Speak to your health care team, who will be able to advise you on the advantages and disadvantages of radical prostatectomy and whether it’s suitable for your situation. Your state of health, your age and the stage of your cancer are all factors to be considered.

Some of the main advantages of having a radical prostatectomy include:

• removal of all the cancer – this is only possible if the cancer is inside the prostate
• reassurance – knowing that the prostate has been completely removed, along with all the cancer, is reassuring and may outweigh the disadvantages.

Additionally, in some cases, the radical prostatectomy will provide confirmation of whether the cancer has spread outside the prostate.

The disadvantages include the risks associated with surgery and the potential side effects. The procedure takes 3-4 hours, there are the inherent risks of surgery: bleeding, infection, damage to other organs, hernias and anaesthetic risks.

When considering the advantages and disadvantages of a radical prostatectomy, remember that everyone has different priorities. What’s important to you may not be so important to someone else.

There are several possible side effects to be aware of before deciding to have a radical prostatectomy. They include:

• urinary incontinence – you may experience urine leakage, as some of the muscles that support the bladder may be impaired after the surgery
• inability to ejaculate – as the prostate and seminal vesicles are removed during surgery, you won’t ejaculate fluid anymore; you will, however, still have and feel an orgasm
• climacturia – you may leak a little urine when you orgasm
• changes in how orgasms feel – as you will ejaculate without fluid, your orgasms may feel different to what you’re used to
• delayed orgasms – some people may find orgasms less intense or harder to achieve after a radical prostatectomy
• change in penis size and shape – the penis may be shorter or curved after a radical prostatectomy, but there are treatments to help with this (read more about erectile issues here)
• not being able to have children naturally – after a radical prostatectomy, you can’t have children naturally; consider storing your sperm before surgery if this is important for you.

It’s important to be aware that these side effects don’t always occur after a radical prostatectomy – not everyone will experience them. There are different factors that may increase or decrease the side effects, including:

• age
• the stage or grade of the cancer
• pre-existing health conditions.

During a radical (ROBOTIC) prostatectomy:

• you are placed under a general anaesthetic
• a breathing tube is inserted into your airway
• you are given antibiotics intravenously
• a catheter is placed in the top of your bladder
• cannulae are placed in a vein in your arm to provide fluids during and immediately after the surgery
• you are positioned in the frog-leg position (this may result in some brief back or leg discomfort after the surgery)
• a camera is introduced above your belly button
• five additional ports or channels for the robotic instruments to pass through into you abdomen.

Your surgeon will then:

• detach the bladder from the abdominal wall to access the prostate
• disconnect the prostate from the bladder and urethra, variably preserving the vessels and nerves to the penis, depending on the cancer stage
• remove lymph nodes from the pelvis, if this is needed
• join the bladder and urethra and place a catheter through the join to support healing.

Before closing the port sites, your surgeon may insert a drain to remove any extra fluid.

If you have open surgery, the process will be similar, but your surgery will be performed via a cut below your umbilicus.

You will return to the ward after waking up. Your medical team will encourage you to eat, drink and move as soon as you are comfortable. You will be able to leave the hospital one to two days after your surgery.

The catheter that was put in place during surgery will drain urine without you needing to go to the toilet. It will typically remain for 7 to 10 days, although if a reconstruction of the bladder was required, the catheter may need to stay for longer. If it feels uncomfortable, your medical team can give you medication to reduce the sensation from your bladder. Your team will also show you how to care for your catheter.

While you recover in hospital, you may notice bruising and swelling around your penis and testicles. This usually goes away after a few weeks. You will have pain-relieving medication to help you recover. Wearing supportive underwear can help you to manage pain.

Your wound will be closed with glue, clips or stitches, depending on whether you had keyhole surgery or open surgery. If you had open surgery, you might need stitches removed one or two weeks after your surgery. Your medical team can give you more information about how to care for your wound at home.

The healing process can take several months. Remember to be kind to yourself while you heal. Eating a healthy diet and resuming gentle exercise will help you to stay healthy while you recover. Start exercise slowly and only under guidance from your medical team. Your team can tell you more about when it is safe to return to activities and which activities you should avoid.