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What Is Involved in Prostate Cancer Surgery?

By H. Colledge
Updated May 17, 2024
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The prostate gland is part of the male reproductive system and is located below the bladder, where it encloses the urethra, the tube through which urine passes. Sometimes the cells which make up the prostate change to become malignant, or cancerous, and, if the cancer is progressing, prostate cancer surgery becomes necessary. If cancer has not spread beyond the prostate gland, an operation known as a radical prostatectomy may be carried out. This involves removing the prostate through an incision using either traditional surgery, keyhole surgery or robot assisted surgery. For cancers which have spread beyond the prostate gland and which are blocking the urethra, transurethral resection of the prostate, or TURP, may be carried out, where a cutting instrument is passed up the urethra to remove the obstruction.

Malignancy of the prostate gland is one of the most frequently occurring men's cancers. Often, there are no symptoms in the early stages of the disease, but as the prostate enlarges it may begin to affect the flow of urine through the urethra, causing urination problems. Symptoms may include difficulty in starting urination, a decreased flow of urine during the process and difficulty stopping. There may be a frequent need to urinate and a feeling that the bladder has not been fully emptied each time. Sometimes, prostate cancers grow too slowly to require treatment and they may simply be monitored, but if they are noticeably progressing, prostate cancer surgery may be performed.

A radical prostatectomy involves removing the whole gland. In traditional prostate cancer surgery, the operation is carried out through a cut which may be made in the abdomen, or in the skin that lies between the anus and the scrotum. Alternatively, keyhole, or laparoscopic, surgery may be used, in which a number of smaller incisions are made in the abdomen. Laparoscopic instruments are inserted through the holes, including surgical tools and a camera which allows the surgeon to view the procedure. The prostate is cut away from surrounding tissue and extracted through an existing incision.

Another laparoscopic technique uses robotic arms to manipulate the instruments. Instead of handling the instruments directly, the surgeon controls the robotic arms from a console. This allows more precise movements to be made.

Following prostate cancer surgery, a tube called a catheter may be placed inside the urethra to drain the bladder while healing takes place. Painkilling medication may be needed to ease any discomfort. Recovery is usually quicker following laparoscopic surgery, allowing patients to leave the hospital sooner.

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