Open Surgery

This treatment involves the removal of the prostate gland. There are 3 types of procedure - open, robotic and laparoscopic (keyhole). The aim of this surgery is to remove the cancer by removing the prostate gland. This is major surgery so patients undergoing this procedure need to be fit.

In the case of open surgery, an incision is made in the lower abdomen or through an incision in the perineum (between the anus and the scrotum). With the removal of the prostate, the urethra (water passage through the penis) is joined back up to the neck of the bladder. In all types of prostatectomy, the join is made over a catheter (a plastic tube inserted through the penis into the bladder) to transport the urine.

This means that when you return from the operating theatre, you will have a tube like this and a tube through the abdominal wall called a drain. The drain is removed prior to discharge home. The catheter is usually left in place for 7-10 days or until a dye test X-ray called a cystogram is performed to make sure that the join has healed up.

Sometimes the cystogram shows a leak and it is necessary to leave the catheter in a little longer until the join has healed up completely. As the area around the prostate has many blood vessels, some blood can be lost at the time of surgery so a blood transfusion may be required. This is more common with open rather than laparoscopic or robotic surgery.

The apex of the prostate is very close to the urinary sphincter (the muscle/mechanism that keeps men dry). This can be damaged at the time of surgery, leading to urinary incontinence (involuntary leakage of urine) which is usually temporary, but in some men can be permanent. The prostate itself is very close to the nerves that supply the penis causing erections. These can also be damaged at the time of surgery leading to impotence, which is often permanent or may require treatment.