During this operation the entire prostate gland is removed surgically in an attempt to cure the disease. It is only done when the cancer has not spread from the prostate, and usually in men under 70. It is a common operation for prostate cancer. An incision is made in the abdomen or in the perineum, the area between the legs between the scrotum and the anus. The operation is usually carried out under general anaesthetic. Most men remain in hospital for three to seven days. Some of the men who had this operation describe their hospital experiences (also see section on 'Side effects of treatments').
Richard's surgery seemed to go well though he was in the operating theatre for six hours. He...
Well the operation, it was a very long operation, I think, I was told by my consultant that it would be, maybe two to three hours, but as it turned out it was a much longer operation than, I think it was maybe about five or six hours, but obviously I wasn’t (brief laugh) I wasn’t conscious for the operation so I don’t know if there was any complications, but I know from my wife, I mean she was waiting for me when I came out, she was waiting a long time, and obviously thought something might have gone wrong, but yeah, the operation seemed pretty straight forward, and yeah, it was a little bit of discomfort, not really a lot of pain, so I think that was the easy part of the treatment, was the operation, yeah you don’t think it at the time because you haven’t experienced the recovery, but to me, that was the easiest part, I think the recovery period and things you have to go through after that, was much more difficult.
Describes his experience of the Radical Prostatectomy.
So that wasn't a difficult time and I think 2 days, on the second morning, not the first morning after the op the night before but the next one after that I was offered did I want a bed bath. And I think the nurse, she was a middle aged nurse who had been an army nurse and she said 'Do you want a really strong bed bath?' I said 'Oh yes I feel filthy,' and at 5 o clock in the morning just a few days before Christmas I had the best wash I've ever had in my life (laughs) it felt wonderful, absolutely marvellous. So she sorted me out and a few hours after that I was out of the high dependency and into a room where a nurse was designated to look after me for the next day. And as the days went on the tubes came out and life became a bit more comfortable. And by the time, I was in hospital one week, came Christmas Eve, I was down to, from 10 tubes on the first night down to just the catheter and a tube coming out of a, to a waste bag, I forget what they call them.
Yes a drain, taking the rubbish from where the wound, where the operation, that's right a drain, so I had the drain in just taking a bit of rubbish out from the op.
So the experience in hospital was good?
Yes it was, everybody was so, and especially of course when the surgeon came in on the 5th or 6th night and said 'The prostate is, we've caught it in time, it's been,' he said they carve it up and it hasn't reached the outer zone so you're not even in the margin area, it was all central. So that of course made you, you didn't mind how much discomfort you were in at that stage you were basically being told that you hadn't got it in your bones, you hadn't got it, they'd taken out the lymph nodes surrounding the prostate it wasn't there, it was contained all within the prostate. So at that stage he was delighted but that it looked as if it had been a complete success and caught in time and no further problems. But of course it was very uncomfortable for the first month, especially with the catheter and I got an infection in the wound and I got a bladder infection and those were quite uncomfortable but you don't mind that, once you've been told that it's all, you're in the clear. But it was pretty uncomfortable the month, as you no longer had an epidural which I'd had very, very good monitoring by the anaesthetist and the epidural certainly kept me very comfortable in hospital.
So you had an epidural before the operation?
No I think, I don't think I had, no I think that went in whilst I was under the general anaesthetic, I believe that I went in for the operation and the first things they did were fix up things like the epidural and a few tubes here and there and then I was into the surgeon. I was shaved by him, often I think before the nurse or someone else shaves you but he actually wanted to do his own shaving, get it absolutely where he wanted it (laughs) and the scar now 9 months on or so is rather disappointingly fading so I haven't got anything to show off. But it was the first month was quite uncomfy but we had very good, the nurse, the Distric
Describes his experiences of the hospital and discomfort afterwards.
The first person that came into the ward was the physiotherapist and she said "Right let's be having you out of bed", and at this stage after having major surgery I was frightened to get out of bed. There were tubes everywhere and I was frightened to do any damage to those. Anyway,she said "Come on let's be having you." So I rolled out of bed,and she said, "I want you to sit in that chair," so I sat in the chair and she reassured me "You'll be alright," and went. So I sat in the chair for about 10, 15 minutes, felt a bit shaky, got back into bed and I thought well that's not bad. And then nurse brought me soap and water, I freshened myself up and then I just progressed from there. I must add at this stage I was still on liquids only, nil by mouth, I wasn't allowed to eat and I wasn't allowed to eat for a four days because of the operation.
