✦ Prostate Cancer Treatment

Open Radical Prostatectomy

Q: Is open prostatectomy still performed?

Yes — in settings without robotic access, or for complex revision cases, open surgery delivers equivalent oncological outcomes. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Q: How does recovery compare to robotic prostatectomy?

Open surgery has a longer hospital stay (3–5 days vs 1–2) and slower continence recovery, but equivalent long-term cancer control.

Q: What is the transfusion rate for open prostatectomy?

Blood transfusion is needed in approximately 5–10% of open cases; this is higher than robotic or laparoscopic approaches. Your consultant will provide specific guidance based on your individual clinical situation and recovery.

Open Surgical Removal of the Prostate for Localised Prostate Cancer

2–3 Hours PROCEDURE

3–5 Days HOSPITAL STAY

>88% 10yr SUCCESS RATE

6–8 Weeks RECOVERY

What is Open Radical Prostatectomy?

Open Radical Prostatectomy is performed through a lower midline or Pfannenstiel incision providing direct access to the prostate via the retropubic space. The prostate, seminal vesicles, and pelvic lymph nodes are removed under direct vision. Despite the advent of minimally invasive approaches, open surgery remains an important option where robotic or laparoscopic expertise is unavailable and delivers excellent cancer control. The procedure is performed under general or spinal anaesthesia with a hospital stay of 3–5 Days. Success rates reach >88% 10-year survival in appropriately selected patients at experienced centres.

Men with localised prostate cancer where minimally invasive surgery is not available, in complex revision cases, or in patients requiring simultaneous open abdominal procedures. Patients must be adequately fit for anaesthesia and free from active systemic infection before proceeding.

How the Procedure Works

Incision & Access

A lower midline incision from the pubis to the umbilicus provides access to the space of Retzius.

Dorsal Venous Complex Control

The dorsal venous complex (Santorini's plexus) overlying the prostatic apex is suture-ligated with a figure-of-eight 0-vicryl.

Nerve-Sparing & Apex Dissection

The neurovascular bundles are identified and preserved in the interfascial plane using sharp dissection with cold scissors.

Posterior Dissection & Specimen

The prostate is retracted anteriorly and Denonvilliers' fascia incised posteriorly, developing the plane to the seminal vesicles.

Vesicourethral Anastomosis

Bladder neck reconstruction performed if necessary; watertight anastomosis constructed with the urethral stump.

Outcomes

2–3 HoursDURATION

3–5 DaysHOSPITAL STAY

>88% 10yrSUCCESS RATE

6–8 WeeksFULL RECOVERY

Who Needs This Treatment?

→Men with localised prostate cancer in settings where robotic or laparoscopic surgery is not available.
→Patients with very large prostates, severe obesity, or prior pelvic surgery making minimally invasive access difficult.
→Those with locally advanced disease (T3–T4) where tactile feedback guides safe dissection.
→Patients with pelvic anatomy altered by prior radiation or surgery requiring open exploration.
→Men who prefer open surgery due to concerns about cost or availability of robotic platforms.
→Those in healthcare systems where open radical prostatectomy remains the established standard of care.

"Open radical prostatectomy has produced outstanding cancer outcomes for decades. While minimally invasive approaches have advantages, open surgery in skilled hands delivers results that are second to none."

— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon

Common Questions

Frequently Asked

Is open prostatectomy still performed?+

How does recovery compare to robotic prostatectomy?+

What is the transfusion rate for open prostatectomy?+

Not sure which treatment is right for you?

Book a consultation with Dr. Vipin Reddy and get a personalised treatment plan.

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