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: Simple prostatectomy—removal of part of prostateRadical
prostatectomy—removal of entire prostate and some surrounding tissue
Anatomy of the Prostate
Copyright © Nucleus Medical Media, Inc.
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
If you are planning to have a prostatectomy, your doctor will review a list of possible complications, which may include: BleedingInfection
Inability to control urinary stream (
Inability to get an erection (
) and other sexual difficulties
Blood clots in the legs or lungsSterilityInjury to the rectum or other nearby structures
Factors that may increase the risk of complications include: ObesityChronic or recent illnessLung, kidney, liver, or heart diseaseSmokingAlcohol abuse
drug useUse of certain prescription medicinesDiabetesAdditional surgery to repair a hernia of the groin
Before surgery your doctor may do the following: Physical examBlood and urine tests
(ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle
—a test that uses sound waves to visualize the inside of the body
if your doctor is concerned about a spreading cancer
Leading up to the procedure:
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
Non-steroidal anti-inflammatory drugsBlood thinnersAnti-plateletsThe night before, have a light meal. Do not eat or drink anything after midnight.
or spinal anesthesia
will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a section of your body numb.
The procedure can be done as: Open surgery—incision is made in the skin to allow the doctor to see the prostateLaparoscopic
surgery—only very small incisions are needed; the surgery is done with specialized tools and a tiny camera that is passed through the incisions
surgery—similar to laparoscopic with use of small incisions but the surgery is done with robotic tools that the surgeon controls
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.
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.
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: Lack of access to the lymph nodesHigher risk of nerve damage
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
may also be placed to help fluid drain from the surgery site.
Simple prostatectomy—2-4 hoursRadical prostatectomy—2-4 hours
Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for: 7-10 days after open surgery3-4 days after laparoscopic surgery
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. Stool softeners may also be given 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 (such as
) 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. Doing so will help to clear your bladder of urine and blood.Ask your doctor about when it is safe to shower, bathe, or soak in water.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.
After you leave the hospital, call your doctor if any of the following occur: Signs of infection, including fever and chillsRedness, swelling, increasing pain, excessive bleeding, or any discharge from the incision siteNausea 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 hospitalPain that you cannot control with the medicines you have been givenPain, burning, urgency or frequency of urination, or persistent blood in the urinePoor drainage from Foley catheterAbdominal swelling or painCough
, shortness of breath, or chest pain,
Headaches, muscle aches, dizziness, or general ill feelingConstipationNew, unexplained symptomsDrainage from your incision
In case of an emergency, call for medical help right away.
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, 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.
. 2009 Aug 13. [Epub ahead of print].
Benign prostatic hypertrophy (BPH). EBSCO DynaMed website. Available at:
. Updated August 27, 2012. Accessed September 11, 2012.
6/2/2011 DynaMed's Systematic Literature Surveillance
: 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
10/21/2013 DynaMed's Systematic Literature Surveillance
: 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
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 medical condition.
Copyright © EBSCO Publishing. All rights reserved.