Prostatectomy is surgical removal of all or part of the prostate gland. The prostate gland is part of a man’s reproductive system. It is about the size of a walnut and is inside the body between the bladder and the penis. It surrounds the upper part of the urethra, the tube that carries urine from the bladder out through the penis. It makes fluid that nourishes sperm and helps carry it out of the body during sex. The nerves that control penile erection also run through the prostate.
Prostatectomy may be needed to treat an enlarged prostate that is blocking the flow of urine, for recurrent prostate bleeding, to obtain tissue to look for cancer of the prostate (called a biopsy), or for the treatment of prostate cancer.
How is a prostatectomy done?
Before the procedure:
Your healthcare provider will ask you to sign a consent form for a prostatectomy. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
Tell your healthcare provider if you are allergic to any medicines.
Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
You will have a needle (IV) inserted into a vein in your hand or arm. This will allow for medicine to be given directly into your blood and to give you fluids, if needed.
During the procedure:
You will be given medicine called anesthesia to keep you from feeling pain. Depending on the type of surgery your surgeon recommends, you may have either regional or general anesthesia.
You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
Your surgeon will recommend the best surgery for you. The type of surgery you have to remove the prostate gland may be one of the following:
Radical retropubic prostatectomy: Surgery to remove the prostate gland, tissue around the prostate gland, and the glands that make semen (seminal vesicles) through a large cut (incision) on the lower abdomen
Laparoscopic radical prostatectomy: Surgery to remove the prostate gland, tissue around the prostate gland, and seminal vesicles through several small cuts on the lower abdomen
Radical perineal prostatectomy: Surgery to remove the prostate gland, tissue around the prostate gland, and seminal vesicles through a cut in the perineum (the area between the scrotum and anus)
Your provider will then close the cut with stitches or staples.
After the procedure:
You will be checked often by nursing staff.
Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
Your heart rate, blood pressure, and temperature will be checked regularly.
Your surgical wound will be checked often and dressings will be changed as needed.
You will have a catheter in your bladder to drain your urine until you are able to urinate on your own.
Your provider may prescribe medicine to:
Treat or prevent an infection
Treat or prevent side effects, such as nausea or constipation, from other treatments
What can I do to help?
You will need to tell your healthcare provider if you have new or worsening:
Trouble emptying your bladder
Weak flow of urine
Blood in urine
Pain or burning when urinating
Swelling in your scrotum or groin
Pain or cramping in your belly
Redness, swelling, pain, warmth, or drainage from your surgical wound
Fever, chills, or muscle aches.
Ask questions about any medicine or treatment or information that you do not understand.
How long will I be in the hospital?
How long you will need to stay in the hospital will depend on many factors. The average amount of time to stay in the hospital after a prostatectomy is 2 to 3 days.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-11-07 Last reviewed: 2014-10-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Wein, A., Kavoussi, L., Novick, A., Partin, A. and Peters, C. (2012). Laparoscopic and Robotic-Assisted Laparoscopic Radical Prostatectomy and Pelvic Lymphadenectomy. Campbell-Walsh Urology [10th ed.]. Retrieved from https://www.clinicalkey.com.
US Department of Health & Human Services. (2012) National and regional estimates on hospital use for all patients from the HCUP nationwide inpatient sample. Agency for healthcare research and quality website. Retrieved 07/22/2014 from http://hcupnet.ahrq.gov/HCUPnet.jsp.