Prostate Cancer Surgery

In general, there are three types of surgery that can be performed as prostate cancer treatment. The type of surgery that would be recommended depends on the stage of cancer the surgeons are dealing with and the location of the cancer.

Prostate cancer surgery is performed only when there is likelihood that the cancer is treatable. If the cancer is too far advanced, more than likely surgery will not be an option. Surgery options are usually limited to prostate cancer at Stages I, II, and III.

Standard Non-Nerve Sparing Surgery
In this type of prostate cancer surgery, the surgeon cuts widely around the prostate. In this surgery, a wide cut is made to make sure that the cancer is removed and that there is nothing left behind. Nerves are cut and removed with the rest of the portion, giving the chance that the cancer will be completely removed from the patient.

Standard Nerve Sparing Surgery
In this type of prostate cancer surgery, the nerves are spared. The surgeon cuts close to the edge of the prostate and removes only that portion, leaving the nerves intact. This is an attempt to preserve the natural potency of the semen. Even if this type of surgery is performed, the potency may still decrease.


Radical Prostatectomy
This prostate cancer surgery is a better option than radiation for patients who have a Gleason score of 8.9.or 10. It is used to help treat prostate cancer in Stages I, II, and III. At the surgeon's discretion, the incision can be made in the perineal area, between the scrotum and the rectum, or in the lower abdominal region. A small number of surgeons can perform a laparoscopic surgery through a surgical robot.

In this surgery, the entire prostate and the seminal vesicles will be removed. The surgery will also consist of reconnecting the urethra to the bladder so that the patient will be able to void normally after the procedure is done. This operation does take three to four hours and will require a four- to five-day hospital stay for recovery. The laparoscopic surgery takes a considerably longer time; however, the hospital stay is reduced quite a bit. With this surgery, the cancer will be removed completely; however, it can leave the patient impotent (with no ability to gain or maintain an erection).

Complications
Complications include but are not limited to:
• Impotence. The loss of the ability to get or maintain an erection
• Incontinence
• Inability to control urine after surgery (either temporary or permanent)
• Loss of ejaculation
• Loss of fertility
• Other complications that are related to any form of surgery

After surgery you will be required to follow up many times with your physician. This is to ensure that there are no problems, to assist you with the problems that you may have, and to make sure that the cancer has not spread or returned in another location.

If you have any questions about prostate cancer surgery, it is best that you ask your physician prior to the surgery so that you know what to expect before, during, and after the procedure.

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