PROSTATE CANCER TREATMENT: ABOUT RADICAL PROSTATECTOMY
Radical prostatectomy is certainly not a new cure for prostate cancer; it’s been around since 1904. There are two versions of this operation—the perineal approach, and the retropubic approach. The radical retropubic prostatectomy used to be notorious among surgeons for the extreme bleeding that went along with it, and both of these procedures used to have two devastating side effects— impotence and incontinence.
That picture has changed. The last fifteen years have seen dramatic improvements to the retropubic approach, based on new understanding of the prostate’s anatomy. The development of new techniques has lessened the awful blood loss, and the operation has become far safer for patients. And, with what surgeons call “a bloodless field,” it’s now possible for them actually to see what they’re doing—a major improvement! In the process, critical structures can be looked for and saved that previously were unrecognized and damaged as surgeons blindly felt their way. More precise techniques have reduced the likelihood of troublesome urinary incontinence to about 2 percent (and even those 2 percent aren’t incontinent all the time). New anatomical discoveries also have made it possible for surgeons to preserve potency in the majority of men.
And perhaps most exciting, better understanding of the anatomical terrain means surgeons can now remove more tissue along with the prostate than anyone ever thought possible—which improves the operation’s chances of cutting out all the cancer.
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