At this time I have only experience with radical prostatectomy.

What is a prostatectomy?

A prostatectomy is a surgical procedure for the partial or complete removal of the prostate. It may be performed to treat prostate cancer or benign prostatic hyperplasia.

A common surgical approach to prostatectomy includes making a surgical incision and removing the prostate gland (or part of it).

Types

Radical prostatectomy is a surgery that takes out the entire prostate gland and some surrounding tissue. This surgery is done to treat prostate cancer. Sometimes nearby lymph nodes also are taken out.

• Open radical prostatectomy. In this traditional open surgery, a surgeon takes out the prostate through a single long cut, also called an incision.
• Open radical retropubic prostatectomy. This is a type of open radical prostatectomy that's done through a long cut in the lower belly.
• Open radical perineal prostatectomy. This is a type of open radical prostatectomy that's done through a long cut in the area between the anus and the scrotum. This area is called the perineum. This surgery isn't commonly done because it's more likely to cause trouble with erections and does not allow for lymph node removal. However, it may be less painful and have an easier recovery compared with a retropubic approach.
• Radical laparoscopic prostatectomy. In this type of surgery, the prostate is taken out with tools inserted through several small cuts in the lower belly rather than through one large cut. This approach is now more common than open surgery. And it's usually done with robotic assistance. Because it's done through the lower belly, it's also considered a retropubic approach.
• Robot-assisted radical laparoscopic prostatectomy (RALP). A robotic prostatectomy is a common type of laparoscopic surgery. A surgeon sits at a control panel called a console and uses it to move surgical tools that are attached to robotic arms. The tools usually are inserted through several small cuts in the lower belly. Because the surgery is done through the lower belly, it's also considered a retropubic approach. Less often, the surgery is done through a larger cut in the perineum, which is called a perineal approach. A robotic prostatectomy lets the surgeon operate with precise movements. As a result, robotic prostatectomy may cause less pain and bleeding than open surgery. Recovery time also may be shorter.

• Nerve-sparing prostatectomy. For this procedure, the surgeon uses one of the approaches described to take out the prostate while trying not to injure the nerves that play a role in erections. This may not be possible if the cancer is very close to the nerves. In that case, a non-nerve-sparing prostatectomy may be needed.