What should you know about radical prostatectomy for prostate cancer?

Radical prostatectomy is an operation to remove the prostate gland and usually the seminal vesicles. The surgeon may also assess nearby lymph nodes. It can be considered when prostate cancer appears confined enough for surgery to be useful, but suitability depends on examination, scans, biopsy findings, age, general health and your preferences.

The operation may be open or performed through small incisions with instruments; the choice depends on the surgical team and your circumstances. After the prostate is removed, the bladder is joined to the urethra and a catheter supports healing. The prostate tissue is examined, and the result helps decide whether monitoring or further treatment is appropriate. Possible effects include urine leakage and changes in erections because nearby muscles and nerves are involved.

Radiotherapy and brachytherapy are alternatives that use radiation rather than removing the prostate. The right option depends on cancer features and the trade-offs you value.

Ask how the cancer stage and grade affect the recommendation, whether lymph nodes will be assessed, and what continence and sexual-function recovery may look like. Review medicines, smoking, bowel preparation and activity instructions with the team. Plan transport and help at home, and understand catheter care before discharge. Bring a written list of priorities so the consultation covers both cancer control and quality of life.

Call the surgical team for fever, worsening wound redness, pus, increasing pain, catheter blockage, inability to pass urine or persistent heavy bleeding. Get urgent help for chest pain, sudden breathlessness, fainting, severe leg swelling or coughing blood. These symptoms need prompt assessment and should not be left until the next clinic visit.

Why is surgery suitable for my cancer? What are the alternatives and their main trade-offs? Will you try to preserve the nerves controlling erections? How long will the catheter remain? When will pathology results guide the next step? What support is available for continence and sexual recovery?