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Overview
The surgery used to treat prostate cancer is called a radical prostatectomy, performed by a urologist. It treats cancer through removal of the whole prostate, where the cancer is.
The urologist also removes the seminal vesicles (glands connected to the prostate) and some tissue in the area. They make an incision (cut) in the urethra to remove the prostate, then reconnect the bladder to the urethra.
Prostatectomy is an option for localised (Stage 1 and Stage 2) prostate cancer. Your specialist will discuss whether it is an option for you if you have Stage 3 (locally advanced) prostate cancer.
A prostatectomy is a major surgery under general anaesthetic. You can expect to spend two nights in hospital and recover at home for several weeks.
Prostatectomy types
There are two methods of doing this surgery:
- open prostatectomy where the surgeon makes one incision that is about 7.5cm to 10cm long.
- laparoscopic prostatectomy is a keyhole surgery where a surgeon makes small (5 to 10mm) incisions. They have vision through a mini camera inside the body. In a robot assisted laparoscopic prostatectomy, they precisely control the surgery using robotic arms.
At Epworth, patients can access surgery with our advanced da Vinci® robotic technology. We pioneered the first robotic assisted prostatectomy in Australia in 2003 and continue to excel in prostate surgery.
Choosing your surgeon
Research shows a direct link between successful outcomes and a surgeon experienced in prostatectomy. When choosing your surgeon, you can ask about their experience and whether they perform several prostatectomies a year.
Epworth is a private hospital group where you can choose your surgeon from a number of leading urologists based across Melbourne and Geelong.
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What are the side effects of prostatectomy?Side effects of prostatectomy may include the risk of erectile dysfunction, urinary incontinence, shorter penis length and complications associated with surgery. A prostatectomy results in infertility, meaning you cannot conceive a child afterwards. Your specialist can speak to you about fertility options.
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How do I prepare for prostatectomy?
Pre-surgery appointment
You will usually have an appointment with an Epworth specialist urology nurse before your surgery admission. They can answer any questions ahead of the surgery, and provide you with more information so you feel prepared.
Pelvic floor muscle exercises
You will be referred to a continence physiotherapist to teach you how to activate and exercise your pelvic floor (muscles that support the bladder and bowel). As the prostate is next to the bladder opening (sphincter), you may experience leaking of urine, called urinary incontinence, after surgery. Making your pelvic floor muscles stronger will help maintain continence after surgery.
Most patients regain good bladder control by three months, though this is individual and can take more time or require further treatment.
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What happens when I return home after prostatectomy?
Catheter care
You leave hospital with a catheter, a tube that drains urine, attached to your leg. Your team will take you through how to look after it and answer any questions.
The catheter needs to stay in to help the healing process. After about 7 to 10 days following prostatectomy, you will have an appointment with the urology nurse to remove it. You can then gently start your pelvic floor muscle exercises.
Follow-up appointments
Your appointments may include:
- catheter removal with your urology nurse
- post-operative check with your surgeon
- follow-up with your physiotherapist about one or two weeks after catheter removal.
Your team is there to listen to any concerns you may have and equip you with tools to help manage side effects.