Prostate Cancer Surgery

Surgery can be performed in some cases of prostate cancer. In general, your surgeon will perform surgery if the cancerous cells have not spread into other distant sites of your body; in this case, your surgeon will remove the tumor from your body by removing the prostate, totally or partially. If the tumor is very large, your surgeon may decide not to proceed with surgery to avoid very serious damages to your nervous system.   

Radical prostatectomy - also called radical retropubic prostatectomy, radical prostatectomy is a surgical procedure involving removal of the entire prostate gland and, sometimes, the seminal vesicles. In general, radical prostatectomy is performed under general spinal or epidural anesthesia. This surgical intervention cannot be performed if the cancer exceeds the limits of the prostate gland. A radical retropubic prostatectomy often requires blood transfusion.  

Some patients can have good results from radical retropubic prostatectomy; however, about 10% of patients with a localized prostate cancer will develop local recurrence within 5 years following the surgery. In addition, radical retropubic prostatectomy tends to cause complications such as urinary incontinence and impotence.  

Transurethral resection of the prostate (TURP) - this procedure is usually performed in cases of benign prostatic hyperplasia. In the treatment of prostate cancer, it is used as a palliative treatment for urinary problems due to obstruction of the urinary tract caused by the disease. The operation can bring an improvement; however, it should be associated with an appropriate treatment to prevent recurrence of the obstruction.  

Laparoscopic Robotic Assisted Prostatectomy – also known as robotic prostatectomy, this is a new form of surgery performed with the assistance of a surgical robot. During the procedure, there is no direct contact with you and your surgeon. The surgeon sits in another place (room), but able to view and control the procedure using a camera with the binocular Insite vision system. According to U-M Health System group, the goal of the robotic prostatectomy is to:  

• excise the cancer completely; 
• provide good urinary continence post-operatively; 
• Maintain ability to have erections after the surgery (if present before the surgery).  

Enlarged Prostate Surgery

If you have an enlarged prostate, the following surgical procedures can be performed to treat it:

Transurethral Resection of the Prostate(TURP) - transurethral resection of the prostate gland is the most used surgical treatment in moderate to severe enlargement of the prostate gland. It is performed to provide relief with urine retention or bladder stones; it often provides lasting relief. TURP eliminates the blockage, allowing urine to flow more freely and the bladder to empty completely. During the procedure, your surgeon introduced through the urethra an instrument called resectoscope. The inside of the prostate that causes the obstruction is removed in small pieces, which are then evacuated from the bladder. The operation is done under anesthesia and can last up to 90 minutes.  

Total Prostatectomy - total prostatectomy is the complete removal of the prostate gland. It is indicated if the volume of the prostate is really big and the symptoms are accompanied with complications. This surgery is performed under routine anesthesia and consists in incising in the lower abdomen to remove adenomas of the prostate gland. It is effective in reducing the obstruction of the urethra and eliminating the symptoms; however, prostatectomy can cause infertility.  

Transurethral Incision of the Prostate or ITUP - ITUP is a new surgical method used to treated benign prostatic hyperplasia (BPH). It causes fewer side effects and gives good results. It is performed to widen the urethra by making a small incision at the neck of the bladder and prostate. This small operation improves emptying with less risk of complications, but its long-term effectiveness is still being studied. 

Holmium Laser Enucleation of the Prostate (HoLEP) - approved by the FDA in March 1996, HoLEP is an effective option to treat an obstructive prostate with few or no complications. During the procedure, a specialist uses a cytoscope to pass laser fiber through the urethra into the prostate. The laser energy destroys prostate abnormal tissues and causes it to shrink. This procedure, however, is not effective when the prostate gland is severely enlarged.