What is the prostate?
The prostate gland is a small but important gland in the male reproductive system. Its main job is to produce secretions that make up part of the semen protecting and enriching the sperm. The prostate gland sits just below the bladder and surrounds the neck of the bladder and the beginning of the urethra (the tube through which you pass urine).
About the procedure
A radical prostatectomy is an operation for men with prostate cancer. A small incision is made in the lower abdomen. The pelvis and lymph nodes are carefully evaluated for the presence of disease. The entire prostate gland and seminal vesicles are removed. The bladder neck is then joined to the urethra. A catheter is left in place to drain urine from the bladder. A small drain is left in the pelvis for 48 hours.
Prior to the operation you would have discussed important aspects of the surgery. The way your surgery is approached depends upon the extent of the disease. The aim of the surgery is to remove all prostate cancer as well as maintain urinary control and sexual function.
In order to maintain urinary control, as much bladder neck and urethra is preserved as possible. Return of sexual function after radical prostatectomy depends upon preservation of the nerves that travel alongside the prostate down to the penis (nerve sparing). In many cases we are able to preserve these nerves. It relies on very careful separation of the nerve containing tissue (neurovascular bundle) from the prostate. In the setting of more aggressive disease, nerve sparing may not be advised as it could increase the risk of leaving disease behind.
The pelvic lymph nodes are located on the side wall of the pelvis. Prostate cancer can spread to these lymph nodes if more aggressive or advanced. If there is a risk of the lymph nodes being involved, then removal of these nodes will be advised.
Complications of surgery
The main longer term risks of prostate surgery are the potential for incontinence and erectile problems.
The risk of these for you will be discussed in detail as part of the decision-making process.
Surgical risks include the following:
- Bleeding 0% 0%
- Wound infection 0% 0%
- Urine infection 10% 10%
- Deep vein thrombosis (DVT) / Pulmonary Embolus 1% 1%
- Rectal or ureteric injury 1% 1%
- Bladder neck stenosis 2% 2%
Overall, most men do very well at the time of surgery and the risk of complications at the time of surgery is low.
In the event of an emergency, call our office within business hours and speak to our Practice Nurse.
If out of hours, please call our office to contact our On-Call Urologist, or present to your nearest Emergency Department.
Ashford Hospital (8375 5205)
55 Anzac Highway, Ashford SA 5035
Emergency Department is open 7 days a week, 8:00am until 10:00pm
Wakefield Hospital (8405 3440)
300 Wakefield Street, Adelaide SA 5000
Emergency Department is open 7 days a week, 24 hours
**For patient’s outside the Metropolitan area, please present to your nearest hospital emergency department.