Surgery may be a treatment option and will depend on the type, size and spread of your cancer. The following types of surgery are used:

• Radical prostactectomy: surgical removal of the entire prostate and some nearby tissue. It is most often used during the early stages (I + II) of prostate cancer, when the cancer is located only within the prostate. It may also be used in combination with hormonal therapy (see Hormonal Therapy), when the disease has spread locally beyond the prostate (Stage III).
  
  
  
  Figure 1: Surgery
  
  There are two common types of procedure, retropubic where the surgeon removes the prostate through an incision in the lower abdomen or perineal, where the incision is made between the scrotum and the anus. The entire prostate gland, attached seminal vesicles, and some nearby tissue are removed during such surgery.
  
  
• Transurethral resection of the prostate: a surgical procedure in which an instrument is inserted through the urethra (the tube that carries urine from the bladder and out through the penis) and the cancerous tissue that is blocking the urethra is removed. It is not intended to completely remove the cancer.

Most men experience some temporary urinary incontinence following prostate surgery. However, permanent loss of urinary control is uncommon. Impotence may occur in men who undergo prostate surgery. Where possible, nerve-sparing surgery may be used in an attempt to spare the nerves that control erection.

• Orchidectomy (or surgical castration) is the removal of the testes, which are the organs that produce the male hormones e.g. testosterone. Such surgery is generally reserved for advanced prostate cancer (Stage IV). Whilst it is included here as a surgical technique, it can also be described as hormonal therapy, since it prevents the production of testosterone. It has now largely been replaced by the use of medical castration