Radical Prostatectomy at Apollo Hospitals, Lucknow

Why Patients Choose Apollo Hospitals Lucknow for Radical Prostatectomy

• Part of the Apollo Hospitals Group, established in 1983 ? India's first corporate hospital chain, now with more than 70 hospitals and over four decades of clinical experience across oncology and urology.
• Dedicated Urology and Uro-Oncology department at Apollo Hospitals Lucknow, working alongside medical oncology, radiation oncology, radiology, pathology and anaesthesia teams under one roof.
• Multidisciplinary tumour board approach ? prostate cancer cases are discussed jointly by urologists, oncologists and radiologists before a treatment plan is finalised, rather than surgery being offered by default.
• Team-based experience ? the consultant urology team at Lucknow brings several decades of combined surgical experience; the current panel of urologists and uro-oncologists, along with their individual qualifications and experience, is listed on the hospital's "Find a Doctor" page and can be confirmed at reception.
• Modern operating and imaging infrastructure ? modular operation theatres, high-resolution CT and MRI, digital pathology support and a level-3 intensive care unit for post-operative monitoring when needed.
• Technique options discussed openly ? open retropubic, laparoscopic and, where clinically appropriate and available, minimally invasive robot-assisted approaches are explained with their trade-offs, so the choice is shared and not assumed.
• Structured continence and sexual-health rehabilitation ? pelvic floor physiotherapy, bladder retraining and counselling are built into follow-up rather than left to the patient to arrange.
• Care pathways adapted by age group ? fit older men receive detailed pre-anaesthetic and geriatric risk assessment; younger men with long life expectancy receive extra counselling on nerve-sparing, fertility preservation and long-term PSA surveillance.
• Insurance and TPA help desk on site for cashless approvals, pre-authorisation paperwork and estimates.
• Central Lucknow location serving patients travelling from across Uttar Pradesh, with assistance for outstation families in arranging accommodation and consolidated single-visit investigations.

No hospital or surgeon can guarantee a cancer-free outcome. What can reasonably be offered is careful staging, an honest discussion of alternatives, experienced surgery and structured follow-up.

Overview

Radical prostatectomy is a surgical procedure aimed at removing the prostate gland and some surrounding tissue, primarily to treat prostate cancer. At Apollo Hospitals Lucknow, we pride ourselves on our reputation for excellence in urological care, utilising current technology and advanced surgical techniques. Our team of skilled surgeons and medical professionals is dedicated to providing personalised care, ensuring that each patient receives treatment tailored to their individual needs. With a focus on patient trust and measurable outcomes, Apollo Hospitals Lucknow is recognised as a leading centre for radical prostatectomy in the region.

The operation usually removes the whole prostate gland along with the seminal vesicles, and in selected higher-risk cases, the pelvic lymph nodes. The bladder is then rejoined to the urethra. It is one of two main curative options for localised prostate cancer, the other being radiotherapy, and for many men either can be reasonable.

Why Radical Prostatectomy is Necessary

Radical prostatectomy is often recommended for patients diagnosed with localised prostate cancer, where the cancer has not spread beyond the prostate gland. The procedure is considered for several reasons:

• Cancer control: By removing the prostate gland, radical prostatectomy aims to eliminate cancerous cells and reduce the risk of recurrence.
• Improved survival in suitable patients: Long-term studies suggest that men with localised disease who undergo radical prostatectomy can have better cancer-specific survival than those managed by watchful waiting, particularly younger men and those with intermediate or higher-risk disease.
• Symptom relief: The procedure can relieve some symptoms linked to a bulky prostate cancer, such as difficulty passing urine, and can improve quality of life.
• Accurate staging: Examining the removed prostate and lymph nodes gives precise information on grade, margins and spread, which guides whether any further treatment is needed.

At Apollo Hospitals Lucknow, our urologists assess each case meticulously to determine the most appropriate treatment plan, and will say clearly when surgery is not the best option ? for example in low-risk disease suitable for active surveillance, or in advanced disease where systemic treatment takes priority.

