Radical prostatectomy and Perineal prostatectomy

Radical prostatectomy consists of removing the entire prostate gland, the seminal vesicles, both of the ampullae (the enlarged lower sections of the two vas deferens which are the tubes that carry sperm from the testicles to the actual prostate gland) and the other surrounding tissue. The portion of the urethra that travels through the prostate is cut away as well as the bladder neck and some of the sphincter muscle that controls urine flow.

Dissection of the pelvic lymph node is routine with a retropubic prostatectomy but with a perineal prostatectomy the dissection requires a separate incision.

A radical prostatectomy is a serious, complicated, demanding procedure. The surgery itself will take anywhere from 2 to 4 hours. The patient will remain in the hospital for approximately 3 days. He will require a catheter (tube to drain urine) for about 10 days to 2 weeks. There is a small percentage (5 to 10%) of surgical related problems like bleeding or infection. The risk of death from the surgery is very minimal and much less for younger men as opposed to older men who may be frail.

Post surgical, long term problems associated with prostatectomy range from sexual impotence, stool incontinence and urinary incontinence. It is highly unlikely that a man will father children after the procedure. The reason is that without the prostate, very little ejaculate is produced.