Prostate Cancer Surgery – What to Know before You Start the Treatment


What is Prostate?


Prostate is a gland situated under the bladder, in front of the rectum. This gland plays a crucial role in the male reproductive system that produces sperm carrying fluids.


Surgery for removal (partial or complete) of the prostate is referred to as prostatectomy. Doctors suggest his surgery for treating the following:

  • Prostate cancer
  • Enlarged prostate
  • Benign prostatic hyperplasia (BPH)

When it comes to the effective treatment of prostate cancer, you must focus on pretreatment learning as the first step to making a decision about treatment.

Prostate surgery of all types can be done with general anesthesia. It puts the patient to sleep. Sometimes, doctors may also give spinal anesthesia, which numbs the lower half of a patient’s body.

Anesthesia type will be recommended by the doctor based on the patient’s situation.

Prostate Surgery Aims at:

  • Curing the condition
  • Maintaining urinary continence
  • Maintaining erection ability
  • Reduce side effects
  • Reduce pain before, during, and after surgery

Types of Prostate Surgery

The primary aim of prostate surgery, also depends on the patient’s condition. In some cases, prostate cancer surgery aims at removing the cancerous tissue. BPH surgery removes prostate tissue and helps with the restoration of the normal urine flow.

Open Prostatectomy

Also the traditional open approach or surgery for prostate cancer, the most experienced prostate surgeons still prefer this approach for treating patients. The procedure involves creating an incision through the patient’s skin for removing the prostate and surrounding tissues.

It has two primary approaches:

Radical Retropubic – The surgeon will create a cut from the belly button to the pubic bone. Only prostate is removed in some cases. However, if the spreading of cancer is suspected, some lymph nodes may also be removed for testing. The surgery may not be undertaken if the cancer is spreading.

Radical Perineal Approach – The surgeon will create a cut in the space between scrotum and rectum. The process is undertaken only when the patient suffers from other medical conditions that may complicate retropubic surgery. This procedure takes less time as compared to retropubic surgery. However, it may create a higher risk for erectile dysfunction.

The patient needs to be under the effect of general anesthesia, spinal or epidural anesthesia for both procedures.

Laparoscopic Approach

It is a minimally invasive approach to surgery for prostate cancer. It is categorized into two primary approaches:

Laparoscopic Radical Prostatectomy – The procedure demands multiple small cuts to help surgeon insert very small surgical instruments. A thin tube will be used with a camera to get a clearer view into the region.

Robotic-Assisted Laparoscopic Radical Prostatectomy – Certain types of surgeries demand robotic interface. The surgeon directs a robotic arm from the surgery room while looking at a computer monitor. This arm ensures more maneuverability and precision as compared to other procedures.

Benefits of Laparoscopic Radical Prostatectomy and Robotic-Assisted Laparoscopic Radical Prostatectomy:

  • Less pain
  • Reduced blood loss
  • Shorter stay in hospital
  • Faster recovery time
  • Faster recovery in continence

Prostate Laser Surgery

It mainly treats BPH sans creating any cuts outside of the body. The doctor will insert a fiber-optic scope using the tip of the penis and into the urethra. Thereafter, prostate tissue that blocks urine flow is removed. In most cases, laser surgery is not found effective.

Endoscopic surgery

This surgery also does not require any incisions. The doctor will use a long, flexible tube combined with a lens and light to remove prostate gland parts. The tube goes through the penis tip. This is a less invasive procedure.

Widening of Urethra

TURP (Transurethral Resection of the Prostate) BPH – It is the standard procedure for BPH. The enlarged pieces of prostate tissue are cut into small pieces by a urologist using a wire loop. The pieces will move into the bladder. These work towards flushing out at the end of the process.

TUIP (Transurethral Incision of the Prostate) – The surgical procedure comprises of some tiny cuts in the bladder neck and prostate with a goal to widen the urethra. Urologists prefer TUIP as it is known to have a lower side effects risk as compared to TURP.


The surgeon will place a catheter into the patient’s penis before he wakes up. This will help in draining bladder. This catheter stays in place for around 2 weeks. The patient stays in the hospital for a few days. Usually, most patients are discharged after 24 hours. The doctor will provide instructions to patient on handling catheter and caring the surgical site. The catheter will be removed by a healthcare worker when it’s time. This will help the patient urinate on his own.