Receiving a prostate cancer diagnosis is a daunting prospect for many men that only becomes more worrying when you're facing surgery. Most men who require an operation undergo a radical prostatectomy, which involves removing the prostate and some of the surrounding organs and lymph nodes to reduce the risk of the cancer spreading to other areas. By learning more about the different types of procedures in advance, the process may become less worrying.
The retropubic approach
Making a small incision in your lower abdomen, your surgeon will gain access to your prostate and remove it and potentially the seminal vesicles that are responsible for producing semen and any nearby lymph nodes that show signs of lymphatic spread. This type of approach sometimes gives you the option of choosing between an epidural that numbs the lower half of your body but leaves you conscious, or a general anaesthetic. In the days that follow, your surgical team will send the lymph nodes they remove to a lab to test for cancerous cells, which will then determine any another treatment you undergo. You'll likely remain in hospital for a few days afterwards.
The perineal approach
Although the perineal approach to removing your prostate is often as effective as the retropubic, it does increase the risk of erectile dysfunction and isn't suitable for removing lymph nodes. However, as the procedure and the recovery time are quicker, you may want to discuss the benefits of choosing perineal prostate cancer surgery with your medical team. Your surgeon will make an incision close to your anus, which will allow them to gain faster access to the prostate.
Laparoscopic and robotic surgeries
Although open incisions remain as the gold standard for prostate cancer surgery, some surgeons possess the skills needed to take a laparoscopic approach. Laparoscopic surgery involves smaller incisions, which means you spend less time in hospital and the recovery is easier. Robotic surgery is similar, allowing you to benefit from a less painful post-operative period.
However, as there are no studies examining the long-term benefits of choosing laparoscopic techniques, it's difficult to say whether the overall prognosis is just as good as more traditional approaches. In addition, post-operative side effects such as erectile dysfunction and catheter use are just as common, which means the only overall benefits are a faster and easier recovery time.
Now that you have a better idea of what prostate cancer surgery involves, you may wish to discuss the merits of each option with a medical professional who is familiar with your case. Together you can arrive at an option that's ideal for your lifestyle and medical condition.