Prostatectomy

If you’ve been diagnosed with prostate cancer, getting a prostatectomy may be part of your prostate cancer treatment plan. At Aurora, we offer different types of prostatectomy surgery, or the procedure to remove your prostate gland.

What are the types of prostatectomy procedures?

Open prostatectomy

Open surgery is the traditional technique of surgeons using instruments such as scalpels to make incisions. During an open radical prostatectomy, your surgeon will make an incision in either your lower abdomen (retropubic) or in the skin between your anus and scrotum (perineal). Then, your prostate gland and surrounding tissues are removed.

Laparoscopic prostatectomy

Laparoscopic surgery employs tiny surgical instruments inserted through small incisions. A thin tube containing a video camera is inserted in one of the incisions so your surgeon can see inside your abdomen. When used for prostatectomy, the advantages of minimally invasive laparoscopic surgery are less blood loss and pain, shorter hospital stays and faster recovery times.

Robotic prostatectomy

Robotic-assisted surgery uses the laparoscopic technique with the help of robotic arms controlled by the surgeon. This allows for more precise movements and maneuverability and also results in less blood loss and pain, shorter hospital stays and faster recovery times. At Aurora, our surgeons use the state-of-the-art da Vinci® Surgical System.

To help shorten the length of your surgery and contribute to a more successful recovery process, many surgeons prefer conducting prostatectomy procedures laparoscopically or robotically.

Prostatectomy risks

Having a prostatectomy carries some risks that are common for many surgeries such as infection, blood clots and the risk of undergoing anesthesia. Prostatectomy risks may also include:

• Urinary incontinence, or the uncontrollable leaking of urine
• Impotence (erectile dysfunction), or the inability to maintain an erection
• Loss of fertility due to removal of the seminal vesicles
• Change in orgasm (dry orgasm) due to removal of the seminal vesicles
• Change in penis length due to a shortened urethra after surgery
• Lymphedema, or the painful accumulation of fluid in soft tissue

What should I expect when getting a prostatectomy?

Though the thought of getting a prostatectomy may make you nervous, this surgery is fairly common – around 90,000 prostatectomy surgeries are conducted in the U.S. every year. Learn about what you can expect before and after this procedure.

Before your prostatectomy

Similar to any procedure, you’ll receive anesthesia – either general anesthesia so you’re asleep and don’t feel pain, or sedation with spinal or epidural anesthesia, which numbs the lower half of your body. The prostatectomy typically takes between two and four hours.

After your prostatectomy

The catheter that was inserted into your bladder to drain urine will remain in place for a few days to a few weeks. If you had a drain inserted to help remove extra fluid near the surgical site, this will be removed within a few days. Most people stay in the hospital for one to four days. People who have laparoscopic or robotic prostatectomy often return home the day after surgery.

Post-prostatectomy care

Your care team will encourage you to begin walking around the day after surgery to promote blood flow to the area. This also helps prevent blood clots and other complications. Once you’re released from the hospital, you’ll be advised to follow postsurgical instructions and recovery tips, which may include:

• Having a friend or family member drive you home
• Having a friend or family member available to take care of you for a few days
• Taking any prescribed medications, such as pain medications, antibiotics or stool softeners
• Keeping the surgical site clean and dry
• Avoiding heavy activity such as strenuous exercise to allow the incision(s) to heal

Life after your prostatectomy

Most people find their bladder function gradually returns to normal after a few weeks or months. If incontinence continues to be an issue months after surgery, talk with your doctor about treatment options.

Impotence, or erectile dysfunction, is a common issue after prostatectomy due to nerve damage. Penile function may gradually improve, though you might find it takes up to two years to feel fully recovered. Even without an erection, you may still be able to have an orgasm without loss of sensation.

After your prostatectomy, your care team will monitor your condition with regular checkups. Depending on your original diagnosis, your care team may also recommend additional therapies to prevent your cancer from recurring or spreading further. These options could include chemotherapy, radiation or hormone therapy.