Radical Prostatectomy

What Is a Radical Prostatectomy?

A radical prostatectomy removes the prostate gland and seminal vesicles to treat localized prostate cancer. The goal is to eliminate cancer while preserving urinary control and sexual function.

Three main surgical approaches:

• Robot-assisted laparoscopic prostatectomy (RALP): The most common approach; uses 5-6 small incisions with robotic instruments.
• Traditional laparoscopic prostatectomy: Similar approach without robotic assistance.
• Open retropubic prostatectomy: Single lower-abdominal incision; less common now.

The procedure typically takes 2-4 hours.

Why It's Done

Surgery treats prostate cancer confined to the gland or surrounding tissue, typically in men expected to live 10+ more years. It provides exact pathology information and can be curative for early-stage cancers.

Risks & Complications

Major complication rates range from 3-6%, with mortality less than 0.5%.

• Urinary incontinence: 5-30% at 12 months
• Erectile dysfunction: 30-70% (varies by age and nerve-sparing technique)
• Bleeding requiring transfusion: 1-3%
• Infection/fever: 1-2%
• Lymphocele: 1-3%
• Rectal injury: Less than 1%
• Deep vein thrombosis: Less than 1%

Recovery Timeline

• Hospital stay: 1-2 nights
• Catheter removal: 7-10 days
• Desk work: 2-3 weeks
• Heavy activity: After 6 weeks
• Sexual recovery: Erections may return over 6-24 months

Surgeon Specialists

Urologic Oncologists or Urologists with specialized robotic or nerve-sparing training perform these procedures. Experience significantly matters—surgeons performing over 100 procedures annually achieve superior outcomes.