Laparoscopic radical prostatectomy

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Radical prostatectomy means removing the entire prostate gland. Laparoscopic refers to the surgical approach by which this is performed – through 5 tiny keyhole incisions in the lower abdomen. Keyhole surgery for prostate cancer is now replacing open surgery. The advantages of keyhole surgery include less blood loss, less pain after the operation and a quicker return to normal day to day activities. The only disadvantages are that it takes longer to perform, and is more technically demanding.

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The operation also removes the seminal vesicles. We make every attempt to preserve the nerves that run next to the prostate which help to produce erections (the cavernosal nerves). However, these may have to be sacrificed in order to remove all the prostate cancer. We may also elect to remove the lymph glands draining the prostate – We will discuss this with you before the operation. 

What are the benefits of having a radical prostatectomy?

If left alone prostate cancer can grow and invade surrounding structures e.g. bowel and bladder, or even spread to other parts of the body e.g. lymph glands and bones. The operation aims to remove all of the cancer. We believe that this form of treatment can offer the best chance of cure for many patients. 

What are the risks of having a radical prostatectomy?

As a sub-specialists in prostate cancer, we perform a lot of these operations (approximately 50/year/surgeon). Most operations are straightforward; however as with any major surgical procedure there is a chance of side effects or complications.

Frequently occuring problems:

  • Temporary insertion of a bladder catheter and a wound drain
  • Impotence if nerves cannot be preserved
  • Dry orgasm with no seminal fluid produced causing infertility

Occasional:

  • Urinary incontinence, temporary or permanent, requiring pads or further surgery
  • Discovery that cancer cells already outside the prostate, needing observation or
  • further treatment including radiotherapy or hormonal therapy
  • Conversion to an open procedure, as removal of the prostate not possible via keyholeroute

Rare:

  • Blood loss requiring transfusion or repeat surgery
  • Anaesthetic or heart problems possibly requiring intensive care admission (including chest infection, pulmonary embolus, stroke, deep vein thrombosis, heart attack and death)
  • Rectal injury, very rarely needing temporary colostomy

It is important to discuss with us exactly what is going to happen during the operation. If you are concerned about any of these risks, or have further queries, please speak with us directly about them.
 

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