Version July 2025
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What is a prostatectomy? —
This is surgery to remove the prostate. The prostate is a gland that surrounds the urethra (the tube that carries urine from the bladder out through the penis) (figure 1). Lymph nodes or tissue around the prostate might also be removed during this surgery.
The surgery can be done in 2 ways:
●Open surgery – The doctor makes a cut, or "incision," in the skin. This can be done on the lower belly or between the rectum and the scrotum. This lets the doctor see directly inside the body when they do the surgery.
●Minimally invasive surgery – The doctor makes smaller cuts in the skin. They insert long, thin tools through the cuts. One of the tools has a camera (called a "laparoscope") on the end, which sends pictures to a TV screen. The doctor can look at the screen to see inside the body. Then, they use the long tools to do the surgery. They can control the tools directly, or with the help of a robot (called "robot-assisted" surgery).
How do I prepare for a prostatectomy? —
The doctor or nurse will tell you if you need to do anything special to prepare.
After having your prostate removed, you will not be able to get a partner pregnant through sex. If you want the option of getting a partner pregnant in the future, talk to your doctor. They might suggest you collect and store sperm before the surgery.
Before the surgery, your doctor will do an exam, including a "digital rectal exam." During the exam, they put a gloved finger into your rectum to feel your prostate. They might send you to get tests, such as:
●Prostate-specific antigen ("PSA") and other blood tests
●Urine test
●Ultrasound – This is an imaging test. It uses sound waves to create pictures of your prostate.
●Special tests to check your bladder function
Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:
●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all your medicines with you.
●Any allergies you have
●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.
You will also get information about:
●Eating and drinking before your procedure – You might need to "fast" before surgery. This means not eating or drinking anything for a period of time. Or you might be allowed to have liquids until a short time before the procedure. Whether you need to fast, and for how long, depends on the procedure.
●Lowering the risk of infection – You might need to wash the area with a special soap.
●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.
Ask the doctor or nurse if you have questions or if there is anything you do not understand.
What happens during a prostatectomy? —
When it is time for the procedure:
●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.
●You will get anesthesia medicines. This is to make sure you do not feel pain during the procedure. Types of anesthesia include:
•Local – This type uses medicine to numb a small part of your body so you don't feel pain.
•Regional – This type blocks pain in 1 area of your body, such as an arm, a leg, or the lower half of your body. You might be awake. Or you might get medicines to make you relax and feel sleepy, called "sedatives."
•General – This type makes you unconscious so you can't feel, see, or hear anything during the procedure. You might get a breathing tube to help you breathe.
●You might get medicines to help control pain after the procedure.
●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.
●The doctor will put a thin, flexible tube called a "catheter" into your bladder. This is to drain urine during the procedure.
●The doctor will remove your prostate. In some cases, they will also remove lymph nodes or other tissue.
●The doctor will close your incisions and cover them with clean bandages.
●The procedure takes about 3 to 4 hours.
What happens after a prostatectomy? —
You will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off. Some people stay in the hospital overnight, and others stay a bit longer.
As you recover:
●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.
●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.
●The catheter will remain in your bladder to help drain urine. It is common for your urine to have a small amount of blood or blood clots in it. After a week or so, the doctor will remove the catheter.
●The staff will help you get out of bed and start moving around when you are ready.
●You will get medicine if needed to help with pain. You might need other medicines, too.
●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.
What are the risks of prostatectomy? —
Your doctor will talk to you about all the possible risks and answer your questions. Possible risks include:
●Infection – Urinary tract infection is the most common.
●Problems with ejaculation – When this happens, semen goes into the bladder instead of out through the urethra.
●Loss of fertility – "Fertility" means being able to get a partner pregnant. If you want to be able to get a partner pregnant in the future, talk to your doctor before surgery. There are procedures that can help with this.
●Problem with urine control, which is rarely long-lasting
●Injury to the urethra, bladder, bowel, or nerves
●Need for another procedure – This could happen if symptoms do not get better or return as the prostate continues to get bigger.
●Trouble getting an erection
●Bleeding or small blood clots in urine
●Swelling in the genital area or legs (if lymph nodes were removed)
What else should I know? —
Before you go home from the hospital, make sure you know what problems to look out for and when you should call the doctor. Make sure you understand your doctor or nurse's instructions. Ask questions about anything you do not understand.
Patient education: Prostatectomy – Discharge instructions (The Basics)
Patient education: Benign prostatic hyperplasia (enlarged prostate) (The Basics)
Patient education: Surgery for benign prostatic hyperplasia (The Basics)
Patient education: Prostate biopsy (The Basics)
Patient education: Prostate cancer (The Basics)
Patient education: Prostate cancer screening (PSA tests) (The Basics)
Patient education: Choosing treatment for low-risk localized prostate cancer (The Basics)
Patient education: Benign prostatic hyperplasia (BPH) (Beyond the Basics)
Patient education: Prostate cancer screening (Beyond the Basics)
Patient education: Treatment for advanced prostate cancer (Beyond the Basics)
