Understanding Radical Prostatectomy – Procedure, Recovery, and Side Effects
Among men with localised prostate cancer, radical prostatectomy is one of the most commonly used treatments. This surgery entails removal of the entire prostate gland, as well as some surrounding tissue to eliminate the cancer from spreading beyond that area. Although it sounds frightening, UK patients can be reassured that advances in surgical techniques are helping to transform results and their subsequent post-op recovery.
The two most common types of radical prostatectomy are traditional open surgery, which requires larger incisions, and the newer robot-assisted radical prostatectomy, in which small incisions are made. This is typically recommended for early-stage prostate cancer in men, for example where the cancer cells are still contained within prostate tissue.
Robot-Assisted Radical Prostatectomy: A Modern Approach
A major development in prostate cancer surgery is the robot-assisted radical prostatectomy, with the most popular system being the da Vinci® Surgical System. This enables surgeons to perform surgery through a few small incisions with 3D imaging of the operative field and better dexterity than the human hand.
The surgeon “has full and total control,” directing robotic arms that are so precise they can spare the nerves, a key to maintaining continence and erections after surgery. The advantages over open surgery are many: less blood loss, less pain after surgery, and a shorter hospital stay, often no more than one or two nights.
Recovery is usually faster, too. Most patients are back to light activities of daily living at 2–3 weeks and return to their full functional status sooner than patients recovering from open surgery. Most importantly, robotic surgery has been associated with improved functional outcomes, especially for erectile function and urinary continence.
Radical Prostatectomy Recovery Time: What to Expect
Whether robotic or open RP, recovery following RP depends on patients’ baseline health and operative factors. Postoperatively, some patients may stay in the hospital overnight, although for open surgery, a longer stay may be necessary.
A 7- to 14-day urinary catheter is generally needed to promote healing of the bladder. Strenuous activity and heavy lifting in the days to weeks immediately following the procedure should be avoided. Nonetheless, light walking is recommended to encourage circulation and avoid blood clots.
It may take 3 to 6 months to fully heal. It is during this phase that men may encounter side effects such as short-term urinary incontinence and erectile dysfunction. Both problems tend to get better over time, especially with consistent rehab.
To help recovery, patients are encouraged to start Kegel exercises for the pelvic floor before surgery and to follow a programme of exercises after the operation. These exercises facilitate recovery of bladder function and improve long-term recovery rates.
Radical Prostatectomy Side Effects: Managing Risks
As with any surgery, radical prostatectomy carries side effects—but many are manageable and can be mitigated with proper care and support.
Urinary incontinence is one of the most frequent adverse effects in the early period. This could be stress incontinence (leakage on coughing or movement), and most commonly improves over a matter of months. There is also the issue of erectile dysfunction (ED), particularly in cases where nerves in and around the prostate are being impinged upon during surgery. But with robot-assisted surgery, the risk is much less thanks to nerve-sparing techniques—although it could still take two years to recover.
Chronic incontinence (5–10% of cases) and permanent ED can occur, albeit rarely. The treatment options also involve surgery such as urethral slings, penile implants, and drugs and injections to restore sexual function.
It’s important to recognise the emotional effects of radical prostatectomy, too. Depression, anxiety, or frustration can be experienced. Men can find assistance in counselling, support groups, and open discussions with loved ones as they adjust physically and emotionally to having had the surgery.
Life After Radical Prostatectomy: Adjusting to a New Normal
While the operation is intended to get rid of cancer and extend life, the months afterward can be a time of trial and adjustment. Most men do well and get back to a normal lifestyle, a full range of activities, and sex, but it takes time.
If you are still recovering from surgery, you may be able to improve your recovery with lifestyle shifts, including eating the right foods, staying active, and avoiding smoking and excessive alcohol. There’s about a 25% chance the cancer might come back after surgery, so it’s important to keep coming in for regular follow-ups to check PSA levels and stay on track in case it does make a return.
Don’t underestimate mental health support. Speaking with a therapist or participating in a support group for prostate cancer survivors can help you avoid feeling isolated after therapy is over.
Conclusion: Is Radical Prostatectomy Right for You?
The decision to have a radical prostatectomy is very personal and should be made in consultation with trusted medical professionals. Factors to consider include your stage of cancer, your age, your overall health, and preferences for how to live your life.
For others, alternative therapies including radiation or focal therapies might be more suitable. Nevertheless, radical prostatectomy is highly effective at treating localised cancer and is a curative treatment when diagnosed at an early stage.
Whichever path you take, early detection is still crucial—and so is aggressive rehabilitation and follow-up care. With proper medical direction and encouragement, the majority of patients will continue their normal, active lifestyle after surgery.
Get in touch with Chase Lodge Hospital to find out more about prostate cancer treatment or to speak with an expert.
