Radical prostatectomy is a surgical operation for the total removal of the prostate gland and, if necessary, nearby lymph nodes and neurovascular structures. It is performed using traditional surgery or laparoscopy. Radical prostatectomy should not be confused with partial prostatectomy (or simple prostatectomy), which involves removing part of an organ. This surgical intervention is successfully carried out by the specialists of the Bogolyuby Medical Center.
When is it performed?
Radical prostatectomy is the treatment of choice for moderate to high risk prostate tumors without metastases and without spread to adjacent tissues (except lymph nodes). This intervention may also be used for patients with low-risk prostate cancer. A situation that may prompt the surgeon to evaluate the need for surgery in a high-risk prostate cancer is an obstruction of the urinary tract by a tumor mass. To determine the risk level of prostate cancer, the patient must undergo a biopsy, CT and MRI.
How to prepare for the operation?
Radical prostatectomy is performed under general spinal or epidural anesthesia. Preoperative preparation involves preliminary fasting for at least 8 hours before surgery. If the intervention is scheduled for the morning, the last meal allowed is dinner the night before. A few hours before the intervention, you should stop drinking and water.
If the patient is being treated with anticoagulants, he should temporarily stop this treatment to avoid bleeding during and after surgery. If the patient smokes, this habit should be stopped at least temporarily, as smoking increases the risk of various complications, including postoperative infections.
How is the intervention going?
There are currently two surgical methods for performing radical prostatectomy: the traditional surgical method , also known as the "open" method, and the laparoscopic method. The choice of technique remains with the operating surgeon.
Radical prostatectomy, performed by the traditional surgical method, involves making one large incision in the area below the navel or at the level of the perineum (i.e. between the scrotum and anus ) . Through the hole created by the incision, the surgeon accesses the pelvic area and performs the removal of the prostate.
If prostate cancer has spread to nearby lymph nodes or nearby neurovascular structures, removal may also include these items; in such situations, obviously, the intervention will be more invasive.
Laparoscopic radical prostatectomy is a minimally invasive surgical procedure that involves making 3-4 incisions (1 cm) in the abdomen using a laparoscope. The small size of the incisions, which distinguishes laparoscopic radical prostatectomy, guarantees an easier and faster postoperative recovery.
Postoperative period
In the first 24-48 hours after anesthesia, the patient may experience weakness, headache, confusion and slow reflexes.
After prostatectomy, the use of a urinary catheter is envisaged. The period of its use ranges from 2-3 weeks with the intervention of classical surgical techniques to 7-10 days with laparoscopic surgery. Pain at the sites of surgical incisions after surgery, especially when walking, is normal.
After several days of hospitalization, the rehabilitation period continues at home. In order for it to pass most favorably, it is necessary to avoid tedious activities, for example, lifting weights, to abstain from sex for 6-8 weeks. You should return to your normal daily routine gradually.
