Prostate Cancer

Radical Prostatectomy (Open Retropubic)

In a radical prostatectomy (open retropubic approach), the prostate is removed through an incision in the midline of the lower abdomen, typically between the navel and pubic bone, just above the base of the penis. This is the most common form of prostate removal for several reasons. First, the surgeon can use the same incision to remove surrounding lymph nodes, which are tested to ensure the cancer has not spread. Second, the surgeon can get better access to the prostate, making it easier to save nerve bundles that control erection and bladder function. Surgeons are able to use their fingers to feel for cancer and to guide the operation, an excellent technique both for prostate cancer removal and functional recovery. Many surgeons also often use optical magnification to enhance their view of the prostate and surrounding tissues (although the operation can be done without magnification).

Other advantages of the retropubic surgical technique at Mayo Clinic include:

• It is based on the experience of more than 14,000 operations since 1966 at Mayo Clinic.
• The intestinal cavity is not intentionally entered as part of the procedure.
• The bladder outlet is carefully reconstructed.
• It has been proven to preserve nerve function, thus preventing erectile dysfunction and urinary problems.
• Patients may experience less pain after surgery, if a program of preemptive analgesia is used by the anesthesiologist.
• Mayo's approach is designed for quick recovery.