A radical (complete) resection of the prostate, one of the most common options for treating localized prostate cancer, removes the prostate gland and its cancer cells.

Prostate cancer treatment in Israel

 

The importance of selecting a urologic oncology specialist

Choosing the right surgeon plays a crucial role in the success of this type of complex surgery. At Lev Naot Hospital, prostate cancer surgeries are performed only by surgeons who specialize in urologic oncology.

Who is a candidate for surgery?

Candidates for a radical resection include:

  • Young patients with prostate cancer or those with a life expectancy of more than 10 years; in these cases, surgery is typically better than radiotherapy or brachytherapy (internal radiation).
  • Patients with mild or moderate risk
  • Patients at high risk – only those with a Gleason score of 8 or lower who have limited disease or are participating in a research protocol
  • Patients with significant urinary incontinence, usually accompanied by a large prostate – a over 60 grams

About radical resection of the prostate surgery

A radical (complete) prostatectomy is a common surgery for patients with prostate cancer. Assuta surgeons tailor the surgical procedure to each patient. During this surgery, the prostate gland and seminal vesicles are removed, and at times, it is also necessary to remove the pelvic lymph nodes. This procedure is performed under regional or general anesthesia.

The objectives of the surgery are to:

  • Remove the cancerous prostate gland and a small amount of surrounding healthy tissue (margins)
  • Promote optimal control over urination
  • Help the patient maintain erections (the success rate depends on the patient’s age and his ability to maintain an erection prior to the operation)
  • Prevent nerve damage from the surgery

Laparoscopic surgery is performed through a small incision in the lower abdomen. During the operation, the surgeon disconnects the prostate gland from the urethra and bladder, while preserving the two erectile nerves located on the sides of the prostate. This nerve-sparing procedure preserves the nerves that are responsible for erectile function. In a small number of cases, it is necessary to excise part or all of the erectile nerves to ensure that the prostate cancer is removed completely.

At the conclusion of the prostate resection, the surgeon uses a catheter to reconnect the bladder to the urethral stump. This catheter supports the recovery process and is removed 10-14 days after the operation. All tissues removed are sent for microscopic examination by a pathologist.

 

What are the possible complications of the surgery?

Because the prostate is located near the urinary tract and genitals, a prostatectomy can impair the proper functioning of any of these systems, causing potential involuntary leakage of urine, urinary incontinence, genital swelling, or impotence. In addition, the surgery usually causes infertility.

Surgical complications may include bleeding or infection, which usually appear near surgery site.