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Radical prostatectomy

Contents of this page:

Alternative Names   

Prostatectomy - radical; Radical retropubic prostatectomy; Radical perineal prostatectomy; Laparoscopic radical prostatectomy; LRP; Robotic-assisted laparoscopic prostatectomy; RALP; Pelvic lymphadenectomy

Definition    Return to top

Radical prostatectomy is surgery to remove all of the prostate gland and some of the tissue around it, to treat prostate cancer.

See also: Prostate resection - minimally invasive

Description    Return to top

There are four main types of radical prostatectomy surgery. These procedures take about 3 to 4 hours:

For these procedures, you will be asleep (under general anesthesia) or receive medicine to numb the lower half of your body (spinal or epidural anesthesia).

Why the Procedure is Performed    Return to top

Radical prostatectomy is most often done when the cancer has not spread beyond the prostate gland. Healthy men who will probably live 10 or more years often have this procedure.

Other treatment options for prostate cancer are:

Sometimes, your doctor may recommend one treatment for you because of what is known about your type of cancer and your risk factors. Other times, your doctor will talk with you about two or more treatments that could be good for your cancer.

Risks    Return to top

Risks for any surgery are:

Risks of this procedure are:

Before the Procedure    Return to top

You will have many visits with your doctor and tests before your surgery:

If you smoke, you should stop several weeks before the surgery. Your doctor or nurse can help.

Always tell your doctor or nurse what drugs, vitamins, and other supplements you are taking, even ones you bought without a prescription.

During the weeks before your surgery:

On the day of your surgery:

Prepare your home for when you come home after the surgery.

After the Procedure    Return to top

You may stay in the hospital for about 1 to 4 days. After laparoscopic or robotic surgery, you may go home the day after surgery.

You may need to stay in bed until the morning after surgery. Afterwards, you will be encouraged to move around as much as possible.

Your nurse will help you change positions in bed, show you exercises to keep blood flowing, and recommend coughing or deep breathing to prevent pneumonia. You should do these every 3 to 4 hours. You may need to use a breathing device to keep your lungs clear. You may also:

Outlook (Prognosis)    Return to top

The surgery should remove all of the cancer cells, but your doctor will watch you carefully to make sure the cancer does not come back. You should have regular checkups, including prostate specific antigen (PSA) blood tests.

References    Return to top

Su L, Smith JA. Laparoscopic and robotic-assisted laparoscopic radical prostatectomy and pelvic lymphadenectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 99.

Walsh PC, Partin AW. Anatomic radical retropubic prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 97.

Hartke DM, Resnick MI. Radical perineal prostatectomy. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 98.

Update Date: 3/4/2009

Updated by: Louis S. Liou, MD, PhD, Assistant Professor of Urology, Department of Surgery, Boston University School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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