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    • Prostatectomy

    Prostatectomy is a surgical procedure in which all or part of the prostate gland is removed. The prostate is a small gland (commonly compared in size and shape to a walnut) that is responsible for producing seminal fluid in the male reproductive system. When cancer arises in the prostate, a prostatectomy is performed to cure early-stage tumors that have not spread beyond the tissues of the prostate gland.

    Types of Prostatectomy

    A variety of surgical techniques exist to help surgeons tailor a prostatectomy to each patient and their cancer:

    RETROPUBIC PROSTATECTOMY

    Retropubic prostatectomy is the most popular surgery used to treat cancer of the prostate. In this procedure, a surgeon makes an incision from your belly button to your pubic bone. This operation allows surgeons to remove the entire prostate as well as surrounding tissues and lymph nodes if necessary. In many cases, if surrounding tissues contain cancer cells, the prostatectomy is discontinued. Such cases are deemed incurable.

    Duration: 2 to 3 hours

    PERINEAL PROSTATECTOMY

    In this procedure, a surgeon makes an incision in the perineum (the skin between the anus and the scrotum). The prostate and surrounding tissues can then be removed through the perineal incision. This surgery is a shorter operation than retropubic prostatectomy, but it may cause nerve damage. As a result, perineal prostatectomy is not a common treatment option for prostate cancer patients.

    Duration: 1 ½ to 4 hours

    TRANSURETHRAL PROSTATECTOMY

    In this procedure, a cytoscope (a long, flexible instrument) is inserted into the prostate gland via the urethra. A camera, light, and special tools are attached to the cytoscope, which allows a surgeon to excise cancerous prostate tissue. This surgery is minimally invasive, but nevertheless warrants several days of hospital recuperation.

    Duration: 30 to 60 minutes

    LAPAROSCOPIC RADICAL PROSTATECTOMY

    In this operation, a surgeon makes several small incisions through which long, flexible instruments are inserted to remove the prostate gland. This surgery results in less blood loss, pain, and shorter hospital recuperation periods than retropubic and perineal prostatectomy operations.

    Duration: 2 ½ to 4 hours

    Drawbacks include:

    • Longer surgery
    • Difficult surgical technique to master
    • Because of the small incisions, surgeons cannot use the sense of touch during the operation.

    Prostatectomy Side Effects

    Prostatectomy is associated with a variety of risk factors and side effects, most of which are common to all surgeries. Risk factors unique to prostatectomy include:

    • Impotence: Prostatectomy may result in the temporal or permanent inability to have an erection.
    • Stress Incontinence: Approximately 15% of prostatectomy recipients report stress incontinence (difficulty holding urine). In such cases, urine may leak when the patient laughs, coughs, sneezes, or exercises.
    • Overflow Incontinence: This side effect causes men to have a dribbling urine stream.
    • Urge Incontinence: This side effect causes men to have sudden urges to urinate.
    • Sterility: Prostatectomy severs the connection between the testicles and the urethra. As a result, prostatectomy patients can no longer secrete the sperm and semen needed to fertilize an egg in a woman’s uterus.

    Side effects common to all surgeries:

    • Infection at the Site of Incision
    • Fatigue
    • Nausea and Vomiting
    • Blood Clots in the Legs

    References

    • American Cancer Society. 2009. Retrieved on April 20, 2009 from.
    • The HealthCentral Network, Inc Family of Sites. 2004-2009. Retrieved on April 20, 2009 from.
    • Galil Medical Family of Sites. 2006. Retrieved on April 20, 2009 from < http://www.prostate-cancer-institute.org/prostate-cancer-treatment/radical-prostatectomy.html>