The radical prostatectomy is a surgery that represents one of the main treatments for prostate cancer. Learn more before making this important decision
Radical prostatectomy is a surgical intervention that involves removing the prostate and, in some cases, nearby structures, aiming to eliminate the prostate tumor. Although effective, the surgery can be intimidating for men due to the possibility of erectile dysfunction and urinary incontinence.
This treatment for prostate cancer is highly significant for men’s health, and thanks to different surgical approaches, many patients can reduce postoperative impacts and improve their quality of life.
Continue reading to learn everything about this surgery!
What is radical prostatectomy?
Radical prostatectomy is a surgery that involves the removal of the prostate and, depending on the case, the seminal vesicles and nearby lymph nodes. It is mainly indicated for patients diagnosed with localized prostate cancer—that is, when the tumor has not spread to other organs.
This surgical procedure aims primarily to remove the prostate tumor, significantly reducing the chances of cancer recurrence.
The surgery is only indicated after the disease diagnosis, usually identified through a digital rectal exam, PSA (prostate-specific antigen), and prostate biopsy.
Types of radical prostatectomy and when they are indicated
There are different types of prostatectomy, each with specific characteristics. The choice of the most suitable technique depends on factors such as the stage of cancer, age, overall health, and the surgeon’s experience.
- Open radical prostatectomy: Performed through an incision in the abdomen, it allows the surgeon direct access to the prostate. Although more invasive, it is effective in complex cases requiring a broad view of the affected area.
- Robotic-assisted radical prostatectomy: Uses advanced technology to perform precise movements with instruments controlled by a surgeon. This technique minimizes the risk of damage to the nerves responsible for erection and urinary control, helping the patient recover faster.
- Laparoscopic: Performed through small incisions with the aid of a camera, this approach is less invasive and generally results in less pain and quicker recovery.
Preoperative preparation
Preparation for prostate cancer surgery includes a series of medical evaluations. In addition to diagnostic tests, men should undergo imaging tests like CT scans and MRIs.
In some cases, adjustments in medications and diet are necessary to reduce risks during the procedure. Emotional preparation is also essential, as the surgery can significantly affect self-esteem and masculinity perception.
During this period, communication with the medical team is crucial to clarify doubts about risks, complications, and postoperative expectations.
How the surgery is performed
Radical prostatectomy is performed under general anesthesia. In the open technique, an abdominal incision is made for direct access to the prostate. In laparoscopic and robotic-assisted prostatectomy, small incisions are made to insert surgical instruments.
During the procedure, the surgeon carefully removes the prostate. Special care is taken to avoid damaging nerves and muscles responsible for bladder control and erection, to prevent complications.
Postoperative recovery
Postoperative recovery varies depending on the technique used.
In general, patients remain hospitalized for two to five days, with those undergoing open surgery requiring more observation time.
At home, it is mandatory to follow instructions such as avoiding strenuous physical efforts and properly using a urinary catheter, as well as attending regular medical appointments.
Full recovery can take several weeks or months, depending on the technique and the patient’s overall health. However, monitoring for potential complications and adjusting care is essential.
Risks and complications of radical prostatectomy
The complications of prostatectomy can be managed with appropriate follow-up from the early postoperative period. They include:
- Urinary incontinence
- Erectile dysfunction
- Infections
- Bleeding
- Internal scar formation
Why can men experience impotence?
Erectile dysfunction after surgery can occur due to damage to the nerves responsible for the erection mechanism.
Today, techniques aim to preserve these nerves whenever possible, but many men still face difficulties achieving or maintaining an erection post-surgery.
For patients in this situation, it is crucial to know they can regain a satisfying sexual life through a penile prosthesis surgery. Treatments like medications or injections are often ineffective for this type of complication, as the nerve damage is irreversible.
Post-prostatectomy rehabilitation
Rehabilitation after radical prostatectomy in the initial days requires rest. Patients should avoid heavy lifting, driving, or intense physical activities. Gradually, they will be able to return to their normal routine, including work. Recovery times vary, but most patients are cleared for activities after a few weeks, following medical advice.
Rehabilitation may also include pelvic floor muscle physiotherapy to reduce urinary incontinence risks.
Men experiencing erectile difficulties should seek specialized treatment. Psychological support can also help rebuild the confidence needed for a fulfilling sexual life.
Prognosis
The survival rate for prostate cancer patients can be high, especially when diagnosed and treated early. When cancer is detected early and controlled with radical prostatectomy, the chances of a longer and healthier life are significantly improved.
Lifelong medical follow-up after cancer treatment is crucial for maintaining health.
Take care of your health with Dr. Paulo Egydio
Radical prostatectomy is one of the available options for prostate cancer treatment and may be indicated depending on the case. To minimize risks like erectile dysfunction, contact Dr. Paulo Egydio and achieve full sexual health.
