(Prostatectomy, Radical Prostatectomy, Radical Retropubic Prostatectomy, Radical Suprapubic Prostatectomy, Radical Perineal Prostatectomy, Nerve-Sparing Prostatectomy, RP, RPP, RSP)
What is a prostatectomy?
A prostatectomy is a surgical procedure for the partial or complete removal of the prostate. It may be performed to treat prostate cancer or benign prostatic hyperplasia (BPH).
A common surgical approach to prostatectomy includes making a surgical incision and removing the prostate gland (or part of it). This may be accomplished with either of two methods, the retropubic or suprapubic incision (lower abdomen), or a perineum incision (through the skin between the scrotum and the rectum).
Prior to having a prostatectomy, it's often necessary to have a prostate biopsy. Please see this procedure for additional information.
What is the prostate gland?
The prostate gland is about the size of a walnut and surrounds the neck of a man's bladder and urethra—the tube that carries urine from the bladder. It's partly muscular and partly glandular, with ducts opening into the prostatic portion of the urethra. It's made up of three lobes, a center lobe with one lobe on each side.
As part of the male reproductive system, the prostate gland's primary function is to secrete a slightly alkaline fluid that forms part of the seminal fluid (semen), a fluid that carries sperm. During male climax (orgasm), the muscular glands of the prostate help to propel the prostate fluid, in addition to sperm that was produced in the testicles, into the urethra. The semen then travels through the tip of the penis during ejaculation.
Researchers don't know all the functions of the prostate gland. However, the prostate gland plays an important role in both sexual and urinary function. It's common for the prostate gland to become enlarged as a man ages, and it's also likely for a man to encounter some type of prostate problem in his lifetime.
Many common problems that don't require a radical prostatectomy are associated with the prostate gland. These problems may occur in men of all ages and include:
Benign prostatic hyperplasia (BPH). This is an age-related enlargement of the prostate that isn't malignant. BPH is the most common noncancerous prostate problem, occurring in most men by the time they reach their 60s. Symptoms are slow, interrupted, or weak urinary stream; urgency with leaking or dribbling; and frequent urination, especially at night. Although it isn't cancer, BPH symptoms are often similar to those of prostate cancer.
Prostatism. This involves decreased urinary force due to obstruction of flow through the prostate gland. The most common cause of prostatism is BPH.
Prostatitis. Prostatitis is inflammation or infection of the prostate gland characterized by discomfort, pain, frequent or infrequent urination, and, sometimes, fever.
Prostatalgia. This involves pain in the prostate gland, also called prostatodynia. It's frequently a symptom of prostatitis.
Cancer of the prostate is a common and serious health concern. According to the American Cancer Society (ACS), prostate cancer is the most common form of cancer in men older than age 50, and the third leading cause of death from cancer.
There are different ways to achieve the goal of removing the prostate gland when there's cancer. Methods of performing prostatectomy include:
Surgical removal includes a radical prostatectomy (RP), with either a retropubic or perineal approach. Radical prostatectomy is the removal of the entire prostate gland. Nerve-sparing surgical removal is important to preserve as much function as possible.
Transurethral resection of the prostate, or TURP, which also involves removal of part of the prostate gland, is an approach performed through the penis with an endoscope (small, flexible tube with a light and a lens on the end). This procedure doesn't cure prostate cancer but can remove the obstruction while the doctors plan for definitive treatment.
Laparoscopic surgery, done manually or by robot, is another method of removal of the prostate gland.