A surgical approach to treating prostate cancer will remove all or part of the prostate. Typically, men with early-stage disease or cancer that’s confined to the prostate will undergo radical prostatectomy—removal of the entire prostate gland, plus some surrounding tissue.
Types of Prostatectomy
Radical Retropubic Prostatectomy (RRP)—An incision is made in the abdomen and the prostate is removed from behind the pubic bone. The surgeon then stitches the urethra directly to the bladder so urine is able to flow.
It typically takes a few days for the body to get used to this new setup, so the surgeon will insert a catheter into the bladder. Urine will flow automatically out of the bladder, down the urethra, and into a collection bag. The catheter usually stays in for 7 – 10 days.
Robotic assisted Laparoscopic Radical Prostatectomy (RALRP – Davinci Prostatectomy)—Very small incisions are made in the abdomen. The surgeon then inserts narrow instruments fitted with cameras and/or surgical tools, allowing him or her to visualize and operate on the internal structures without cutting open the entire abdomen. On the inside, the procedure closely resembles the Radical Retropubic Prostatectomy.
Nerve-Sparing—Surgeons who perform either RRP or RALRP should be capable of performing nerve sparing surgery if the cancer is contained within the prostate. With this approach, the surgeon cuts to the very edges of the prostate, taking care to spare the erectile nerves that run alongside the prostate and preserve long-term erectile function.
Surgeons won’t know until the time of the procedure if nerve-sparing is possible.