If the prostate carcinoma is organ confined after all preliminary examinations, there is also the option of surgical removal of the prostate in addition to local internal or external radiation therapy.

The long-term results of surgery are equivalent to those of brachytherapy in early stages. Radical prostatectomy (removal of the prostate) can be performed with an abdominal incision, perineal incision or laparoscopically during laparoscopy. The choice of procedure depends primarily on the surgeon's experience with each technique.

The hope that robotic-assisted surgery to remove the prostate (da Vinci robot) would allow for less incontinence, better potency rates due to nerve preservation, or shorter layover times has unfortunately not been demonstrated in large interanational studies.

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Incontinence and impotence

After the prostate is removed, the urethra is reconnected to the bladder so that urination can occur normally. However, there may be involuntary leakage of urine after the operation - the sphincter muscle must be trained with pelvic floor exercises for several weeks. Permanently, 10 to 35% of all patients complain of problems with urine retention (urinary incontinence) after radical surgery and have to wear pads.

Other undesirable side effects are disorders of limb stiffness (impotence). One tries to avoid this by preserving the corresponding nerves. Potency disorders occur in about 60-90% of patients. After radical surgery, the patient should expect to stay in hospital for 10 to 14 days, followed by 3 weeks of follow-up treatment.