What is Prostatectomy?
Prostatectomy is a surgical procedure that involves partial or complete removal of the prostate gland. The procedure may be required to treat benign prostate hyperplasia or remove prostate cancer. It may be performed by an open surgery or laproscopy. After the removal of the prostate, a pathologist tries to determine the extent of cancer.
The surgeon makes thin incisions into the body and then inserts a thin tube attached to a video camera inside one of the cuts to get a vivid picture of the part being operated upon.
An incision is made either in the perineum or in the lower belly. When the surgeon makes an incision in the lower belly, they may also remove lymph nodes to test for cancer signs. Inspecting the lymph nodes is a crucial part of the procedure that helps the surgeon detect if the cancer has spread beyond the prostate. This type of prostatectomy procedure follows the retropubic approach and may be done if the cancer has spread to other parts.
When the surgeon makes an incision in the perineum, it is known as the perineal approach. In this case, the surgeon must make a separate incision to remove lymph nodes.
You may consider surgery to remove the prostate gland if:
- Localized prostate cancer that is still in the early stage
- Your PSA level continues to rise despite initial treatment
- There is an advanced tumor
The prostate is a small gland situated in the lower abdomen just below the bladder. It surrounds the neck of the bladder and urethra
The surgeon removes the prostate using a robotic device to make small incisions in the lower abdomen. During the procedure, the surgeon sits at a console and uses the instruments connected to a robot or mechanical device.
Urologists often recommend open simple prostatectomy for men with very large prostate and severe urinary symptoms. The procedure does not remove the entire prostate but only the obstructive part that is blocking the urine flow.
If the urologists find signs of cancer spreading beyond the prostate, they may discontinue the surgery, which won’t treat the cancer completely and additional treatments may be required.
Nerve-Sparing Prostatectomy Approach
In some men, the cancer may be tangled with the nerves. The surgeon may cut the nerves to remove the cancerous tissue. A man will not be able to have an erection if both sides of the nerves are removed. If only one side of the nerves is cut, there are chances of less erectile function. The function of the erectile tissue may remain normal if neither of the nerve bundles is disturbed during surgery.
Radical prostatectomy is advised for patients who
- Are in good health
- Have cancer localized to the prostate
- Have cancer not spread beyond prostate
- Is expected to have a life expectancy for more than 10 years
The doctor may perform a number of tests before the surgery to determine the extent of cancer.