NCCN Guidelines for Patients® | Prostate Cancer - page 28

28
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 4: Overview of cancer treatments
Open retropubic prostatectomy
This operation removes tissue through a cut that runs
from your belly button down to the base of your penis.
During the operation, you will lie on your back on a table
with your legs slightly higher than your head. Before
removing your prostate, some veins and your urethra will
be cut to clear the area.
Your cavernous nerve bundles are on both sides of your
prostate. They are needed for natural erections. A nerve-
sparing prostatectomy will be done if your cavernous
nerves are likely to be cancer-free. However, if the cancer
involves them, one or both bundles of nerves will be
removed. If removed, good erections are still possible
with aids, and orgasms can occur with or without these
nerves.
Afterward, your prostate and seminal vesicles will be
removed. After removing your prostate, your urethra
will be reattached to your bladder. It takes between 90
minutes and 3 hours to complete this operation, and
you may stay 1 to 2 days in the hospital. It takes about 2
weeks to feel very well, and 4 to 6 weeks to resume all
normal activities.
Open perineal prostatectomy
This operation removes tissue through a cut in your
perineum. The perineum is the area between your
scrotum and anus as shown in Figure 8. During the
operation, you will lie on your back with your legs spread
open and supported with stirrups. The prostate and
seminal vesicles will be removed after being separated
from nearby tissues. Nerve sparing is possible but more
difficult. Lymph nodes can’t be removed. After your
prostate has been removed, your urethra will be re-
attached to the bladder. This operation is completed in
1 to 3 hours. You may need to stay 1 to 2 days in the
hospital. It takes about 2 weeks to feel very well, and 4 to
6 weeks to resume all normal activities.
Laparoscopic prostatectomy
A newer retropubic method is the laparoscopic
prostatectomy. This operation makes five small cuts,
called ports, in your pelvis. Tools are inserted into these
cuts to see and remove tissue. It takes between 90
minutes and 4 hours to complete this operation. You will
likely leave the hospital the next day. It may take another
2 weeks at home to recover.
Figure 8. Open prostatectomy
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