Side effects and risks
Many patients shy away from this procedure out of fear they will become incontinent or impotent. These issues occur when the neurovascular bundles located very close to the prostate are damaged or removed during the operation, or when the sphincter that controls the flow of urine cannot be entirely spared.
Removing only the tumour while leaving the rest of the prostate intact is only an option in rare cases. More than 80% of all prostate tumours are multifocal, which means that there are multiple small tumour lesions in the prostate. Such lesions cannot be seen by the naked eye during surgery. We therefore perform a fresh-frozen section analysis during the operation (called the NeuroSAFE technique) to determine whether the tumour extends beyond the capsule. This tells us whether we can spare the nerves adjacent to the prostate or if they must also be removed.
At the Martini-Klinik, we place special emphasis on preserving patients’ potency and continence when removing the prostate.
This involves carefully removing the very fine layer containing the neurovascular structures responsible for continence and erectile function from the prostate, leaving them fully intact. The full length of the sphincter is also spared and retained. In most cases, this approach preserves patients’ continence and potency at same level as before the operation.