RADICAL RETROPUBIC PROSTATECTOMY (RRP)

• Radical prostatectomy is performed to treat localised prostate cancer. It is performed under general anaesthetic and takes about 2-3 hours. Dr Patel has recommended surgery for you with the expectation that you will make a good recovery.
• The whole prostate gland and seminal vesicles are removed in the operation. Sometimes, nearby lymph nodes are removed during the operation. The overall cure rate for RRP nowadays is around 80-90%
• Most patients go home after 3-4 days, but a urethral catheter (see diagram over) is left in place for 7 days after the operation
• Loss of erections (impotence) can occur as a result of surgery but most patients are suitable for “nerve-sparing surgery” whereby the nerves that control erections are protected, and this can result in maintenance of erections after radical prostatectomy. The success of nerve-sparing surgery depends on many factors, such as the patient’s age, sexual function prior to surgery, anatomical variations and how motivated they are to recommence sexual activity after their surgery.
• Incontinence (involuntary urine leakage) can occur after surgery also, but the vast majority of men will improve in the months after surgery, especially if they perform male pelvic floor exercises daily after the catheter is removed. Dr Patel will provide you with a brochure on pelvic floor exercises. The risk of permanent and significant leakage is only around 1-3%, and if it does occur, it can often be permanently improved by a small operation.
• DVT and pulmonary embolism (blood clots in the legs or lungs) can occur after any surgery and are potentially life-threatening. The risk is low (less than 2%) and appropriate precautions will be taken to minimize your risk.
• Blood transfusion is required in less than 5% of operations performed by Dr Patel
• Rarely, the rectum, or back passage can be damaged in RRP (less than 1%). This may require further surgery to repair any injury.
• Sometimes fluid collections in the pelvis (lymphocoele or haematoma) can occur after RRP and may need to be drained out as a separate procedure (less than 5% chance)
• After surgery, the prostate is examined by a pathologist to see if all the cancer is contained in the specimen. If so, then no further treatment will be required.
• PSA levels should be undetectable around 6-8 weeks after the operation if the cancer has been fully cleared. Dr Patel will arrange a time for you to have your PSA checked after the operation, and it will need to be monitored periodically for at least 8 years after surgery.
• You will need to avoid any very strenuous activity or heavy lifting for 6 weeks after your operation.