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Effectiveness of Radical Prostatectomy
Success rates for a radical prostatectomy can range from
30 - 98%. Studies have shown success rates between 76
- 98% for low-risk disease; 60 - 76% for moderate-risk
disease; and 30 - 76% for high-risk disease. It is also
recognised that the experience of the surgeon performing
the surgery is important i.e. surgeons have greater success
rates and lower complication rates if they routinely
perform the procedure.
Polascik TJ, Pound CR, deWeese TL, Walsh PC: Comparison of radical prostatectomy and iodine 125 interstitial radiotherapy for the treatment of clinically localized prostate cancer: a 7-year biochemical (PSA) progression analysis. Urology 1998, 51:884-890.
Stokes SH: Comparison of biochemical disease-free survival of patients with localized carcinoma of the prostate undergoing radical prostatectomy, transperineal ultrasound-guided radioactive seed implantation, or definitive external beam irradiation. Int J Radiat Oncol Biol Phys 2000, 47:129-136.
D'Amico AV, Whittington R, Malkowicz SB, et al.: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998, 280:969-974. |
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Recovery Time For Radical Prostatectomy
Since a radical prostatectomy is major surgery, patients may require blood transfusion. Prostatectomy patients typically stay in the hospital for 2-4 days. Full recovery can take up to 12 weeks.
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Risks and Side Effects of Prostatectomy
The risks after surgery are similar to those of any major surgery. They include:- Heart attack
- Stroke
- Blood clots in the legs
- Infection at the incision site
- Post-operative bleeding
Common side effects of a radical prostatectomy include:
Impotence (51 - 96% impotence rates have been shown) & Incontinence
Lim AJ, Brandon AH, Fiedler J, et al.: Quality of life: Radical prostatectomy versus radiation therapy for prostate cancer. J Urology 1995, 154: 1420-1425.
Jonler M, Messing EM, Rhodes PR, Bruskewitz RC: Sequelae of radical prostatectomy. Br J Urology 1994, 74: 352-358. |
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Laparoscopic Prostatectomy
A less invasive surgical procedure, called a laparoscopic prostatectomy, eliminates the need for a large surgical incision to remove the prostate. As a result, the patient may experience less pain and scarring, faster recovery and less risk of infection.
During a laparoscopic prostatectomy, a telescopic instrument called a laparoscope is inserted into the abdomen through a small incision at the belly button. The laparoscope allows surgeons to view inside the abdomen and perform the surgery without having to make a large incision. Usually, four more small incisions are made in the abdomen to accommodate surgical instruments during surgery.
In some cases, the surgical procedure may require conversion to the standard open operation if extreme difficulty is encountered during the laparoscopic procedure. |
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Recovery Time For Laparoscopic Prostatectomy
The procedure usually takes 3-4 hours. Average hospital stay is two days. Unlike open surgery where the catheter stays in for 2-3 weeks, laparoscopic prostatectomy patients often have their Foley catheters removed on the seventh day after surgery. Recovery time to normal activity averages 2-4 weeks. |
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Side Effects of Laparoscopic Prostatectomy
Side effects are similar to those of a radical prostatectomy. |
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