What happens during the procedure?
This procedure is usually done with general anesthesia so you won't be awake. After the anesthesia is given, the doctor makes an incision from the top of the pubic bone to the navel. The prostate gland is removed. A small sample of tissue from the lymph nodes in the region is taken in cases of prostate cancer so the severity (or stage) of the cancer can be determined.
Doctors use special care to save the nerves around the prostate to reduce the risk of the man being unable to have erections after the surgery. Because the urethra (the tube through which urine passes out of the body) is cut during the procedure, it must later be attached directly to the bladder.
Another less common approach for surgery is to make an incision between the anus and the scrotum. There is less bleeding with this approach but there is a higher risk of rectal injury. As well, if any lymph nodes need to be removed, a second incision will be necessary.
How should I prepare for this procedure?
You may need blood tests several days or weeks before the surgery. To clear your colon before the procedure, your doctor may ask you to take a laxative the night before or use an enema the morning you go to the hospital.
Recovery time is often faster for people who exercise regularly. You can speed up the healing process by not smoking, and losing weight, if necessary, before the procedure. Your doctor may also recommend that you do Kegel exercises to strengthen your pelvic muscles to help with recovery.
Tell your doctor about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any medication allergies and medical conditions that you may have.
Do not eat for 8 hours before the procedure. If your doctor has recommended different times, follow the timing recommended by your doctor.
Ask your doctor or pharmacist whether you need to stop taking any of your medications before the procedure.
Arrange for someone to drive you home from the hospital.
What can I expect after the procedure?
Staying at the hospital for a few days after the procedure is normal. Pain medication will help you if you are uncomfortable or in any pain.
When you wake up from the surgery, you will probably have a catheter in your penis to drain urine from the bladder. Having the catheter is normal; however, it may be uncomfortable because it may make you feel as though you need to urinate. The catheter usually remains in place for about one to three weeks after you return home from the surgery. Over time (usually three to six months), most men regain their bladder control through the use of Kegel exercises. These exercises help build the muscles on the pelvic floor that make it possible to control urination.
It generally takes men four to six weeks to recover from the surgery.
Results
Doctors recommend testing your prostate specific antigen (PSA) levels (a prostate cancer screening test) every three to six months for the first year after the procedure. After the first year, you'll need a PSA test every 6 to12 months.
You may notice a loss in your ability to get or keep erections. This is normal and may go away, depending on your age and overall health before the procedure. Also, if no nerves were damaged during the procedure, you are less likely to experience problems related to sexual function. Talk to your doctor about treatment options if you do not notice an improvement in your sexual ability over the first year.