Surgery

The two most common prostate operations are radical prostatectomy and transurethral resection of the prostate.

Radical prostatectomy
 

This procedure removes the entire prostate gland plus some tissue around it. Radical prostatectomy is used most often if the cancer is thought not to have spread outside of the gland. The patient is generally put under general anesthesia or under spinal or epidural anesthesia during the surgery.

There are two main types of radical prostatectomy radical retro pubic prostatectomy and radical perinea prostatectomy. In the retro pubic operation, the surgeon makes a skin incision in the lower abdomen. The surgeon can remove lymph nodes during this operation through the same incision.

Radical Retro Public Prostatectomy

A nerve-sparing radical retro pubic prostatectomy is a modification of this operation. During this procedure, the surgeon carefully fells the small bundles of nerves on either side of the prostate gland. If the cancer has not spread to these nerves, the surgeon will not remove them. Because these are the nerves that are needed for erections, leaving them intact lowers the risk of impotence following surgery.

Radical Perinea Prostatectomy

The radical perinea prostatectomy removes the prostate through an incision in the skin between the scrotum and anus.

These operations last from one to four hours. This is followed by an average hospital stay of three days and average time away from work of three to five weeks. In most cases, you will be able to donate your own blood before surgery. This blood can be given back to you during the operation, if needed.

For most patients, a catheter is  inserted through the penis and into the bladder after surgery   while the patient is still asleep. The catheter stays in place      for 10 to 21 days and allows you to urinate easily while you are healing. You will be able to urinate on your own after the catheter is removed.

Tran urethral resection of the prostate

This operation removes part of the  prostate gland that surrounds the urethra. It is most often   used to treat men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia. The procedure is also used for men with prostate cancer who cannot have a  radical prostatectomy because of advanced age or a serious illness in addition to their prostate cancer. It can be used to relieve symptoms caused by a cancer before other treatments begin. But it is not expected to cure this disease or remove all of the cancer.

A tool with a small loop of wire on the end is placed inside the prostate through the urethra.  Electricity is passed through the wire to heat it and cut the tissue. Either spinal anesthesia or general anesthesia is used. The operation usually takes about one hour.

A catheter is inserted through the penis into the bladder after surgery. It remains in place for two or three days to help urine drain while the prostate heals. You can usually leave the hospital after one to two days and return to work in a week or two. There may be some bleeding into the urine after surgery anesthesia used.

Cryosurgery

Cryosurgery, also called cryotherapy or cryoablation, is used to treat localized prostate cancer by freezing its cells with a metal probe. Warm saline water is circulated through a catheter in the urethra to keep it from  freezing. The probe is placed through a skin incision located between the anus and scrotum, and guided into the cancer using transrectal ultrasound. The appearance of prostate tissue in  ultrasound images changes when it is frozen. Spinal or epidural anesthesia is used during the procedure.

The catheter is removed on to two weeks later. After the procedure, there will be some bruising and soreness of the area where the probe was inserted. Men usually remain in the hospital for one or two days.

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