Laparoscopic Radical Prostatectomy in Ahmedabad

Surgery is one of several treatment options for prostate cancer. Others include active surveillance, radiotherapy and hormone therapy. The right choice depends on the cancer's risk level, the man's age and general health, and his priorities about possible side effects, especially urinary control and erections. This decision is usually made together with a urologist or uro-oncologist and, where relevant, a radiation oncologist.

At Tirtham Surgical Hospital, Science City Road, Sola, Ahmedabad, laparoscopic radical and simple prostatectomy are listed among the advanced laparoscopic surgeries. This page explains prostate cancer treatment options, the difference between radical and simple prostatectomy, the operation, recovery, effects on urinary control and sexual function, follow-up and risks.

The Prostate and Prostate Cancer

The prostate is a small gland below the bladder in men. It surrounds the urethra (the tube that carries urine out of the body) and makes part of the fluid in semen. The nerves that control erections run very close to it on each side, and the muscles that control urine flow lie just below it.

Prostate cancer is a common cancer in older men. Many prostate cancers grow slowly, and some may never cause harm during a man's lifetime, while others grow faster and need treatment. Early prostate cancer often causes no symptoms and is found through a PSA blood test or a prostate examination. Urinary symptoms such as a weak stream or passing urine often at night are more commonly caused by benign (non-cancerous) prostate enlargement, but should be checked by a doctor.

How Prostate Cancer Is Diagnosed and Staged — Step by Step

• Medical history and examination: symptoms, family history and a digital rectal examination of the prostate
• PSA blood test: a raised PSA level can suggest prostate cancer, but can also be raised in benign enlargement or infection
• MRI of the prostate: shows areas that look suspicious and helps guide the biopsy
• Prostate biopsy: small samples of prostate tissue are examined to confirm cancer and its grade (Gleason score or Grade Group)
• Staging scans when needed: a bone scan, CT scan or PSMA PET scan, especially for higher-risk cancers, to check whether the cancer has spread
• Risk group: the PSA, grade and stage together place the cancer in a low, intermediate or high-risk group
• Treatment discussion: all suitable options, with their benefits and side effects, are explained before a decision is made

Treatment Options for Prostate Cancer Confined to the Prostate

Surgery and radiotherapy are both established treatments for localised prostate cancer. They differ mainly in their side effects and in how the treatment is given. The choice is made after discussing all options with the treating specialists.

How Radical and Simple Prostatectomy Differ

Simple Prostatectomy for a Very Large Benign Prostate

Laparoscopic simple prostatectomy in Ahmedabad is considered for men with a very large non-cancerous prostate causing urinary blockage, for whom an operation through the urethra, such as TURP, is less suitable because of the size of the gland. The enlarged inner part of the prostate is removed through small incisions in the abdomen, and the outer layer of the prostate is left in place. A urinary catheter is needed for some days afterwards.

Other options for a large benign prostate include laser enucleation through the urethra, available at some centres. Possible effects of simple prostatectomy include bleeding that may need transfusion, urinary infection, dry orgasm (semen flowing backwards into the bladder), and, uncommonly, leakage of urine or narrowing of the urethra.

Related page: Prostate surgery (TURP)

The rest of this page is about radical prostatectomy for prostate cancer.

Who Is Radical Prostatectomy Suitable For?

Radical prostatectomy is generally considered for men whose cancer is confined to the prostate, who are fit for surgery, and whose expected lifespan is long enough to benefit — generally at least 10 years. In selected men with higher-risk cancer, it may be part of a combined treatment plan. It is usually not the first choice for very low-risk cancer, where active surveillance may be suitable, or when the cancer has spread to distant parts of the body.

A laparoscopic prostatectomy doctor in Ahmedabad can explain whether keyhole surgery is suitable in your case, based on the cancer's risk group, the size of the prostate, previous abdominal or pelvic surgery, and your general health.

Radical Prostatectomy Operation in Ahmedabad: Step by Step

• General anaesthesia is given
• Small incisions are made in the lower abdomen for a camera and fine instruments
• The prostate and seminal vesicles are separated from the bladder, rectum and surrounding tissues
• The nerves for erection are preserved where the cancer allows (nerve-sparing)
• Lymph nodes in the pelvis are removed when the cancer risk group needs it
• The prostate is removed, and the bladder is joined to the urethra with stitches
• A urinary catheter is placed to allow this join to heal; a drain may also be placed

Compared with open surgery, the keyhole approach usually means less blood loss, less pain and a shorter hospital stay. Sometimes the operation is changed to open surgery when that is safer. Robotic-assisted surgery follows the same principles using a robotic system and is available at some centres. The removed prostate is sent for histopathology, which confirms the grade and stage of the cancer and shows whether the edges of the removed tissue (margins) are clear of cancer.