Risks of Delay

Delaying treatment for clinically significant prostate cancer can have consequences. Prostate cancer may progress over time, potentially spreading beyond the gland to nearby tissues, lymph nodes or bone. This progression can lead to:

• Increased cancer stage: As disease advances, curative options may narrow and the chance of long-term control falls.
• Worsening symptoms: Increasing urinary difficulty, blood in urine, pelvic or back pain.
• Higher treatment complexity: Advanced disease may need combined radiotherapy and hormone therapy, with a wider side-effect burden.

An important qualification: not every prostate cancer needs immediate surgery. Low-risk, low-volume cancers are often safely monitored under a formal active surveillance protocol with PSA, MRI and repeat biopsy. Delay is a risk when it is unplanned and unmonitored ? planned surveillance is different. Our team is committed to prompt consultation so that this distinction is made correctly for each patient.

Benefits of Radical Prostatectomy

• Removal of the cancer-bearing organ: For many men with organ-confined disease, surgery achieves durable PSA control.
• Enhanced quality of life: Many patients report improvement in obstructive urinary symptoms and reduction in cancer-related symptoms after recovery.
• Psychological relief: Definitive treatment can reduce the anxiety of living with an untreated cancer diagnosis.
• Clear follow-up signal: After prostate removal, PSA should become undetectable, making recurrence easy to detect early on blood tests.
• Long-term monitoring: Patients at Apollo Hospitals Lucknow receive ongoing surveillance and support so that any issue is addressed promptly.

Benefits must be weighed against the well-recognised risks of urinary leakage and erectile dysfunction, which are discussed in detail before consent.

Preparation and Recovery

Preparation tips

• Preoperative consultation: A thorough discussion with your urologist at Apollo Hospitals Lucknow covering the procedure, risks, alternatives and expected outcomes.
• Medical evaluation: Blood tests, ECG, chest imaging, and staging scans as indicated, plus pre-anaesthetic assessment.
• Medication review: Tell your doctor about every medicine and supplement, including blood thinners, diabetes medicines and ayurvedic or herbal preparations. Some must be adjusted or stopped.
• Lifestyle adjustments: A balanced diet, light activity, tobacco cessation and good glycaemic control before surgery.

Recovery tips

• Follow postoperative instructions on wound care, catheter care, activity limits and medicines.
• Hydration and nutrition: Adequate fluids and a protein-adequate diet to support healing and avoid constipation.
• Gradual return to activities: Avoid heavy lifting and strenuous exercise for several weeks.
• Regular follow-ups: Attend all scheduled reviews so recovery and PSA can be monitored.

Current Guidelines Guiding Treatment Decisions

Decision-making at Apollo Hospitals Lucknow follows internationally accepted and Indian consensus guidance:

• Urological Society of India (USI) ? the national speciality body for urology in India; its annual conference proceedings and Indian Journal of Urology publish Indian consensus positions on prostate cancer diagnosis, MRI-targeted biopsy and management. Indian data consistently show a higher proportion of men presenting with advanced disease than in Western registries, largely because organised PSA screening is not practised in India.
• National Cancer Grid (NCG) India, Management Guidelines for Prostate Cancer (2024 edition) ? resource-stratified recommendations widely used across Indian cancer centres, supporting active surveillance for low-risk disease and radical prostatectomy or radiotherapy for intermediate and selected high-risk localised disease.
• European Association of Urology (EAU) Guidelines on Prostate Cancer, 2024?2025 update ? recommends multiparametric MRI before biopsy, MRI-targeted plus systematic biopsy, and PSMA PET-CT in place of conventional bone scan and CT for staging of high-risk disease. It also supports extended pelvic lymph node dissection only when the estimated nodal risk exceeds roughly 5 per cent, and no longer supports routine limited node dissection.
• American Urological Association / ASTRO / SUO Guideline on Clinically Localized Prostate Cancer (2022, amended 2024) ? recommends active surveillance as preferred management for low-risk disease, and shared decision-making between surgery and radiotherapy for intermediate-risk disease, noting that no high-quality trial shows one to be clearly superior for survival.

