A prostatectomy is a surgical procedure in which a urologist removes your prostate to treat prostate cancer or benign prostatic hyperplasia. The two main types include a simple prostatectomy and a radical prostatectomy. Risks include incontinence, erectile dysfunction and surgical risks. Most people recover after four to 10 weeks.
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A prostatectomy is a surgery to remove part or all of your prostate gland. The prostate is part of the male reproductive system. It surrounds your urethra and contributes extra fluid to your semen.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Healthcare providers generally consider a prostatectomy (pros-tuh-TEK-tuh-mee) to be a major surgery. But it’s generally safe if you’re healthy enough to undergo surgery without major heart or lung problems.
Healthcare providers most often recommend a prostatectomy to treat:
Prostatectomies are common. Surgeons perform tens of thousands of them each year in the U.S.
They’re a very common surgery for prostate cancer that hasn’t spread. Prostate cancer is the second most common cancer that affects males. Skin cancer is the most common.
There are two main types of prostatectomies:
Your prostate has three parts:
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During a simple prostatectomy, your surgeon removes the inner portion. They scoop out the inner portion while leaving the outer part and capsule intact.
Depending on the size of your prostate, your surgeon may perform a simple prostatectomy as a laser enucleation, an open surgery or a robotic surgery.
During a laser enucleation, your surgeon performs the procedure through your urethra. They remove the inner part of your prostate with a laser. They take pieces of tissue out through your urethra. Providers usually use laser enucleation for smaller prostates. But with new technology and techniques, they may use it for larger prostates.
During an open simple prostatectomy, they make one cut (incision) in your lower abdomen. It goes from below your belly button to your pubic bone.
A robotic simple prostatectomy is minimally invasive. Your surgeon makes four to seven small incisions (half an inch or less) in your abdomen. These incisions are for the ports. They insert a thin rod with a camera at the end (laparoscope) into one port to see inside your body. They insert surgical tools to remove the inner portion of your prostate through the other ports.
You may be a candidate for a single-port simple prostatectomy. This is also a type of robot-assisted surgery. But instead of many small ports, your surgeon only uses one. This is a newer procedure. It might not be an option in all hospitals.
During a radical prostatectomy, your surgeon removes your entire prostate gland and seminal vesicles due to cancer. They may also remove other things around your prostate, too, like lymph nodes and fat.
Your surgeon then reattaches your urethra to your bladder and cuts your vas deferens. Your vas deferens is the tube that transports sperm from your testicles to your urethra.
A radical prostatectomy may be an open surgery or a robotic-assisted surgery. During a robotic-assisted surgery, your surgeon “pilots” the robot’s arms. It isn’t AI or a preprogrammed system. The robot’s arms allow your surgeon to move in hard-to-reach areas inside your body.
You may be a candidate for a single-port radical prostatectomy. It’s a robot-assisted surgery that only uses one small port. It might not be an option in all hospitals.
Before a prostatectomy, you’ll meet with members of your care team. They’ll:
A member of your care team will also give you specific directions on when to stop eating and drinking before the prostatectomy. They base these instructions on your medical history and the time of your surgery. If you must take medications, ask your care team when to take them. You should take them with water.
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Your prostatectomy care team typically includes:
Your anesthesiologist will put you under with general anesthesia. You won’t be awake, won’t move and won’t feel any pain during the procedure. After you’re under, a provider will insert a urinary catheter.
The procedure varies according to whether you have an open or robotic prostatectomy.
During an open prostatectomy, your urologist will:
During a robotic prostatectomy, your urologist will:
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A radical prostatectomy usually takes about two to four hours to complete. But you may be in the operating room longer because it takes some time to give you anesthesia and position your body for the procedure. A simple prostatectomy takes less time to complete.
After a prostatectomy, healthcare providers will:
Anesthesia makes a lot of people feel like they may throw up after surgery. If you have nausea, providers will give you medication to treat it. They may also prescribe:
What you eat after surgery depends on how you’re feeling. Don’t push it if you’re not hungry. Listen to your body.
