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 seminal fluid (a milky fluid that forms part of semen). The gland is below the bladder and in front of the rectum. The urethra (tube that urine flows out through) runs through the prostate.
The procedure may be:
Simple prostatectomy—removal of prostate only
prostatectomy—removal of prostate and some surrounding tissue
Simple prostatectomy—This may be done to relieve urinary symptoms from a noncancerous condition like
benign prostatic hyperplasia
(BPH). BPH is a non-cancerous growth of the prostate. It can cause problems urinating as it puts pressure on the urethra.
Radical prostatectomy—This may be done to remove a prostate gland containing
If you are planning to have a prostatectomy, your doctor will review a list of possible complications, which may include:
The doctor makes an incision in the lower abdomen to access the prostate. The doctor removes the inner part of your prostate gland. 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
The doctor makes a cut in the lower abdomen between the navel and pubic bone. This allows him to access the prostate and pelvic lymph nodes. The doctor detaches the prostate from the bladder and urethra. The urethra is then re-attached to the bladder. The doctor will try to preserve nerve function related to bladder function and erections. In some cases, the doctor will remove lymph node tissue for testing before deciding to continue with surgery.
Perineal Radical Prostatectomy
The doctor makes a cut in the skin between your anus and your scrotum. He then removes your prostate. This type of surgery is less common since it does not allow access to the lymph nodes. There is a higher risk of nerve damage with this procedure.
The doctor makes five small, keyhole incisions in the abdomen for robotic arms, including one with a small camera (laparoscope). This gives him a wider and more flexible range of motion. A doctor sits at a console and guides the robotic arms during the surgery. With these arms, he can cut out the prostate and other tissue. Benefits include less scarring.
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
may be left in place to help fluid drain from the surgery site.
How Long Will It Take?
Simple prostatectomy—2-4 hours
Radical prostatectomy—2-4 hours
Will It Hurt?
Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for:
7-10 days after open surgery
3-4 days after laparoscopic surgery
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:
Take medicines as directed.
Your doctor may give you antibiotics to prevent infection and/or stool softeners to prevent
You may need to take a medicine for several weeks to normalize your bladder function.
For a while, you may need prescription pain medicines. You will then be switched to non-prescription pain relievers (eg,
) as needed. Avoid taking
or aspirin-containing products.
When resting in bed, keep legs elevated and moving. This will help to prevent
from forming in your legs.
To promote healing, resume normal activities as soon as possible.
Drink plenty of liquids. It will help to clear your bladder of urine and blood.
Shower as usual. Avoid baths until the incision has healed completely.
Wash the incision gently with mild soap and water.
Do not drive unless your doctor has given you permission to do so. You may need to wait up to one month.
Avoid vigorous exercise for six weeks after surgery.
Resume sexual activity when able.
Avoid caffeine, alcohol, spicy foods, or any other food or drink that might aggravate your stomach, intestines, bladder, or urinary tract.
Be sure to follow your doctor’s
Complete healing from surgery usually occurs within six weeks.
Call Your Doctor
After you leave the hospital, call your doctor if any of the following occurs:
Signs of infection, including fever and chills
Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
Nausea and/or vomiting that you cannot control with the medications you were given after surgery, or which persist for more than two days after discharge from the hospital
Pain that you cannot control with the medicines you have been given
Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
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
Mitchell RE, Lee BT, Cookson MS, Barocas DA, Herrell SD, Clark PE, Smith Jr JA, Chang SS. 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.
. 2009 Aug 13. [Epub ahead of print].
Please be aware that this information is provided to supplement the care
provided by your physician. It is neither intended nor implied to be a
substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER
IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the
advice of your physician or other qualified health provider prior to
starting any new treatment or with any questions you may have regarding a