What changed recently: the two most significant shifts are the move to MRI-before-biopsy pathways, and the replacement of bone scan plus CT by PSMA PET-CT for staging higher-risk disease. Both reduce unnecessary biopsies and improve the accuracy of case selection for surgery. Guidelines are updated regularly, and your surgeon will explain the version applied to your case.

Timing of Surgery and the Pre-Procedure Phase

Radical prostatectomy is a planned operation, not an emergency. Typical sequence and timing:

• Diagnosis to decision: usually two to six weeks, covering MRI, biopsy, pathology grading and, if needed, PSMA PET-CT.
• Interval after biopsy: surgery is commonly scheduled around four to eight weeks after prostate biopsy to allow inflammation to settle, which can make tissue planes easier to handle.
• Interval after decision: for most localised cancers, operating within a few weeks to about three months of diagnosis is not associated with worse outcomes. This allows time for medical optimisation without meaningful risk.
• Pre-habilitation: two to four weeks of pelvic floor exercise training, walking, blood sugar and blood pressure control, and stopping smoking. Learning pelvic floor exercises before surgery is one of the few things patients can do themselves that may help continence recovery.
• Blood thinners: aspirin, clopidogrel or oral anticoagulants are stopped on a specified schedule set by the surgeon and physician together ? never on your own.

Technique Options and Alternatives Compared

Availability of any specific technology at Apollo Hospitals Lucknow on your surgery date should be confirmed with the urology department at the time of booking.

Additional Procedures Sometimes Performed at the Same Time

• Pelvic lymph node dissection: extended dissection when the calculated risk of nodal involvement is significant, for staging accuracy.
• Nerve-sparing dissection: preservation of one or both neurovascular bundles when tumour location allows; the decision may be made during surgery.
• Bladder neck reconstruction: tailoring the bladder opening to improve the join with the urethra.
• Inguinal hernia repair: a hernia found during pre-operative assessment or at surgery may be repaired in the same sitting if it is safe to do so.
• Frozen section of margins: intra-operative pathology in selected cases to guide how much tissue to remove.
• Cystoscopy: to assess the urethra or bladder if there is a history of stricture or bladder symptoms.

Anything planned as an add-on will be listed on your consent form and reflected in your estimate.

Phase-by-Phase Recovery Timeline

These are typical patterns, not promises. Recovery varies with age, technique, nerve-sparing status and pre-existing health.

Returning to Normal Activity, Work and Exercise

Return is guided by wound healing, continence and comfort rather than fixed dates. General criteria:

• Walking: from day 1, increasing daily.
• Driving a car: usually after the catheter is out and you can brake sharply without hesitation ? commonly 2?3 weeks.
• Two-wheeler riding: generally deferred 4?6 weeks; Indian road surfaces transmit considerable jolting to the pelvis and perineum.
• Lifting: nothing heavier than 4?5 kg for 4 weeks, then graded increase. Avoid lifting water cans, gas cylinders or grandchildren early.
• Squatting and Indian-style toilets: avoid deep squatting and Indian-style toilets for at least 4?6 weeks. Arrange a Western commode or a commode chair over the squat pan before you come to hospital.
• Sitting cross-legged on the floor: usually comfortable again by 4?6 weeks; get up using support rather than twisting.
• Floor sleeping: if the household sleeps on the floor, use a firm mattress with a bedside support for the first 3?4 weeks, since rising from the floor engages the abdominal wall.
• Gym, swimming, running: light cardio at 4 weeks, swimming only after wound and catheter site are fully healed, resistance training and core work usually at 8?12 weeks with surgeon clearance.
• Religious activities: prolonged kneeling, prostration and long temple queues are better postponed for about 6 weeks.
• Sexual activity: typically after 6 weeks and once continence is settling, on medical advice.

