The radical prostatectomy is a surgical procedure which removes the entire prostate. This type of surgery is a curative treatment aimed at eradicating the disease by removing the root of the problem – in this case, the prostate. To improve the chance of success, a margin of tissue surrounding the diseased prostate and seminal vesicles are also removed to ensure all of the cancer has been removed. If cancer is left behind, the cancer may not be cured.
There are three main ways of performing a radical prostatectomy, each with its own advantages and disadvantages. Men should discuss the options for radical prostatectomy with their doctors.
- Radical retropubic prostatectomy: The surgeon removes the entire prostate and nearby lymph nodes through an incision in the abdomen.
- Nerve-sparing radical prostatectomy: The surgeon uses the retropubic approach but makes an effort to preserve the nerves and structures responsible for erection. This is only an option for men whose cancer has not spread to the nerves or their neighboring blood vessels.
- Radical perineal prostatectomy: The surgeon removes the entire prostate through a small incision between the scrotum and the anus. Nearby lymph nodes may be removed through a separate incision in the abdomen if needed.
- Laparoscopic prostatectomy: The surgeon removes the entire prostate and nearby lymph nodes through small incisions, rather than a single long cut in the abdomen. A laparoscope, a small camera on the end of a tube, is used for this surgery.