As a single treatment method (not combined with other treatments), prostate surgery is an effective way to treat cancer confined to the prostate gland. The Department of Urology in Minnesota has tracked the results of prostate surgery performed on more than 14,000 men since 1966. Their data (see Results of Prostate Surgery) show significant improvements in hospitalization time, outcomes and complications over the years.
Surgeons use special techniques to remove the prostate, while sparing both the muscle that controls urination and the nerve bundles that control sexual function.
Three surgical approaches are currently available for prostate removal: open retropubic, robotic retropubic and perineal.
In the open retropubic approach, the prostate is removed through an incision in the lower abdomen. It is the most common form of prostate removal for two reasons: 1) The surgeon can use the same incision to remove lymph nodes that drain the prostate, which are then tested to make sure the cancer has not spread, and 2) the procedure gives the surgeon excellent access to the prostate making it easier to save nerve bundles that control erection.
The robotic retropubic approach being used in urologic surgery in Minnesota allows the surgeon to remove the prostate with 5-6 tiny incisions (portals), with the aid of the computer and two robotic "hands."
In the perineal approach, an incision is made between the anus and the scrotum. This surgical approach is not as popular as the retropubic approach.
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