What is a prostatectomy?

This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on June 21, 2022.

Prostate cancer patients have a number of treatment options available, depending on the stage and grade of the cancer, as well as the person’s health and preferences. Prostate cancer is the most common cancer diagnosed in men, aside from skin cancer, according to the American Cancer Society.

One common treatment is a prostatectomy, a type of prostate cancer surgery often used in cases of localized cancer. This guide may help you learn more about what to expect from the procedure and how to prepare.

Radical prostatectomy surgery

A radical prostatectomy is the main type of surgery used for prostate cancer, when the cancer hasn’t spread outside the prostate. The goal of the surgery is to remove the prostate and, along with it, the tumor. This surgery is performed with general anesthesia by a urologist.

The prostate is removed using either an incision in the wall of the lower abdomen or via a robotic surgical tool. Since the prostate sits close to the bladder and penile nerves, the surgeon makes every attempt to spare the nerves that control erections and the bladder from damage.

Types of radical prostatectomy

Below are the most common prostate cancer surgery types for treating prostate cancer.

Open radical prostatectomy

The surgeon makes an incision, or cut, in the lower abdomen (radical retropubic) or the perineum (radical perineal), which is the area between the anus and scrotum. Through the incision, the prostate is removed. With the perineum approach, it may be harder for the surgeon to spare the nerves or remove nearby lymph nodes.

Radical laparoscopic prostatectomy

To remove the prostate with a radical laparoscopic prostatectomy, several small cuts are made in the lower abdomen. The doctor inserts surgical instruments and a tool called a laparoscope (a thin instrument, similar to a tube, that has a light and lens) through the openings.

Robot-assisted laparoscopic radical prostatectomy

Robot-assisted laparoscopic radical prostatectomy is done via a robotic machine, with the surgeon sitting at a control panel and using robotic arms to control the surgery.

Several small cuts are made, which is used for the machinery to surgically remove the prostate, with a camera providing the visuals.

While laparoscopic procedures tend to result in faster recovery times, less blood loss and shorter hospital stays, the rates of side effects are similar for all the surgery types. Your urologist may help you decide which type of surgery is best for you.

What to expect during the procedure

Leading up to the surgery, the urologist may walk you through the entire procedure, including what to expect during and after. This is a good time to ask questions and find out how to prepare.

General anesthesia means you’ll be asleep for the procedure. The urologist will insert a catheter, which stays for one to two weeks, allowing you to urinate during the recovery period.

You may need to stay in the hospital for several days and then limit your activities for a few weeks once you’ve returned home. If you have questions or concerns about your health at any point in the recovery process, call your care team right away.

Potential risks and side effects

It’s important to be aware of potential side effects and risks associated with a radical prostatectomy.

Immediately after the surgery, risks may include:

  • Reaction to the anesthesia
  • Bleeding
  • Blood clots
  • Infections at the surgery site
  • Damage to other organs near the prostate

You should also ask your doctor about side effects. Some of the most commonly experienced side effects from the surgery include:

  • Impotence or temporary erectile dysfunction 
  • Infection
  • Shortening of the penis
  • Incontinence or urine leakage
  • Inguinal hernia

Not all patients experience side effects, and side effects aren’t always permanent. However, if you experience long-term side effects, treatments are available for some of the main issues, such as erectile dysfunction and urinary incontinence.

Recovery process

Your care team may provide specific instructions for how to take care of your wound and when the catheter needs to be removed.

It’s best to follow their instructions and rest once you get back home, only easing back into regular life when it’s safe to do so. If anything doesn’t feel right once you’re back home, call your doctor’s office to seek advice.

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