In situations where your urologist has recommended surgery for treatment of prostate cancer, radical retropubic prostatectomy, is one of the surgical options. This procedure is performed under a general or regional anesthetic. It is performed through an incision extending from just below the belly-button down to the pubic bone. The prostate, which is located between the bladder and the urethra, is surgically removed. Since the nerves that enable a man to achieve an erection run along side the prostate, when the prostate is removed these nerves are usually damaged, resulting in post-operative impotence. In cases where the patient is sexually active and the pathology of the prostate cancer is favorable, these nerves can possibly be spared, thus preserving potency. Once the prostate has been removed, the bladder and urethra are the reattached and a catheter is placed to allow urinary drainage during the post-operative healing phase. This catheter is left in place for approximately 2 weeks.
The operation usually takes between one and a half to two and a half hours to perform. The patient is in the hospital for approximately 4 days. Activity restrictions are required for 6 weeks to allow adequate healing of the incision. Once the catheter is removed, it is normal to leak urine. It is important for the patient to begin exercising his urinary control muscles immediately in order to regain urinary control as soon as possible.