OP
The surgical treatment option is radical prostatectomy (RPE). The prostate gland (prostate) is completely cut out (ectomy), usually both seminal vesicles and possibly also affected lymph nodes in the immediate vicinity (regional lymph nodes). There are various surgical procedures.
The operation can be performed through the abdomen (retropubic RPE) or from the perineum (perineal RPE). A distinction is also made between open and laparoscopic or even minimally invasive surgery. The minimally invasive procedure has the advantage that there is less incision area and thus fewer wound edges.
However, the major disadvantage compared to the open procedure is that only lymph nodes in the immediate vicinity can be removed. With the prostate, however, a part of the urethra is also cut out. This is sutured again, but often leads to incontinence at first.
How long this lasts depends on the operation itself, but also on factors that the patient brings along. Some incontinence disappears completely immediately or within a few weeks, but it is also possible that it will remain for life. Another complication that can result from the surgery is the injury to the nerves that are responsible for erection.
In the worst case an erection is no longer possible, but the ability to have a climax remains unaffected. However, the surgery around the nerves depends very much on the skill of the surgeon and the technique used. In recent years, the “nerve-sparing technique” has become more and more popular, which can show better results in this respect.
A cosmetic side effect of the operation can also result in a shortening of the outer limb, which causes psychological problems for some patients after the operation.However, despite all complications, radical prostatectomy is the procedure of choice to cure a localized carcinoma. However, the decision for this should always be made on a case-by-case basis and with supportive counseling.
