Surgery for Prostate Cancer
At Scott & White, the majority of prostatectomies are performed with minimally invasive techniques. Benefits of minimally invasive surgery include:
- Better cosmetic result
- Quicker recovery times, allowing you to:
- Return to your daily routine sooner
- Begin future treatment sooner
- Shorter hospital stay
- Less pain
- Less blood loss
- Lower risk of infection
- Fewer complications
Not all patients are candidates for a minimally invasive approach. Factors affecting the decision to use minimally invasive techniques include:
- Tumor size, stage or location
- Patient obesity and health
- Prior surgeries
- Your personal preference
Your Integrated Care Team may recommend the surgical removal of your prostate. Your team may recommend other treatments in addition to surgery.
We use minimally invasive techniques whenever possible and appropriate, based on your condition.
Surgery is often the first treatment approach for prostate cancer.
Robotic surgery is a surgical tool that allows us to do more complex surgery through smaller incisions. It has some clear benefits, like reduced pain recovery time, bleeding and blood transfusions, for example. It’s a fantastic tool.
Radical prostatectomy is the surgical removal of your prostate and surrounding tissues. In some cases, your surgeon may remove adjacent pelvic lymph nodes to check for the presence of malignancy.
Our fellowship-trained urologic surgical oncologists perform three kinds of operations to remove your prostate:
- Robot-assisted laparoscopic prostatectomy
- Traditional laparoscopic prostatectomy
- Conventional open surgery
Your physician will discuss which option is best for you.
Robot-Assisted Laparoscopic Prostatectomy
A robot-assisted prostatectomy is minimally invasive and nerve sparing.
Our expert urologic surgical oncologists employ the daVinci® robotic surgery equipment. Advantages of the robotic surgical equipment are:
- “Wristed,” or having the ability to move inside your body with seven degrees of freedom (standard laparoscopic instruments move with only four degrees of freedom)
- Can replicate any movement of your surgeon’s hand in all directions
- Allows your surgeon to view inside your pelvic area with up to 10x magnification
- Increased maneuverability makes it easier for your surgeon to successfully perform this “nerve-sparing” operation
You have delicate nerves and blood vessels located on the left and right sides of your prostate near your rectum. These nerves and blood vessels:
- Play a key role in the complex physiology of erections
- Can be separated from the prostate and “spared” in most cases of clinically localized prostate cancer
The meticulous precision of robot-assisted surgery provides the best opportunity to recover sexual function after prostatectomy.
Most patients with clinically localized prostate cancer are candidates for robot-assisted surgery. In some cases, severely overweight patients may not qualify. Some patients who have undergone previous abdominal or pelvic surgery may not be candidates for robot-assisted surgery.
Your surgeon will discuss whether robot-assisted laparoscopic surgery is a good option for you.
Traditional Laparoscopic Prostatectomy
In this minimally invasive surgical procedure, your urologic surgical oncologist will make several small incisions in your abdomen or perineum and remove your prostate and some surrounding tissue.
The traditional laparoscopic approach offers a quicker recovery and more favorable cosmetic result than a conventional open surgical approach.
Conventional Open Surgery
In some cases, minimally invasive operations are not an option and your surgeon may determine that conventional open surgery is the best choice for you.
As with all operations, there are some risks. Your surgeon will discuss these risks with you.
What You Can Expect After Your Prostatectomy for Prostate Cancer
At Scott & White, following your surgery for prostate cancer:
- A prostate specimen will be sent to the lab for evaluation.
- A week or so later, your physician will discuss the pathology results with you.
- The report will detail the size and extent of your prostate cancer.
- Your physician will provide information regarding prognosis.
Indicators of “Cure”
The most important indicator of “cure” is your first PSA (blood test), obtained around three months after surgery.
- A desirable PSA is 0 after removal of a cancerous prostate.
- Any detectable or measurable PSA may mean that cancer is still present or has returned.
- Following treatment, you’ll have PSA screenings every four to six months for the remainder of your life.
- Your physician may recommend a biopsy at one year and another every other year unless there’s a change in your PSA.
Monitoring your PSA closely allows your physician to watch for recurrence or spread (metastasis) of your prostate cancer.
Side Effects of Prostatectomy
- Stress urinary incontinence, or involuntary loss of urine that occurs with:
- Heavy lifting
- Other physical activity
- Impotence, or the inability to develop or maintain an erection
Most men will experience some stress incontinence after prostatectomy and find significant improvement within weeks. More than 90 percent of men are dry or socially continent at one year.
Most men experience impotence immediately after prostatectomy. This function may take several months and up to a year to return. Talk to your physician about our penile rehabilitation program to help recover erectile function.