Prostate Cancer Surgery

Whilst this may appear a contradiction, male patients who are considered to be of suitable age and enjoying good health will normally be eligible and offered open surgery to treat prostate cancer. Others will be offered alternative surgical treatments for non-cancerous enlargement of the prostate known as Benign Prostatic Hypertrophy [BPH].

The following surgical procedures apply:

• Pelvic lymphadenectomy

• Radical prostatectomy

• Transurethral Resection of the Prostate [TURP]

• Transurethral Incision of the Prostate [TUIP]

• Cryosurgery

Prostate Cancer Surgery – [Pelvic Lymphadenectomy] - Pelvic Lymph Node Dissection (PLND)

This surgery involves the removal of lymph nodes from the pelvis which are then examined under a microscope by a Pathologist to accurately determine if cancerous cells are present.

Your doctor may consider it advisable to carry out a PLND procedure. He would do this if he thought there was a possibility of pelvic lymph node metastases. Results would show if you would benefit from more invasive surgical procedures. It is the general view of the medical profession that patients with Metastatic prostate cancer would not benefit from more radical surgery.

Prostate Cancer Surgery - Radical Prostatectomy

The removal of the prostate gland, tissue and seminal vesicles* is carried out using either Retropubic Prostatectomy or Perineal Prostatectomy.

• Retropubic Prostatectomy is the removal by making an entry [cut] in the abdominal wall

• Perineal Prostatectomy is the removal by making an entry [cut] in the perineum (the area between the scrotum and anus).

It is possible for lymph nodes to be removed during these procedures.

*Seminal Vesicles – are a pair of tubular glands about 2 inches [5 centimeters] long and are sited behind the bladder and just above the prostate gland. The fluid they secrete forms a major part of semen.

Prostate Cancer Surgery - Transurethral Resection of the Prostate [TURP]

Your doctor or consultant may suggest surgery as ‘enlarged prostate treatment’. Open or external surgery involves an incision in the skin above the base of the penis. However, there is an alternative method. The most common form of surgery for an enlarged prostate gland is known as transurethral resection of the prostate [TURP]. Transurethral resection of the prostate gland does not mean that the prostate is removed.

This surgical procedure is used for approximately 90% of all surgeries to correct BPH. Once the patient has been anesthetized a surgical instrument is inserted into the urethra [a tube inside the penis]. This instrument is called a resetoscope(a thin, lighted tube with a cutting tool). During this procedure, the surgeon removes some of the prostate thereby also removing cancerous cells. Whilst this procedure may not eliminate all the cancerous cells, it does remove the tissue that hinders the flow of urine.

This procedure lasts approximately 90 minutes with the excess tissue taken from the prostate gland and then flushed through the bladder after surgery. Transurethral resection of the prostate gland is favored by the medical profession because it necessitates a shorter recovery time and fewer traumas to the body. As you would expect this procedure requires a stay in hospital and a general anesthetic.

Prostate Cancer Surgery - Transurethral Incision of the Prostate [TUIP]

This is another form of surgery but this time there is no removal of tissue from the prostate gland. It is minimally invasive. The procedure involves widening the urethra by making minor cuts in the neck of the bladder. The cuts are made where the urethra joins the bladder and in the prostate gland. As yet there is no evidence that this method gives the same relief as TURP or to result in fewer side effects. Doctors believe that it reduces the risk of backward ejaculation. This occurs when semen flows backward into the bladder during climax instead of out through the urethra.

Prostate Cancer Surgery - Cryosurgery

Cryosurgery is a treatment that uses an instrument to freeze and destroy prostate cancer cells.

Prostate Cancer Surgery - after effects of Surgery

Patients who have undergone surgery may experience periods of Impotence. It is possible that this can be avoided for some patients when the surgeon uses a technique called ‘nerve-sparing surgery’. When applying this surgical technique the nerves that control erection may be protected.

This specific surgery may not be offered to patients with large tumors or tumors that are very near the nerves.

Patients may also suffer from urine leaking from the bladder and or stool from the rectum.

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