Reducing the Risk of Recurrence and What Follow-Up Involves

Prostate cancer recurrence cannot be prevented by lifestyle alone, but recurrence can be detected early and treated:

• PSA is the key test. After prostate removal, PSA should fall to undetectable levels. A confirmed rise above 0.2 ng/mL is defined as biochemical recurrence and triggers further assessment, often PSMA PET-CT.
• Adjuvant or salvage treatment: current guidance favours early salvage radiotherapy triggered by a rising PSA over routine immediate adjuvant radiotherapy for most men with adverse pathology ? a notable change from older practice.
• Modifiable factors: maintaining a healthy weight, regular physical activity, stopping tobacco, controlling diabetes, and a diet with more vegetables, pulses and less processed red meat are sensible and may help general and cancer outcomes.
• Family screening: brothers and sons of a man with prostate cancer have higher risk; they should discuss PSA testing with a doctor from around age 45, or 40 if there is a strong family history or a known BRCA mutation.
• Bone and metabolic health: if hormone therapy is ever needed later, bone density, calcium, vitamin D and cardiovascular risk require monitoring.

Considerations for Older Men, Younger Men and Family Context

Older men

Age alone does not disqualify a man from surgery, but life expectancy does matter. Guidelines generally reserve radical treatment for men expected to live at least ten more years. For fit men in their seventies, surgery may still be appropriate; for those with significant heart, lung or kidney disease, radiotherapy or hormone therapy may carry a better risk?benefit balance. Continence recovery tends to be slower with age. Pre-anaesthetic assessment, frailty screening and a clear plan for home support are essential.

Younger men

Men in their fifties and early sixties usually have the most to gain from surgery and the most to lose from side effects. Discussions should cover nerve-sparing feasibility, permanent loss of ejaculate and consequent infertility, and sperm banking if further children are wanted.

Children

Prostate cancer does not occur in children, so radical prostatectomy has no role in paediatric practice. Apollo Hospitals Lucknow does provide paediatric urology services for other conditions.

Joint family and caregiving

In most Indian households, care is shared. It helps to nominate one primary attendant who learns catheter and leg-bag handling, one person to manage insurance paperwork and bills, and one to coordinate follow-up appointments. Identify a family member who can accompany the patient to pelvic floor physiotherapy, and be candid within the household about temporary urinary leakage so the patient is not embarrassed into hiding it.

If You Choose Not to Have Surgery

Declining surgery is a legitimate choice, and it is not the same as declining care. Possible pathways:

• Active surveillance for low-risk disease, with a defined schedule of PSA, MRI and repeat biopsy. Around a quarter to a third of men on surveillance eventually move to treatment.
• Radiotherapy with or without hormone therapy, which for intermediate-risk disease offers broadly comparable cancer control to surgery with a different side-effect profile.
• Watchful waiting for men with limited life expectancy or major comorbidity, treating symptoms as they arise rather than aiming for cure.
• No treatment and no monitoring carries a real risk that a curable cancer becomes incurable. If cancer spreads to bone, treatment shifts to hormone therapy, chemotherapy or radiotherapy for pain, which can control but rarely cure the disease.

Whatever you decide, ask for the decision, the reasoning and the follow-up plan to be written down, and take a second opinion if you feel unsure.

Factors That Influence the Cost of Radical Prostatectomy

Apollo Hospitals Lucknow provides a written, itemised estimate before admission. Published aggregator prices are unreliable and are not quoted here. The variables below determine your estimate.

For your specific estimate, package inclusions and exclusions, please speak to the billing counter or the insurance desk at Apollo Hospitals Lucknow.

