Radical Prostatectomy

1. What is Radical Prostatectomy?

Radical prostatectomy is surgery in which the entire prostate gland is removed to treat prostate cancer.

The procedure may also involve removal of:

• Seminal vesicles
• Surrounding tissues where required
• Nearby pelvic lymph nodes in selected patients

The bladder is then reconnected to the urethra to restore the normal passage of urine.

2. When Is Radical Prostatectomy Recommended?

Radical prostatectomy may be recommended for selected patients with:

• Localised prostate cancer
• Selected locally advanced prostate cancer
• Cancer considered suitable for surgical removal
• Good overall health and fitness for major surgery

The decision depends on:

• PSA level
• Biopsy and Gleason score
• Cancer Grade Group
• MRI and staging results
• Cancer location and extent
• Age and overall health

3. How Is the Patient Evaluated Before Surgery?

Evaluation may include:

• Urology or uro-oncology consultation
• PSA blood test
• Prostate biopsy and pathology review
• Gleason score and Grade Group assessment
• Multiparametric prostate MRI
• PSMA PET-CT or other staging scans where appropriate
• Blood and urine tests
• General medical assessment
• Anaesthesia evaluation

These investigations help determine whether surgery is an appropriate treatment option.

4. What Does the Procedure Involve?

The general treatment pathway includes:

PSA and diagnostic evaluation → Biopsy and pathology review → MRI/staging scans → Uro-oncology consultation → Assessment of surgical suitability → Preoperative preparation → Radical prostatectomy → Pelvic lymph-node removal where required → Bladder-urethra reconstruction → Catheter placement → Recovery → Final pathology review → PSA monitoring and follow-up

The procedure is performed under general anaesthesia.

5. What Surgical Approaches Are Available?

Depending on the patient's condition and hospital facilities, radical prostatectomy may be performed using:

• Open radical prostatectomy
• Laparoscopic radical prostatectomy
• Robotic-assisted radical prostatectomy

Nerve-sparing surgery may be considered in suitable patients to help preserve erectile function when medically and oncologically appropriate.

6. How Long Does Surgery and Recovery Take?

Typical considerations include:

• Surgery: approximately 2–5 hours
• Hospital stay: approximately 2–5 days
• Urinary catheter: usually remains temporarily after surgery
• Initial recovery: approximately 4–6 weeks
• Long-term follow-up: regular PSA monitoring is required

Recovery varies depending on the surgical technique and individual health.

7. What Are the Expected Benefits and Outcomes?

For suitable patients, radical prostatectomy may:

• Remove localised prostate cancer
• Provide treatment with curative intent
• Provide detailed final pathological information
• Help assess the extent of cancer
• Reduce the risk of cancer progression in appropriate patients

Outcomes depend on the cancer stage, grade, surgical margins and other pathological findings.

8. What Are the Risks or Considerations?

Potential risks include:

• Bleeding
• Infection
• Blood clots
• Urinary incontinence
• Erectile dysfunction
• Changes in ejaculation and fertility
• Urinary narrowing or bladder-neck contracture
• Injury to nearby organs
• Lymphoedema following lymph-node removal
• Need for additional radiation or systemic treatment

Individual risks should be discussed with the treating uro-oncology team.

9. Why Consider Radical Prostatectomy in India?

India has specialised uro-oncology centres offering:

• Experienced urologists and uro-oncologists
• Advanced prostate cancer imaging
• Multiparametric MRI and PSMA PET-CT
• Open, laparoscopic and robotic surgical options
• Experienced multidisciplinary cancer teams
• Modern ICU and postoperative care
• Long-term cancer follow-up

10. How Can Medavelle Help and What Should the Patient Do Next?

Medavelle can assist with:

Medical-record review → Uro-oncology specialist coordination → Hospital selection → Diagnosis and staging review → Surgical suitability evaluation → Treatment planning → Cost estimation → International patient arrangements.

Next step: Share PSA, biopsy & imaging reports → Uro-oncology evaluation → Cancer staging and risk assessment → Assessment for radical prostatectomy → Personalised surgical planning → Surgery → Recovery → Final pathology review and long-term PSA follow-up.