Radical Prostatectomy
Prostate Surgery
At a Glance
- Surgical procedure to remove the prostate gland
- Used to treat prostate cancer
- Very common surgery
- Two types of surgeries; Open and Laproscopic
- Common side effects are Urinary Incontinence and Erectile Dysfunction
The Details
Radical prostatectomy is a very common surgery and is done only for confirmed cases of prostate cancer. If cancer hasn’t spread outside of the prostate gland it may be recommended by your surgeon to remove the prostate gland completely in the hopes of eliminating the cancer.
What to know about Radical Prostatectomy
How it works
There are two general types of Radical Prostatectomy surgeries.
- Open Radical Prostatectomy: A more traditional type of surgery, in open surgery your surgeon makes a vertical incision between your belly button and pubic bone and uses this incision to remove the prostate and surrounding tissue.
- Laparoscopic Radical Prostatectomy: Also referred to as robotic radical prostatectomy, this minimally invasive procedure makes several small incisions or one single incision across your abdomen. During this type of surgery, your surgeon operates robotic controls outside of your body to remove your prostate and the surrounding tissue.
Who’s it for?
Men who have been diagnosed with Prostate Cancer are the most likely to have a Radical Prostatectomy but this procedure is also done for men dealing with Benign Prostatic Hyperplasia (BPH) as a long-term solution.
What should I expect after the procedure?
After a Radical Prostatectomy, light exercise such as walking can help with the healing process but you should avoid heavy lifting for several weeks.
Your healthcare provider can work with you to improve any problems with erectile dysfunction or bladder control.
Urinary Incontinence
There is a risk of urinary incontinence after surgery but it’s typically temporary. You may experience incontinence or leakage for a few weeks to months after the surgery.
Erectile Dysfunction
Your doctor may prescribe you medication and/or vacuum erection devices for penile rehab and sexual activity. Sexual function is the slowest side effect to recover sometimes taking months or years.
Radical Prostatectomy Side Effects
- Erectile Dysfunction
- Urinary Incontinence
- Sterility
- Lymphedema
- Shortened penis length
- Other general risks associated with anesthesia and the procedure itself
Good to Know
The goal of a Radical Prostatectomy, or any treatment for prostate cancer, is to get you to a point where you’re cancer free! After that, there are medications and devices that can help when the focus shifts to quality of life.
Level Up Your Knowledge
Helpful Articles
How An Enlarged Prostate Affects Your Sexual Health
In this article, Dr. Barbalat discusses the importance of treating the bothersome urinary symptoms of BPH and the longterm complications they can cause, while keeping the patient’s sexual function and goals in mind.
Prostate Surgery and Erectile and Ejaculatory Function
In this article Dr. Loh-Doyle discusses surgical options for treating BPH and prostate cancer and their impact on ejaculatory and erectile function.
Having trouble urinating? You may have BPH
In this article Dr. Martinez discusses the symptoms of BPH and prostate cancer, and why it's important to see your urologist for diagnosis and treatment.
Penile Rehab Post Radical Prostatectomy
What is it
Penile reconditioning (rehab) is a treatment or therapy that helps men reach or regain their erections after a Radical Prostatectomy. After surgery, it’s often recommended to rehabilitate your penis using medications and/or devices to bring oxygen-rich blood into the penis to prevent penile length loss and promote healthy erections. Rehabilitation can include one or a combination of the following; oral ED medications such as sildenafil or tadalafil, a vacuum erection device, and pelvic floor physical therapy. This in combination with a heart-healthy lifestyle will help maximize recovery.
Be sure to discuss your sexual goals with your provider before surgery and formulate a plan for success for implementation shortly after surgery.
How does it work
VEDs for penile rehab are often used in combination with medication. They’re used 3-5 days per week for approximately 20-30 minutes each time without the use of a constriction ring. While the amount of time each man needs to condition their penis for blood flow differs, in most cases doing this for a period of 1-2 weeks is enough time to recondition the penile tissue.
Steps for penile rehab with a VED:
- After the erection is created, hold the erection in the penile tube for 1-3 minutes
- Release the pressure in the tube while maintaining the seal between your body and the device to release your erection
- Once you have created 1 erection and released 1 erection, that’s one “set” done
- Repeat this process for 3-5 sets for a total of 10-15 minutes per training session
Treatment Options Post Radical Prostatectomy
The good news is – there are plenty of ED treatment options post Radical Prostatectomy. menMD has both prescription and non-prescription options available. Dive in and learn which ones might work best for you.
Bimix
Injection therapy, the most effective treatment for ED, is injected into the shaft of the penis 5-15 minutes prior to intercourse.
2 drug mixture available in 4 formulations, prescription required.
Boston Scientific AMS 700™
Highly effective implantable device to treat men struggling with ED. The device has a pump in the scrotum and a reservoir in the pelvic area that control the inflatable device.
Tadalafil
Same active ingredient found in Cialis. Taken one hour prior to sexual activity. Effective for up to 36 hours.
Available in 5mg and 20mg tablets or lozenges, prescription required.
Vacuum Erection Devices
The VED is a plastic tube that fits over the penis and is pressed against the base of the penis and pubis. It uses suction to pull blood into the penis to create an erection.
Sildenafil
Same active ingredient found in Viagra®. Taken orally, 30 to 60 minutes prior to sexual activity.
Available in 20mg and 100mg tablets, prescription required.