Surgical Treatment

The surgical removal of prostate cancer has for many years been the most common treatment of the disease. It has been controversial, with proponents arguing that surgery is the only real hope for permanently curing the cancer, and opponents claiming that the main effect of surgery is to produce incontinence and impotence without any clear evidence, compared to other forms of treatment, that it actually lengthens men's lives.

The surgical removal of enlarged prostates, both those caused by benign prostatic hypertrophy and those resulting from cancer, has a long history. Until the middle of the twentieth century, the operation was carried out through an incision in the perineum, the area between the back of the scrotum and the anus. During the past halfcentury it has become more popular to surgically remove cancerous prostates through an abdominal incision, an operation referred to as a radical retropubic prostatectomy. The term radical is used because lymph nodes and other tissues surrounding the prostate are routinely removed by the surgeon as well as the prostate itself. Because of its location, surgical removal of the prostate is technically a difficult operation, although in the skilled hands of an experienced urologist it has become fairly routine.

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