If as a result of all examinations, the prostate cancer is found to be confined to the prostate, there is aside from the local internal and external radiation therapy, the option of surgical removal of the prostate.
The long-term results of these surgeries are comparable to those of brachytherapy if the cancer is still in its early state. The radical prostectomy (removal of the prostate) can be performed with an abdominal or perineal incision or a laparoscopic procedure. The procedure generally lasts about 2 to 3 hours.
Incontinence and Impotence
After the removal of the prostate, the urethra will be reconnected to the bladder, so that normal urination is reestablished. However, after surgery there can be the inability to hold urine inside the bladder voluntarily or to prevent its leakage. To alleviate this problem, the sphincter muscle must be trained through pelvic base exercises for several weeks. 10 to 35% of all patients report about permanent problems with urinary incontinence and have to wear pads.
Anther undesired side effect is erectile dysfunction, the inability to achieve erections. Newer nerve-sparing operations are less likely to cause erectile dysfunction. Erectile dysfunction occurs in about 60 to 90% of the cases. After a radical surgery, the patient should expect 10 to 14 days of hospital stay, and a post-therapy rehabilitation of about 3 weeks.