Laparoscopic prostatectomy: what it involves

Radical prostatectomy is the procedure that removes the entire prostate gland together with the seminal vesicles and, depending on the case, the lymph nodes in the area. It is one of the treatments with curative intent for localised prostate cancer.

When it’s considered

Not every prostate cancer is operated on. The decision depends on the tumour grade, the PSA level, the extent seen on imaging and, very importantly, each patient’s age and general health. In low-risk tumours, active surveillance may be indicated — that is, monitoring with periodic checks rather than treating straight away.

The laparoscopic approach

In extraperitoneal laparoscopic radical prostatectomy, the prostate is reached without entering the abdominal cavity, through small incisions. Compared with open surgery, it usually means less bleeding, less postoperative pain and a shorter hospital stay.

After the procedure

After surgery, a urinary catheter is worn for a few days. The two effects that cause most concern, and that are worth discussing before the operation, are:

Urinary incontinence

In most cases it improves progressively over the following months, aided by pelvic floor exercises.

Erectile dysfunction

Its likelihood depends on whether the neurovascular bundle could be preserved.

Follow-up afterwards

Follow-up afterwards is done with PSA checks. This article is for information only: the indication is always individual and should be assessed in consultation.