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A prostatectomy is a surgery to remove the prostate gland. The prostate gland is part of the male reproductive system. It makes and stores the milky fluid that forms part of semen. The gland sits below the bladder and in front of the rectum. The urethra (the tube that flows urine out of the body) runs through the prostate gland.
The procedure may be:
A simple prostatectomy may be done to remove an enlarged prostate that is non-cancerous. A common cause of this type of growth is called benign prostatic hyperplasia (BPH). It can interfere with the flow of urine out of the body. The surgery is done to remove extra tissue that is blocking flow.
A radical prostatectomy may be done to remove a prostate gland and lymph nodes that have cancer.
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Factors that may increase the risk of complications include:
Before surgery your doctor may do the following:
Leading up to the procedure:
General or spinal anesthesia will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a specific section of your body numb.
The procedure can be done as:
An incision is made in the lower abdomen. The doctor will be able to see the prostate through this incision. The inner part of your prostate gland will then be removed. This procedure is not as common in the US. It is considered when you have a non-cancerous enlargement of the prostate.
An incision will be made in the lower abdomen between the belly button and pubic bone. The prostate gland and pelvic lymph nodes will be visible through this incision. The prostate will be detached from the bladder and urethra. The urethra is then reattached to the bladder. A main goal of treatment is to try to preserve nerve function related to bladder and sexual functions. Lymph node tissue may also be removed for testing. Your doctor may use these test results to decide whether or not to remove more tissue.
An incision is made in the skin between the anus and scrotum. The prostate can be detached and removed through this incision. This is a less common surgical option because of some limits such as:
Five small, keyhole incisions are made in the abdomen. Robotic arms and a small camera will be passed through these incisions. The robotic tools allow wider and more flexible range of motion. The robotic arms will be controlled by a doctor at a console. The prostate and other tissue will be cut out with these robotic arms. This type of procedure may cause less scarring than other methods.
A catheter tube will be inserted to drain your bladder. Water may be flushed through the catheter to reduce blood in the urine.
The catheter may be left in place for up to 3 weeks. This will let you urinate more easily during the healing period. After a radical prostatectomy, a drain may also be placed to help fluid drain from the surgery site.
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.
After surgery you should expect that:
You'll return home with a catheter in place. Most men need a urinary catheter for 5 to 10 days after surgery. Complete recovery may take up to 6 weeks. During this time you may have to change or restrict activities until your doctor says it is okay. Arrange for help at home for a couple of days.You may need to return to the doctor in one or two weeks to have staples taken out.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for emergency medical services right away.
National Cancer Institute
Urology Care Foundation
Prostate Cancer Canada
Benign prostatic hypertrophy (BPH). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T116944/Benign-prostatic-hyperplasia-BPH. Updated December 11, 2019. Accessed January 7, 2020.
Prostate cancer treatments-Health Profesional. National Cancer Institute website. Available at: https://www.cancer.gov/types/prostate/hp/prostate-treatment-pdq. Updated December 19, 2019. Accessed January 7, 2020.
Mitchell RE, Lee BT, Cookson MS, et al. Immediate surgical outcomes for radical prostatectomy in the University HealthSystem Consortium Clinical Data Base: the impact of hospital case volume, hospital size and geographical region on 48,000 patients. BJU Int. 2009;104(10):1442-1445.
Prostate cancer. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114483/Prostate-cancer. Updated October 6, 2018. Accessed January 7, 2020.
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Last reviewed September 2019 by EBSCO Medical Review Board Nicole Meregian, PA Last Updated: 1/7/2020