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A prostatectomy is a surgery to remove all or part of the prostate gland
A prostatectomy is a surgery to remove all or part of the prostate gland. It is typically performed to treat prostate cancer. This page explains what a prostatectomy is, why you may need a prostatectomy and what to expect during your surgery and recovery.
If you have been diagnosed with prostate cancer and would like to speak to a specialist, call or book online to arrange a consultation with one of our experienced urological surgeons. You can usually find an appointment within 48 hours, and we aim to get you seen and treated as quickly as possible.
A prostatectomy is normally carried out to treat prostate cancer that has not spread to other parts of the body. Less commonly it may be performed to treat severe benign prostatic hyperplasia (BPH) a condition where the prostate becomes enlarged causing problems passing urine.
Your consultant will ask you about your symptoms, general health, and medical history. They may perform a physical examination.
Your consultant may ask to see your previous test or scan results, or they may order them on the day. These may include a blood test, biopsy, MRI, CT, or PET scan.
At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your surgery, so please ask your consultant any questions you may have.
At the end of your appointment, your consultant will decide if a prostatectomy is a suitable treatment for you based on your symptoms, diagnosis and general health. They will explain the procedure to you including any possible risks and complications so that you can make an informed decision.
Before your operation, you will need to have some tests to check that you are fit for surgery including a blood test, ECG, and chest X-ray.
Your consultant will tell you everything you need to do to prepare for your prostatectomy. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.
Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.
Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.
You will not be able to eat or drink anything from midnight on the day of your operation.
Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.
To make sure you are as healthy as possible before your surgery:
There are two main types of prostatectomy: radical prostatectomy and simple prostatectomy. They may be performed as laparoscopic surgery using a camera and special instruments inserted through several small incisions in the skin, or through a larger incision as open surgery.
Your consultant will let you know exactly will happen during your surgery.
The prostate consists of two parts, inner and outer. During a simple prostatectomy, your consultant removes the inner part of your prostate and leaves the outer part intact. This type of prostatectomy is normally performed to treat benign prostatic hypertrophy (BPH) but does not treat prostate cancer.
During a radical prostatectomy, your consultant removes your entire prostate, surrounding tissue, and seminal vesicles (glands that produce semen). They may also remove some lymph nodes. This is the type of prostatectomy used for prostate cancer.
After your surgery, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room.
You will have a urinary catheter (a tube in your penis to drain urine) when you wake up from your prostatectomy. This is normally removed two to three weeks after your surgery.
You may experience some post-operative pain and feel sick after your operation. Your healthcare team will give you medication to help with this. Please tell a member of your healthcare team if you have pain or nausea after your surgery.
Most people spend two to four days in hospital after a prostatectomy.
You will not be able to drive yourself home from hospital after your prostatectomy. Please arrange for someone to come and collect you. We can organise a taxi if you prefer, however you will probably need someone to look after you when you first get home.
How soon you can go back to work after your prostatectomy depends on your recovery and the type of job you do. Recovery is usually faster after a laparoscopic prostatectomy than an open procedure. If your job is sedentary, you may feel ready to return to work within a week or two, but if you have a manual, or strenuous job it may be four to six weeks before you can return to work.
Talk to your consultant about when you can expect to return to work after your prostatectomy.
You should not drive until you can safely control your vehicle and perform an emergency stop comfortably. This is normally around ten days after your surgery. Driving before you are ready could be dangerous and may invalidate your insurance. Make sure you get the all-clear from your consultant and your insurance company before driving after your prostatectomy.
Recovery from surgery is a gradual process that is different for everyone. You can aid your recovery by following your consultant's instructions carefully after your surgery and allowing yourself to recover at your own pace. Call the hospital if you have any questions or concerns during your recovery. Your consultant will arrange follow-up appointments to check your progress during your recovery.
Most people are able to resume normal activities around three weeks after a laparoscopic prostatectomy, whereas recovery takes a few weeks longer after an open prostatectomy.
As with all types of surgery, a prostatectomy carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.
Possible complications of any surgery include:
Possible complications specific to prostatectomy include:
You will also need regular follow-up appointments to check your levels of prostate-specific antigen (PSA), a marker for prostate cancer. PSA levels are checked with a simple blood test. Initially, you will have follow-up appointments every three months for the first year, every six months for five years and then once a year for the next fifteen years.
Erectile dysfunction (impotence) is a known complication of radical prostatectomy and occurs when the nerves that supply the penis are damaged or removed. A type of surgery called nerve-sparing surgery can lower the risk of nerve damage, but if your cancer is close to the nerves they will need to be removed. Erectile dysfunction may be temporary, but in some cases it can take months or even years to resolve. In other cases the condition is permanent. Talk to your consultant or healthcare provider if you are worried about impotence after your prostatectomy.
During a radical prostatectomy, your prostate, surrounding tissue and seminal vesicle are removed. Your consultant may also remove some lymph nodes from the area between your hip bones. This is to reduce the risk of your cancer coming back. How many lymph nodes are removed depends on the risk of your cancer returning.
You will not be able to ejaculate after your prostatectomy so will not be able to make someone pregnant. You will still be able to experience orgasm after your prostatectomy.
In some cases, prostate cancer can come back after a prostatectomy. This is known as biochemical recurrence and occurs when cancer cells have spread to other parts of your body. You will have regular follow-up appointments after your prostatectomy to check that your cancer has not spread or come back.
Your prostate gland cannot grow back after your prostatectomy, but your prostate cancer can come back if cancer cells have spread to other parts of your body.
In some cases, it may be possible to take sperm directly from your testicles after your radical prostatectomy. If you would like to have children in the future your consultant can refer you to a fertility specialist to discuss your options.
Alcohol can irritate the bladder and it is recommended that you abstain from alcohol for several weeks after your prostatectomy. Talk to your consultant about when you can safely drink alcohol after your prostatectomy.
If you would like to see a consultant or learn more about prostatectomy surgery, book your appointment online today or call a member of our team directly.
Content reviewed by Circle in-house team in April 2023. Next review due April 2026.
Paul Jenkins underwent robotic prostatectomy for prostate cancer at The Park Hospital in Nottingham. Find out how we eliminated his cancer and helped him get his life back on track.