Nerve-Sparing Surgery

The nerves that control erections lie very close to each side of the prostate. Where the cancer allows, the surgeon preserves these nerves on one or both sides to improve the chance of recovering erections. Nerve-sparing is not always possible — if the cancer is close to or involves the nerves, removing the cancer completely comes first. Whether nerve-sparing is planned is discussed with you before surgery.

Lymph Node Removal

For intermediate and high-risk cancers, lymph nodes in the pelvis may be removed during the same operation to check whether the cancer has spread to them. This helps decide whether further treatment is needed.

Effects on Urinary Control and Sexual Function

Removing the prostate can affect urinary control and erections, because the structures that control them lie right next to the prostate. Most men improve with time, but it is important to know what to expect before deciding.

Pelvic floor exercises, ideally started before surgery, and a plan for erection recovery where appropriate, are part of care after the operation.

Preparing for Laparoscopic Radical Prostatectomy

• Discussion of all treatment options, and of the expected effects on urinary control and sexual function
• Blood tests, ECG and other tests as advised, and a pre-anaesthesia check-up
• A check of all medicines; blood thinners may need to be stopped or adjusted, only as advised by the doctor
• Teaching of pelvic floor exercises
• Discussion of sperm banking, if future fertility matters to you
• Fasting instructions before surgery
• Written informed consent after the operation, its benefits, risks and alternatives have been explained

For men planning laparoscopic radical prostatectomy in Ahmedabad, starting pelvic floor exercises in the weeks before surgery gives time to learn them properly before the catheter is placed.

Recovery and Follow-Up

PSA Follow-Up

After the whole prostate is removed, the PSA level should fall to a very low level. Regular PSA tests are the main way to check that the cancer remains controlled. A PSA level that stays very low is reassuring. A rising PSA may mean that some cancer cells remain, and further treatment, such as radiotherapy, may be advised. The pathology results also help decide whether any further treatment is needed.

When to Contact the Hospital After Surgery

• No urine draining into the catheter bag, or pain in the lower abdomen
• Fever or chills
• Heavy bleeding or large clots in the urine
• Severe abdominal pain or swelling
• Redness, swelling or discharge from a wound
• Breathlessness, or pain and swelling in the calf

Risks and Possible Complications

Radical prostatectomy is major surgery. The surgeon explains these risks before taking consent.

• Leakage of urine (incontinence) — common at first; long-term leakage in a small number of men
• Erection problems (erectile dysfunction)
• Dry orgasm and loss of natural fertility — expected after radical prostatectomy
• Reduction in penile length in some men
• Bleeding, which may need blood transfusion
• Infection of the urine, wound or abdomen
• Urine leak from the join between the bladder and urethra, which may need the catheter to stay in longer
• Narrowing at the join (bladder neck stricture), which may need a further procedure
• Collection of lymph fluid (lymphocele) after lymph node removal
• Injury to the rectum, bowel, ureter or blood vessels — rare
• Groin hernia developing later in some men
• Cancer left at the margins or cancer returning, needing further treatment
• Conversion to open surgery
• Blood clots in the legs or lungs, and chest infection
• Anaesthesia-related risks — assessed at the pre-anaesthesia check-up

Prostatectomy Cost in Ahmedabad

The cost differs from patient to patient. The main factors are:

• Radical or simple prostatectomy, and whether lymph nodes are removed
• Laparoscopic or open technique
• Investigations required, such as MRI, biopsy and staging scans
• Length of hospital stay, room category, and intensive care if needed
• Medicines, blood transfusion and histopathology
• Any further treatment after surgery, such as radiotherapy

A written estimate based on the patient's diagnosis and chosen room category can be requested from the hospital.

Insurance

• Mediclaim and cashless facility is available, subject to the patient's policy terms and insurer approval
• Assistance is provided with documents required for reimbursement claims

Doctors Involved in Radical Prostatectomy

Radical prostatectomy is commonly performed by a urologist or uro-oncologist, and the decision to operate is usually made after all treatment options for prostate cancer have been discussed. Several doctors may be involved at different stages:

Treating Surgeon

At Tirtham Surgical Hospital, laparoscopic radical prostatectomy in Ahmedabad is performed by:

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Facilities at Tirtham Surgical Hospital

• 24-hour emergency operating team
• Laparoscopic and endoscopic setup
• Mediclaim and cashless facility, subject to policy terms
• 6 themed recovery rooms
• Large parking facility

Contact and Location