(Prostate Gland Removal)
by Deanna M. Neff, MPH
Click here to view an animated version of this procedure.
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 tube that urine flows out through also runs through the prostate.
The procedure may be:
Reasons for Procedure TOP
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 allow urine to flow through again.
A radical prostatectomy may be done to remove a prostate gland containing cancer.
Possible Complications TOP
If you are planning to have a prostatectomy, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
What to Expect TOP
Prior to Procedure
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 section of your body numb.
Description of Procedure
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 United States. It is considered when you have a non-cancerous enlargement of the prostate.
Radical Retropubic Prostatectomy
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 re-attached to the bladder. A main goal of treatment is to try to preserve nerve function related to bladder function and erections. 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.
Perineal Radical Prostatectomy
An incision is made in the skin between your anus and your scrotum. The prostate can be detached and removed through this incision. This is a less common surgical option because of some limits such as:
Robot-assisted Laparoscopic Radical Prostatectomy (RALRP)
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.
How Long Will It Take?
Will It Hurt?
Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for:
Average Hospital Stay
The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.
When you return home, do the following to help ensure a smooth recovery:
Complete healing from surgery usually occurs within six weeks.
Call Your Doctor TOP
After you leave the hospital, call your doctor if any of the following occur:
In case of an emergency, call for medical help right away.
Center for Prostate Disease Research
US Department of Defense
Urology Care Foundation
Men's Health Centre
Urology Resource Center Canada
Griffith HW, Moore S, Yoder K. Complete Guide to Symptoms, Illness & Surgery . New York, NY: Putnam Publishing Group; 2000.
Le CQ, Gettman MT. Laparoscopic and robotic radical prostatectomy. Exper Rev Anticancer Ther . 2006;6:1003-1011.
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 Aug 13. [Epub ahead of print].
Benign prostatic hypertrophy (BPH). EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/ . Updated August 27, 2012. Accessed September 11, 2012.
Prostate cancer. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/ . Updated August 20, 2012. Accessed September 11, 2012.
General information about prostate cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/types/prostate . Accessed September 11, 2012.
6/2/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med . 2011;124(2):144-154.e8.
10/21/2013 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us : O'Reilly EA, Burke JP, O'Connell PR. A meta-analysis of surgical morbidity and recurrence after laparoscopic and open repair of primary unilateral inguinal hernia. Ann Surg. 2012 May;255(5):846-53.
Last reviewed September 2013 by Mohei Abouzied, MD
Last Updated: 9/30/2013