Food never worried me at all, I was just happy to be where I was happy knowing that I'd had the operation so that's how they explained it to me. There's probably a more technical term but they said the stomach goes to sleep, as soon as you touch it and we get no response out of your stomach for 3 or 4 days.
I had no problems at all with the catheter. I was aware of it - I was aware of them changing the bag every now and again, but there was no discomfort. The biggest discomfort after the operation is going to the toilet, but this was after 3 or 4 days later, after which the bowel or the stomach wakes up. I had a bit of a fright then when I went to the toilet and the nurse explained to me "You shouldn't have tried to go to the toilet, you should have left it". But when you haven't been to the toilet you've just got it in your mind "Well I should have to go now". And she was saying "There's nothing there for you to go", and all I did was I make it worse really because I caused bleeding. I thought "Oh what have I done?" But it was nothing, it was just I should have listened, I shouldn't have gone really.
The strain made me bleed and of course with the catheter there I thought something had happened with the tube and I got a little bit of a panic. But when it was explained to me again I was alright. They told me this catheter was really my lifeline and they had it taped to me and they said "Whatever you do don't pull that out, that is your lifeline because that's replacing the tubes inside your body until such times as they heal up."
I was supposed to have been in hospital for 14 days, that's what they told me, after 7 days I think they were glad to get rid of me. My stomach started rumbling and that was, that went on the nurse's report "I've had a rumble, I've had a rumble, my stomach's waking up," so they started me after the fourth day on food. And it was at this stage, once I went onto solids I just had it into my mind that I should have to go to the toilet. I think I just thought well if I've eaten so
Comments that he found the operation straight forward but had some discomfort afterwards.
Describes his experiences on the ward after a major operation to remove a tumour in his abdomen.
Perineum correct thank you, through the perineum area and I can't speak on that because I have no experience at all, as I say my operation was done through the abdomen. And you were told quite clearly that you would be 2 days in intensive care on leaving the theatre and that you would probably be in hospital for something like 6 to 7 days. The anaesthetist was absolutely excellent, following the operation he guaranteed that I would feel no pain and he was absolutely right. He implanted an epidural pretty soon after I came round from the anaesthetic and I can honestly say I had no physical pain at all. There's a certain amount of discomfort of course that you are again fitted with catheters and you've got drips going into your back of your hand and also, or into your wrist and also blood transfusions. These are just a nuisance more than a painful thing. You're pumped fill of antibiotics because they do not wish you to have any infection in the area of the wound because it is a fairly large cut that is made through that abdomen and it was done across the abdomen not as I believe some cases up and down. On leaving hospital I came home, this time I'm absolutely certain with a catheter in and I was incontinent which of course would be the case with the catheter anyway. But after 3 weeks you had to go back and have the catheter removed and I remained incontinent with the catheter out. Now this is the most difficult period of the operation, some people I am informed are lucky the catheter is removed and they're immediately functioning properly, others I'm informed can go on for a year still being incontinent.
The prostatectomy was not as painful as he had expected it to be.
But was that with an injection?
That's right, yes. And then I woke up in intensive care.
And how was that?
Well, I found it much better than I expected. Everybody had talked to me about pain when you wake up and there wasn't a nurse who hadn't come in and sat down and said to me, 'Now I do want to warn you of that' and my surgeon had warned me of this and the anaesthetist. So when I went to sleep I was fully expecting to wake up in considerable pain but I woke up in discomfort, no more. And I had my, I could regulate the amount of analgesic I was getting so that if I had wanted more I could have had more but I didn't want any more. And then there were a massive number of drips going, of course, and oxygen, just the usual intensive care procedure. And a very, very pleasant male nurse was specialing me; he couldn't have been better and very efficient, I thought, forever regulating this and that and putting things into my line, what it was I have no idea.
So how long did it take for you to move back to a regular [ward], were you in a private room or regular ward?
I was in a private room and I was just over 24 hours in the intensive care and then went upstairs. I was still having problems with blood pressure and blood oxygenation because I'd bled during the surgery and I had a fair number of units of blood. But even when I got back to the ward, to my room, my haemoglobin was 7 so I had obviously had quite a biggish bleed.
Haq explains why surgeons found it impossible to remove all of his prostate.
After the operation John developed a MRSA (Methicillin-resistant Staphylococcus aureus) infection.
The latest way of performing radical prostatectomy is laparoscopic (keyhole surgery), either standard or robot assisted. These are minimally invasive with the advantages of reduced blood loss, postoperative pain and a shorter hospital stay. For more information see Robot-assisted laparoscopic radical prostatectomy.
Last updated July 2017.