There are different types of prostate surgery including:
- Radical prostatectomy
- Transurethral resection of the prostate (TURP)
- Pelvic lymphadenectomy
What is Radical prostatectomy?
A radical prostatectomy for prostate cancer can benefit men with prostate cancer. However, if the cancer has spread beyond the prostate, this surgery may not be suitable. A surgeon extracts the entire prostate gland during a radical prostatectomy including the cancerous cells. Also, they can extract the seminal vesicles.
There are various types of radical prostatectomy:
- Retropubic prostatectomy: Retropubic prostatectomy surgery involves the removal of the prostate through incision in the abdominal wall by a surgeon. These can also cut surrounding lymph nodes through the same incision to reduce the risk of cancer cells from spreading
- Perineal prostatectomy: A surgeon removes prostate by incising between the areas of testicles and anus. Through a separate incision in the abdominal wall, they can remove the lymph nodes
- Laparoscopic prostatectomy: The surgeon makes five or six incisions in the abdomen to remove the prostate. This procedure is performed by hand, using a camera and a lighted tube to guide the surgeon
- Robotic prostatectomy: The surgeon performs a laparoscopic procedure using a computer to control a robotic machine with four arms
The type of surgery performed will depend on the hospital’s resources and the expertise of the surgeon.
Risks and side effects
Urinary incontinence and erectile dysfunction are the most common side effects of prostatectomy. Radical prostatectomy also carries risks including:
- Blood clots
- Injury to nearby organs, such as the bowel and nerves
Most men lose control of their bladder after surgery. Some can suffer stress incontinence (few drops of urine are leaking during exercise), coughing, or sneezing. During the procedure, some people encounter urine production problems, and this can happen slowly or unexpectedly.
The prostate places an important role in producing semen in men. Removing it means men cannot ejaculate through sex. Men undergo “dry orgasms” after surgery, which is the feeling of orgasm without the ejaculation. Men intending to have a radical prostatectomy may want to consider storing sperm at a later date for fertility treatment.
What is Transurethral resection of the prostate (TURP)?
This procedure does not aid in cancer cure but helps to overcome urinary difficulties. This difficulty can occur due to the friction of enlarged prostate against the urethra making it narrow. A man who receives a TURP will be given general anesthesia. The surgeon passes a thin metal tube to the urethra with a camera attached through the penis. Then the surgeon passes a short wire loop through the tube and heat is applied to extract small sections of the prostate tissue. They must also transfer fluid into the bladder during surgery to flush away the removed tissue.
Possible side effects of TURP include:
- Retrograde ejaculation
- Erectile dysfunction
- Urinary incontinence
- Urethral stricture
What is Pelvic lymphadenectomy?
Pelvic lymphadenectomy is normally performed before a radical prostatectomy to test whether more intensive surgery is needed. A surgeon removes pelvic lymph nodes and send some of the nodes for biopsy to test the presence of cancer cells indicating the spread of prostate cancer from the prostate into other tissues.
When a biopsy reveals cancer in the lymph nodes, a radical prostatectomy may potentially cause severe side effects without resolving cancer spread. Hence, a cancer specialist may prescribe various other treatments.
What is Orchiectomy?
An orchiectomy is surgery done to remove one or both of your testicles. It’s commonly performed to treat or prevent prostate cancer from spreading.
Types of orchiectomy
There are various types of orchiectomy procedures depending on the condition or to accomplish the purpose by getting this procedure done.
- Simple orchiectomy: In the scrotum a small incision if made to remove one or both of the testicles. This procedure is done to treat prostate cancer when the doctor decides to limit the amount of testosterone the body produces.
- Radical inguinal orchiectomy: One or both testicles are removed instead of scrotum through a slight cut in the lower part of the abdomen. This will be achieved if you have found a lump in the testis and your doctor decides to test for cancer in your testicular tissue. Doctors may prefer to use this surgery over biopsy as it can increase the cancer spread.
- Subcapsular orchiectomy: In this procedure the tissues surrounding the testicles are removed from the scrotum.
- Bilateral orchiectomy: This procedure is performed when a doctor suspects you to have prostate cancer in which both testicles are removed.
What is recovery life after prostate cancer surgery?
Give yourself some time to relax, because you can feel more fatigued after surgery. Your recovery from prostate cancer surgery depends on the type and length of the surgery, your overall health and whether you follow the instructions provided by your doctor which include:
- Keep the surgical wound clean
- Avoid driving for one week after the surgery
- Avoid activity that include physical strength for six weeks
- Avoid climbing stairs more than necessary
- Avoid using bathtubs, swimming pools, or hot tubs
- Avoiding sitting in one position for more than 45 minutes
- Taking medications as prescribed to cope up with pain
Although you are capable to do works on your own, it might be a good idea to have someone around to support you during the time you have got the catheter. Also, having bowel movements within a day or two is important. Drink fluids, add fiber to your diet, and do exercise to help with constipation. If those options do not work, you can also ask your doctor about laxatives.
When the scrotum starts to swell after surgery, you can create a sling with a rolled towel to reduce the swelling. Place the towel roll under your scrotum as you lie down or sit and loop around your legs to provide support. When the swelling does not go down after a week contact the doctor.