The surgery is carried out by a urologist. In an open radical prostatectomy the urologist will remove the whole prostate gland usually through a cut made in the tummy (abdomen). Very occasionally the surgeon will remove the prostate gland through a cut made between the scrotum and the back passage (perineal prostatectomy). The nearby lymph nodes and the glands that help make semen (seminal vesicles) are also removed.
After this operation you may be unable to have and maintain an erection (erectile dysfunction – ED). The operation will also affect your fertility. You’ll be unable to father children naturally. The operation can also cause problems with controlling your bladder (urinary incontinence). You can read more about these side effects.
Sometimes it’s possible to do a type of operation called a nerve-sparing prostatectomy, which reduces the risk of some of these problems. As doctors can’t predict which men will be affected by these side effects, it’s important that you know about them before you have surgery.
Advantages of open prostatectomy
- It may cure the cancer.
- It may prolong the life of men with fast-growing cancers.
Disadvantages of open prostatectomy
- It is only suitable for a small number of men with locally advanced prostate cancer.
- Some men may require radiotherapy after surgery if there’s a possibility that cancer cells have been left behind.
- For some men, cancer cells may come back immediately or some time after the operation. If this happens, radiotherapy or hormonal therapy may be given.