Prostate cancer surgery

For many people, surgery will be a suggested treatment option. It is worth discussing with your urologist or treating doctor whether there are other options, such as radiation therapy, available to you.

The main type of surgery for localised and locally advanced prostate cancer is a radical prostatectomy.

Learn more about:

• What types of surgery are there?
• How the surgery is done
• Radical prostatectomy to remove the prostate
• Making decisions about surgery
• What to expect after surgery

What types of surgery are there?

Radical prostatectomy involves removes all the prostate, part of the urethra and the seminal vesicles. The urethra is rejoined to the bladder, and the vas deferens (that carry sperm from the testicles to the penis) will be sealed.

Some people have a nerve-sparing radical prostatectomy, to avoid damaging the nerves that control erections. This is only for lower-grade cancers where the cancer isn’t close to these nerves, and it works best for those who had strong erections before diagnosis. Problems with erections are common even with nerve-sparing surgery.

Cancer cells can spread from the prostate to nearby lymph nodes. For intermediate-risk or high-risk prostate cancer, nearby lymph nodes may also be removed (pelvic lymph node dissection).

How the surgery is done

There are different surgery methods to remove the prostate:

Radical prostatectomy to remove the prostate

Making decisions about surgery

Talk to your surgeon about whether surgery or another treatment such as radiation therapy is the best option for you. Also ask what surgical methods are available to you. Ask about the advantages and disadvantages of each option. There may be extra costs involved for some procedures and they are not all available at every hospital. You may want to consider getting a second opinion about the most suitable type of surgery. See more about Making treatment decisions.

The surgeon’s experience and skill are more important than the type of surgery offered. Compared to open surgery, both standard laparoscopic and robotic-assisted surgery usually mean a shorter stay in hospital, less bleeding, a smaller scar and a faster recovery. Current evidence suggests that the different approaches have a similar risk of side effects. Take the time you need to make the right decision for you.

For more on this, see our general section on Surgery.

→ READ MORE: What to expect after surgery

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