Open Radical Prostatectomy
This surgical procedure is appropriate for the following patients:
- Those who are physically fit for major surgery
- Diagnosed with a significant tumour
- Unable to have robotic assisted surgery because of previous extensive intra-abdominal surgery
The goal of the prostatectomy is to get rid of all the cancer cells. The open radical prostatectomy is performing under general anaesthesia. In this procedure, A/Prof Patel makes an incision in the lower abdomen. This is called retropubic approach and this procedure is commonly used for removal of lymph nodes along with the prostate. The procedure allows A/Prof Patel to examine the prostate and lymph nodes and also provides a nerve-sparing approach that reduces the risk of impotency. This approach helps A/Prof Patel to preserve the surrounding nerves that are required for unassisted erections.
The surgery requires 2 to 4 days of hospitalisation. Usually after the surgery a thin, flexible tube called a catheter is attached to the bladder to drain the urine for 1 week. Our practice nurse will provide full instruction about the usage and care of the catheter. Immediately after surgery the patient is advised to drink fluids and later can continue with solid foods. Pain medications may be recommended to reduce the pain and inflammation. To prevent certain complications such as pneumonia or blood clots patients are usually recommended to practice walking, leg exercises and use an incentive spirometer, a small disposable device that assists deep breathing. Before discharge A/Prof Patel will schedule the next follow-up visit for a prostate-specific antigen (PSA) test to check the healing process.
As with all surgeries, radical prostatectomy carries some general complications such as heart problems, blood loss or blood clots, allergic reaction to anaesthesia and infection. Specific complications such as urinary incontinence, erectile problems can also occur but improve with time. A/Prof Patel will discuss in detail ways to minimise this and gain early recovery.