The surgery options for prostate cancer are essentially different approaches to radical prostatectomy. The original form of radical prostatectomy, first performed in the late 19th century, is perineal--performed through an incision between the scrotum and anus. Open retropubic radical prostatectomy is performed through an incision below the belly button, and laparoscopic or robotic prostatectomy is performed by inflating the abdominal cavity with carbon dioxide to create a space to insert a scope and instruments through a number of small incisions. The fundamental risks of radical prostatectomy (bleeding, infection, anesthesia, injury to adjacent structures, urinary incontinence and erectile dysfunction) are present regardless of approach, and the surgical approach is best determined by which one the surgeon has the most experience with, as well as occasionally patient-specific factors that favor one approach over another. It is important to appreciate that surgery is one among several treatment options for localized prostate cancer--radiation therapy in the form of external-beam radiotherapy with or without hormone therapy, or radioactive seed implantation (brachytherapy) are other standard treatment options, also with risks of side effects related to urinary, sexual and bowel function, as is active surveillance, as outlined in the response to this answer -http://talkabouthealth.com/in-what-situations-is-active-surveillance-a-treatment-option-for-prostate-cancer-patients
. When a patient receives the diagnosis of prostate cancer, he may wish to seek consultation not only with a urologist (the specialty also typically involved in performing the initial evaluation of elevated PSA, including the performance of biopsy) to discuss surgery options but also a radiation oncologist. In our practice, newly diagnosed prostate cancer patients typically have a multidisciplinary consultation with urology, radiation oncology, and when indicated for high risk or advanced disease, medical oncology at the same visit to review all available options in detail with experts in each respective option.