You won’t poop for four to five days after surgery. That’s because your bowel “falls asleep” due to the anesthesia, and it needs to wake up. Your provider may give you stool softeners to help.
You’ll also likely need to use a urinary catheter after a prostatectomy. It may be in place for as long as 10 to 14 days.
The day of surgery, providers will encourage you to walk. Walking:
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Once your care team finds that you’re healthy enough, you can go home. Your hospital stay can vary. After a robotic surgery, some people can go home the same day. But others need to stay overnight. If you have an open surgery, you may need to stay in the hospital for one to two days.
You must have a family member or friend drive you home. It’s also a good idea to have someone help take care of you for at least a few days.
The main advantage of a prostatectomy is that it helps treat prostate cancer or BPH. A lot of people choose to have their entire prostate removed to treat prostate cancer, even though the risks include urinary and sexual problems (because there's no guarantee you'll have those). If medications don’t control BPH well, then a simple prostatectomy will help you pee more easily. You also won’t have to continue taking BPH medications.
The success rate is good. A prostatectomy can treat prostate cancer that hasn’t spread to other areas. It can also successfully treat BPH.
All surgical procedures have risks, including:
Prostatectomy risks vary according to whether you have a simple or radical procedure. Both types include risks like:
A radical prostatectomy also includes risks like:
Most people can continue with their normal activities about eight weeks after an open prostatectomy. A minimally invasive prostatectomy usually has a faster recovery time — about four to six weeks.
Your recovery depends on the type of prostatectomy, your health history and any other conditions you have. Your care team will give you a better idea of what to expect.
According to one German study, the 10-year survival rate after a radical prostatectomy is over 90%.
There may be an adjustment period after a prostatectomy. Many people have temporary loss of bladder control, especially after a radical prostatectomy. This may include:
Many people have good control of their pee stream within a few weeks of getting their catheter out. But some may leak longer. Most have good control around six to 12 weeks after surgery. But it can take up to 12 to 18 months to recover after a radical prostatectomy. If it takes you longer than expected to control your pee stream, your provider may refer you to a pelvic floor therapist.
You may not be able to get an erection for several months after a radical prostatectomy. Erectile dysfunction is more common after a radical prostatectomy to treat prostate cancer. The procedure may damage the nerves around your prostate that help cause erections.
Erectile function should start to improve about three to six months after surgery. But it may take two years or longer before you recover the same hardness and sexual function.
You can still experience an orgasm, even if you can’t get an erection after surgery. But you may have no semen (anejaculation). Sexual intercourse and masturbation help maintain blood flow to your penis. This helps prevent the buildup of scar tissue (fibrosis). Fibrosis can make it more difficult to get harder erections.
Your provider may recommend treatments to help restore erections. These include:
It depends in part on what you do for work. Many people can return to work about two to three weeks after a prostatectomy. But if you have a more physically demanding job, you may need to take more time off. Your healthcare provider will give you a better idea of what to expect.
Schedule follow-up appointments with your healthcare provider. Your appointments may be with your urologist or another member of your care team. They’ll want to check your incisions and the stitches or staples.
If your surgeon removed your prostate to treat prostate cancer, then they’ll frequently check your blood PSA levels the first year after surgery. If your PSA levels rise above zero after surgery, they may recommend imaging tests or more lab work. They may also refer you to other cancer specialists.
Contact your provider if you have any abnormal symptoms after surgery, like:
It’s normal to feel a wide range of emotions before any surgery, especially in such a sensitive area of your body. You might feel angry, frustrated or sad. You might feel hopeful. You might feel numb. But a prostatectomy is an effective treatment for prostate cancer and BPH when other treatments aren't helping enough.
Learning as much as you can about the procedure and what to expect during your recovery can help. And lean on your support system. This can be your partner, family or friends. You can also reach out to support groups for help.
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