Prostate Cancer Surgery
For localized prostate cancer
Surgical removal of the prostate gland ('radical prostatectomy') is considered the 'gold standard' for treating localized prostate cancer.
- By surgically removing the entire prostate, it virtually guarantees that cancers confined to this organ are eliminated from the body, and reduces the chances that prostate cancer will recur.
- Prostate surgery is our preferred treatment if there is a reasonable chance that the prostate cancer will inflict significant consequences during a man’s lifetime, particularly for men with a life expectancy of more than 10 years.
Prostate cancer surgery is performed at NYU Langone Medical Center using two different approaches:
- Open prostate cancer surgery, in which the surgeon operates directly on the prostate.
- Robotic prostate cancer surgery, in which the surgeon uses hand controls that operate robotic surgical arms placed inside the patient’s body. Additional information about robotic prostatectomy can be found on our Robotic Surgery Center website.
We have not observed any significant differences in outcomes between open surgery and robotic surgery for prostate cancer, if both are performed by expert surgeons.
Open prostate cancer surgery
"Open" radical prostatectomy is a proven method of eradicating prostate cancer. This procedure, performed under general anesthesia, removes the prostate and seminal vesicles through a small incision in the pubic area. Dr. Herbert Lepor, Professor and Martin Spatz Chairman of the Department of Urology, specializes in this procedure, and Dr. Samir Taneja, Director of Urologic Oncology, is also an expert at performing radical prostatectomy.
Dr. Herbert Lepor provides an overview of open radical prostatectomy in this video interview.
Get more more in-depth information on radical prostatectomy
The most experience in the Northeast
Dr. Lepor has performed close to 4,000 radical prostatectomies, one of the largest series in the world—and over 1,000 more than any other surgeon in the Northeastern U.S. He has published over 75 papers on prostate cancer in peer-reviewed medical journals, and lectures throughout the world on prostate cancer.
Preserving erectile function
Dr. Lepor pioneered the development of the nerve-sparing retropubic prostatectomy, which completely removes the cancerous prostate while preserving the nerves that control sexual function. In a study of 400 of Dr. Lepor’s patients published in 2004:
- 80% of men under age 50 regained erectile function satisfactory for intercourse within 24 months of prostate cancer surgery.
- 63% of men over age 50 regained erectile function satisfactory for intercourse within 24 months of prostate cancer surgery.
Post-surgical sexual rehabilitation: a team approach
The Department of Urology has pioneered techniques to minimize erectile dysfunction after radical prostatectomy. Men may resume assisted penetrative sexual activity within six weeks of prostate cancer surgery, if motivated. >> Read more about our post-prostatectomy sexual rehabilitation protocol
The Smilow Center prostate cancer care team includes Dr. Joseph Alukal, who specializes in the treatment of erectile dysfunction. >> Meet Dr. Alukal
Urinary incontinence is a common concern among men facing prostate cancer surgery. In a study of 380 of Dr. Lepor’s patients published in 2005:
- Approximately 80% of men regained continence within 3 months of prostate cancer surgery.
- 98% of men regained continence within 24 months of prostate cancer surgery.
The NYU Langone Medical Center prostate cancer care team includes Dr. Victor Nitti, an international expert in male urinary incontinence. >> Meet Dr. Nitti
The recovery time after prostate cancer surgery depends on the motivation of the patient as well as his type of employment.
- The average hospital stay for Dr. Lepor’s patients is 1.7 days.
- Many of Dr. Lepor's patients return to work within 8 days, if they work in an office setting. For those whose employment requires heavy lifting, most return to work by 3 weeks.
- Dr. Lepor encourages the return to unrestricted activities within 3 weeks of prostate cancer surgery. Over the last four years, Dr. Lepor has collected over 600 pictures of patients engaged in various activities, including parachuting, water skiing, sprinting, fishing, boating, motorcycling, cycling and golfing, all within three weeks of radical prostatectomy.
Improvement in urinary symptoms
Radical prostatectomy has also been shown to improve urinary symptoms that are caused by benign enlargement of the prostate. In a study of 500 of Dr. Lepor’s patients published in 2004, men who had moderate to severe lower urinary tract symptoms (urinary frequency, urgency, straining to initiate urination) reported a clinically significant improvement in their symptoms after radical prostatectomy.