Prostate Cancer: Surgery Health Article

Radical (total) prostatectomy is surgery to remove the entire prostate. It may be done if diagnostic tests show that the cancer is confined to the prostate. Your surgeon will give you detailed instructions on preparing for surgery. After surgery, you’ll be told how to care for yourself at home as you recover. Be sure to ask any questions you have about the procedure and recovery.

Before Surgery

Don’t eat or drink after midnight the night before surgery.

You may be given a laxative or have an enema one day before surgery.

How Surgery Is Performed

• Surgery may be performed through an incision in the abdomen (retropubic approach) or behind the scrotum (perineal approach). Or surgery may be done laparoscopically, with surgical tools inserted through tiny incisions in the abdomen.

• The urologist may remove and check the lymph nodes near the prostate to see if cancer has spread. (If the cancer has spread, the urologist may decide not to remove the prostate.)

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  The prostate, the seminal vesicles, and a portion of urethra will then be removed.

• Nerve-sparing techniques may be used to help preserve erectile function (the ability to achieve and maintain an erection).

After Surgery

• Urine will drain through the catheter into a sterile bag. The urine may be bloody or cloudy at first.

• You may return home in 1-3 days.

• Medications to control pain will be prescribed.

• The catheter will be left in place when you go home. You’ll be given instructions on how to manage it.

• The catheter and stitches will be removed at a follow-up visit. This is often 1-2 weeks after surgery.

• Bladder control often takes a few weeks to several months to return. Improvement can continue for up to a year.