectomy

A radical prostatectomy is the removal of a prostate that has been affected by cancer.

With a radical prostatectomy, the entire prostate is removed, which also means the probability of having completely removed the cancer is high.

Most patients who have a prostectomy regain bladder control and control of their erections after a postoperative recuperation period, though this cannot be guaranteed for every patient. The time needed for recuperation depends on several different factors. How extensive the cancer was plays a role, as does the patient's age and general condition, including whether obesity was a factor or not.

Three types of operations are possible

This operation can be performed using a conventional open surgery, or as a laparoscopic or robot-assisted prostatectomy (this last option is a laparoscopic procedure using a robot).

• Conventional open prostatectomy

For an open surgery, the surgeon makes an incision of about 15-20 cm in order to remove the prostate. With this type of surgery, there may be blood loss and the recovery period is longer.

• Robot-assisted prostatectomy

A robot-assisted prostatectomy is performed in a minimally invasive approach: this means that the same ‘major' operation with long, fine instruments can be performed through very small incisions. On one hand, there is the advantage of receiving a radical surgical treatment and, on the other hand, there are the benefits associated with a minimally-invasive procedure (less blood loss, less pain, a shorter stay in the hospital and the ability to return to your daily activities more quickly).

Robot-assisted prostatectomies have been performed for many years (including within our department). Scientific testing of this technology confirm that a robot-assisted prostatectomy is just as effective as an open procedure, insofar as the completeness of the procedure is concerned (e.g. complete removal of the cancer). The recuperation of bladder control and strength are also quicker as compared to an open operation.

After the procedure: recovery

Prostate cancer patients worry about possible urinary incontinence and possible sexual function disorders. Data has been kept from many patients who had a radical prostatectomy in the past. In 85-90% of the patients, there is no issue with urinary incontinence. And, for patients who had normal erections before the procedure, 75% of these patients continue to have effective erections (e.g. suitable for sexual intercourse) after the operation. Pelvic floor exercises are routinely taught before the operation so that the patient can be continent as quickly as possible after the operation. Scientific studies also indicate that medication may be started right after the procedure in order to regain erectile function as quickly as possible.

Latest publication date: 13/12/2023
Supervising author: Dr Ameye Filip