Surgery

Surgery for prostate cancer is usually recommended only after thorough evaluation and discussion of all treatment options. Generally, surgery is only considered for patients in good general health whose tumor is in the prostate gland only. A man considering surgery should be aware of the benefits and risks of the procedure.

Possible problems that can occur after prostate cancer include:

  • Impotence
  • Leakage of urine from the bladder or stool from the rectum
  • Shortening of the penis by one to two centimeters -- the exact reason for this is not known
  • Inguinal hernia, which is a bulging of fat or part of the small intestine through weak muscles into the groin

Radical Prostatectomy
The surgical procedure used most often to treat early stages of prostate cancer is known as radical prostatectomy. The goal of this procedure is to remove the entire prostate gland and seminal vesicles while preserving nearby structures, such as the nerves that control urination and sexual function. However, it may not be possible to spare the nerves in men with large tumors or tumors that are very close to the nerves. There are two types of radical prostatectomy:

  • Robotically-assisted laparoscopic radical prostatectomy: The prostate is removed in a procedure using several small incisions in the abdominal wall. Removal of lymph nodes can be done at the same time.
  • Retropubic prostatectomy: The prostate is removed through one larger incision in the lower abdominal wall. Removal of nearby lymph nodes may be done at the same time.

Pelvic Lymphadenectomy
This surgical procedure is done to remove the lymph nodes in the pelvis.

Transurethral Resection of the Prostate (TURP)
During this procedure, the provider passes an instrument called a resectoscope through the urethra to the prostate in order to remove tissue from the prostate. This procedure is most commonly used to treat benign prostatic hyperplasia, or BPH, but it may be considered to relieve symptoms caused by a tumor before other cancer treatment is given. TURP may also be done in men whose tumor is in the prostate only and who cannot have a radical prostatectomy.