Understanding prostate cancer is very challenging. Your doctor will integrate your medical history, your digital rectal exam and your PSA blood test to determine what treatment – if any – is required for your cancer.
If the cancer has not spread beyond the prostate gland, many curative treatment options exist. One option is radical prostatectomy – surgery to remove the entire prostate.
Traditionally, radical prostatectomy was performed via a large incision from the umbilicus (“belly button”) to the pubic bone.
With the advent of the da Vinci surgical system, the vast majority of patients who are considering prostatectomy can undergo a minimally invasive procedure which affords less pain, less scarring, less likelihood of blood transfusions and a more rapid discharge from the hospital.
The prostate is a walnut-sized gland that surrounds the urethra at the base of the urinary bladder. Its only function is to produce semen. Nearby however, are the urinary sphincter (the muscle which controls urine flow) and the cavernous nerves (which control a man’s ability to get an erection.)
Goals of Radical Prostatectomy
Cancer Removal – To remove the entire prostate gland, including the cancerous portion. Your doctor will recommend periodic PSA testing to confirm that the cancer has been completely removed. In certain cases, additional therapy (e.g., radiation therapy) may be recommended if there is a relapse, or a high likelihood of relapse.
Maintain Urinary Control – To preserve the urinary sphincter muscle during surgery. After surgery, you will wear a foley catheter (a tube which drains urine to a bag) for approximately 1 week. After this catheter is removed, you may have some difficulty controlling your urine. We recommend that you wear a protective pad or an absorbent undergarment for the first few weeks after surgery as you may have urinary leakage during the recovery process. Most patients regain urinary control within a few weeks after surgery if they utilize our rehabilitation protocol .
Maintain Erectile Function – To preserve the cavernous nerves that enable erections. A ‘nerve-sparing’ prostatectomy is appropriate for most patients who are sexually active, allowing them to regain the ability to get an erection. These delicate nerves run closely alongside the prostate. The prostate is carefully removed without injuring them. For the first few months after surgery, you may not be able to have sexual intercourse. We will recommend a rehabilitation protocol in order to speed up your recovery. There are many options for patients with erectile dysfunction , talk to your Premier Urology physician about them.
Achieving all these goals is known as a “trifecta” in the Urology community. At Premier Urology we strive to attain this goal with each patient. Please call and make an appointment to learn more.