Insurance, Cashless Treatment and TPA Process in India

• Cancer surgery is generally covered by indemnity health insurance policies once waiting periods are complete, since it requires hospitalisation and is not cosmetic or elective in the exclusionary sense.
• Waiting periods matter. Most Indian policies apply a 30-day initial waiting period, and a pre-existing disease waiting period of two to four years depending on the product. Some policies carry a specific waiting period for cancer or for named surgical procedures. Under IRDAI norms, a policy continuously held for eight years cannot ordinarily be repudiated on grounds other than proven fraud or permanent exclusions.
• Planned versus accident cover: radical prostatectomy is planned surgery, so accident-only or personal-accident policies will not pay. Critical illness plans usually pay a defined lump sum on histological confirmation of malignancy, separate from your hospitalisation claim ? file both.
• Cashless route: submit your e-card, ID and the surgeon's estimate to the Apollo insurance desk at least 3?5 working days before admission. The TPA or insurer issues a pre-authorisation letter with a sanctioned amount. Enhancements can be requested during admission if the clinical situation changes.
• Reimbursement route: pay first, then submit the discharge summary, final bill, itemised breakup, all investigation reports, histopathology report, payment receipts, KYC and cancelled cheque, usually within the insurer's stated window after discharge.
• Common non-payables: registration and admission charges, gloves and some consumables, attendant food, telephone, incontinence pads, and proportionate deductions if you upgrade beyond the eligible room category. Room-rent capping can reduce the entire claim proportionately, so check your eligible category before choosing a room.
• Government and employer schemes: if you hold CGHS, ECHS, state government, Ayushman Bharat PM-JAY or a PSU panel entitlement, verify empanelment status and the referral or authorisation process for this specific procedure with the insurance desk before admission, as empanelment and package coverage change from time to time.
• Practical tips: keep a photocopy set of all documents, note your claim number, and retain the histopathology report ? it is required for critical illness claims and for any future policy portability.

Planning the Admission and What to Bring

Documents

• Photo ID and address proof for patient and primary attendant
• Insurance card, policy copy, TPA pre-authorisation letter
• All prior prescriptions, PSA trend records, MRI and PET-CT films or CDs, biopsy report
• Referral letters, and scheme cards if applicable

Medical items

• All current medicines in original strips, with a written list of doses
• Glucometer, inhalers or CPAP machine if you use them
• Spectacles, dentures and hearing aids in labelled cases

Personal items

• Loose kurta-pyjamas or lungi, and roomy underwear that accommodates a catheter leg bag
• Non-slip slippers or chappals, toiletries, towel
• Charger and power bank; a small notebook to record instructions
• Two to three packs of absorbent adult pads for after catheter removal

At home before you leave

• Arrange a Western commode, commode chair or a raised seat over the squat pan
• Clear passageways, add a bedside lamp and, if possible, a bathroom grab bar
• Shift the bed to a room near the toilet; keep a night urine bag stand or hook ready
• Plan light, easily digested home food and a stool-softening diet with plenty of fluid
• Agree who will be the primary attendant for the first two weeks

Warning Signs That Need Prompt Medical Review

Contact the urology team or attend the emergency department if you notice:

• Fever above 100.4?F, chills, or foul-smelling cloudy urine
• No urine draining into the catheter bag, or a blocked, dislodged or accidentally pulled-out catheter
• Heavy fresh bleeding in the urine, or passage of large clots
• Inability to pass urine at all after catheter removal
• Increasing abdominal pain, distension, persistent vomiting or no bowel movement for several days
• Wound redness, spreading swelling, or discharge of pus or fluid
• Sudden calf pain or swelling, breathlessness or chest pain ? possible clot, needing urgent attention
• Leakage of clear fluid from the wound or a rapidly enlarging pelvic swelling
• Sudden worsening of urinary leakage after an initial period of improvement

Do not attempt to reinsert or flush a catheter at home. Keep the hospital number saved on the attendant's phone as well as the patient's.

For Patients Travelling from Nearby Districts and Cities

Apollo Hospitals Lucknow receives patients from across central and eastern Uttar Pradesh and neighbouring states ? including Kanpur, Barabanki, Sitapur, Hardoi, Unnao, Raebareli, Sultanpur, Amethi, Bahraich, Gonda, Balrampur, Shravasti, Faizabad and Ayodhya, Basti, Gorakhpur, Pratapgarh, Jaunpur, Fatehpur, Lakhimpur Kheri, Shahjahanpur, Bareilly, Jhansi, Prayagraj and Varanasi, as well as from Nepal's border districts.

Practical planning

• Consolidate the first visit. Ask the OPD coordinator to schedule consultation, blood tests, MRI or PET-CT and pre-anaesthetic review across one or two days so you travel less.
• Carry all prior films and reports, physically or on a CD or pen drive. Repeating imaging costs time and money.
• Use teleconsultation for report review and post-operative queries where the hospital offers it, and reserve travel for the procedure and key reviews.
• Plan to stay in Lucknow for about two