A prostatectomy is surgery to remove your prostate gland. The prostate gland is part of a man’s reproductive system. It is about the size of a walnut and located between the bladder and the penis. The prostate gland 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.
When is it used?
This surgery may be done to:
Treat prostate cancer
Remove an enlarged prostate gland that is blocking the flow of urine or causing bleeding
Ask your healthcare provider to explain why you are having the procedure and any risks.
How do I prepare for this procedure?
Make plans for your care and recovery after you have the procedure. Find someone to give you a ride home after the procedure. Allow for time to rest and try to find other people to help with your day-to-day tasks while you recover.
Follow your provider’s instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
Tell your provider if you have any food or medicine allergies.
You may or may not need to take your regular medicines the day of the procedure. Some medicines (like aspirin) may increase your risk of bleeding during or after the procedure. Tell your healthcare provider about all medicines and supplements that you take. Ask your provider if you need to avoid taking any medicine or supplements before the procedure.
Antibiotics may be prescribed for a few days before and after surgery to help prevent infection.
You may go home with a catheter for a few days after the procedure. A catheter is a small tube used to drain urine from the bladder. It’s best to learn about the catheter and urine collection bag before your procedure. Ask your healthcare provider about this.
Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
Your provider may ask you to take an enema or medicine to clean out your bowels before the procedure.
Follow any instructions your healthcare provider may give you.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.
What happens during the procedure?
The surgery is usually done at the hospital.
You will be given medicine to help you to relax. You will be given medicine called anesthesia to keep you from feeling pain during the surgery. General anesthesia relaxes your muscles and you will be asleep. A breathing tube is usually put in your throat when you have general anesthesia.
There are 2 ways to remove the prostate:
Your healthcare provider may make a cut in your lower belly.
Your provider may make a cut in the skin between your scrotum and rectum.
If the surgery is to treat prostate cancer, your provider may also remove the ducts draining the gland and the nearby lymph nodes. Lymph nodes are small, bean-shaped glands. They are part of the lymph system and can be found in groups or just one by itself. The lymph system is part of your body’s system for fighting infection. The lymph system consists of lymph nodes that store blood cells (lymphocytes) to fight infection and vessels that carry fluid, nutrients, and wastes between your body and your bloodstream.
The cut will then be sewn closed.
The surgery usually takes 2 to 3 hours.
What happens after the procedure?
You may be in the hospital for several days, depending on your condition.
You will have a catheter in your bladder to drain urine and flush out any blood clots after surgery. You may go home with the catheter. Your healthcare provider will remove the catheter when the bleeding stops and when you are able to urinate on your own.
While recovering from surgery, you may have trouble controlling your bladder. You may notice blood in your urine or have trouble urinating. These symptoms usually go away as you heal.
Ask your healthcare provider:
How long it will take to recover
If there are activities you should avoid, including lifting, and when you can return to your normal activities
How to take care of yourself at home
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.
What are the risks of this procedure?
Every procedure or treatment has risks. Some possible risks of this procedure include:
You may have problems with anesthesia.
You may have infection, blood clots, or bleeding.
Your bladder could be damaged. This can cause discomfort with urination or you may not be able to pass urine.
The muscle around your urethra may be permanently damaged. This could make it hard to control your urine.
A scar may form around the urethra and make it narrow. In the future, you may need to have your urethra stretched to widen the passageway.
It may be harder for you to have an erection. Also, when you have an orgasm, semen may not come out of your penis. Instead it may flow backward into your bladder.
You may become sterile and unable to have children after the procedure.
Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-09-16 Last reviewed: 2014-09-15
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.
Prostate Gland Removal: References
Sugihara, T., et al. (2014). Robot-assisted versus other types of radical prostatectomy: population based safety and cost comparison in Japan, 2012-2013. Cancer Sci.
Active monitoring, radical prostatectomy, or radiotherapy for localised prostate cancer: study design and diagnostic and baseline results of the ProtecT randomised phase 3 trial.
Carlsson S, et al. Surgery-related complications in 1253 robot-assisted and 485 open retropubic radical prostatectomies at the Karolinska University Hospital, Sweden. . Urology. 2010 May;75(5):1092-7.
Constantinides CA, et al. Short- and long-term complications of open radical prostatectomy according to the Clavien classification system. BJU Int. 2009 Feb;103(3):336-40. Epub 2008 Sep 8.
LÃ¶ppenberg B, et al. Reporting complications after open radical retropubic prostatectomy using the Martin criteria. J Urol. 2010 Sep;184(3):944-8.
Porpiglia F, et al. Transcapsular adenomectomy(Millin): a comparative study, extraperitoneal laparoscopy versus open surgery. Eur Urol. 2006 Jan;49(1):120-6.
Sausville J, and Naslund M.. Benign prostatic hyperplasia and prostate cancer: an overview for primary care physicians. Int J Clin Pract. 2010 Dec;64(13):1740-5. doi: 10.1111/j.1742-1241.2010.02534.x.