Prostatectomy

A prostatectomy is a surgical procedure for the partial or full removal of the prostate gland. The prostate gland is part of the male reproductive system, located below the bladder and in front of the rectum. It surrounds the urethra, the tube that passes urine and semen out of the body. It’s performed mainly for the treatment of prostate cancer or benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate.

There are two main types of prostatectomies: simple and radical.

• Simple prostatectomy: Sometimes referred to as a partial prostatectomy, this procedure involves removing the part of the prostate that is blocking the flow of urine. It’s typically performed to treat severe symptoms of BPH rather than prostate cancer. Simple prostatectomy can be done using either open surgery or minimally invasive techniques.
• Radical prostatectomy: Sometimes referred to as full prostatectomy, this procedure involves the complete removal of the prostate gland and some surrounding tissue, including the lymph nodes and the glands involved in ejaculation. It’s most commonly performed to treat localized prostate cancer. Radical prostatectomy can be done using either open surgery or minimally invasive techniques, such as laparoscopic or robotic prostate surgery.

People who have had a full or partial prostatectomy can live a healthy life. However, undergoing a prostatectomy can affect your urinary and sexual functions. Talk to your healthcare provider about potential risks and benefits.

Your Penn Medicine provider may recommend a prostatectomy if you’ve been diagnosed with a prostate-related condition that needs surgical intervention, such as prostate cancer that hasn’t spread to another part of the body or BPH.

Candidates for a prostatectomy undergo a thorough evaluation by a multidisciplinary team of Penn Medicine professionals, including surgeons, oncologists, and urologists to determine the most appropriate treatment plan for your specific situation.

Certain patients may also be candidates for a more minimally invasive form of this procedure called a robotic prostatectomy, also known as robot-assisted laparoscopic prostatectomy. If you have intermediate-risk or high-risk prostate cancer, robotic prostatectomy may be a treatment option to discuss with your doctor.

Before your prostate removal surgery, your doctor will explain how the procedure is done and give you time to ask questions. Your care team will review your medications with you, discuss your health history, and let you know how to prepare for surgery. You may also be required to have preoperative tests and evaluations—such as imaging, heart, or other tests—to assess your overall health for surgery. 

The choice of procedure depends on various factors, including your overall health, the size of the prostate, the severity of symptoms, and whether cancer is present. Penn Medicine surgeons use the least invasive methods possible, which allows for smaller incisions, less pain, and a faster recovery.   

On the day of your procedure, you can expect the following:  

• You’ll have anesthesia with sedation, so you’re asleep and pain-free during surgery. 
• If you’re undergoing an open prostatectomy, your surgeon will make an incision in the lower abdomen to provide access to the prostate. Then they’ll remove all or part of your prostate. 
• If you’re undergoing a laparoscopic prostatectomy, your surgeon will make several small incisions in the abdomen. Then special instruments are used to remove all or part of your prostate. 
• Your urethra will be attached to your bladder and a catheter is placed to drain urine during the healing process. Your surgeon will close the incision using stitches or staples. 
• The procedure usually takes two to four hours. 
• After the surgery, you’ll be monitored closely as you wake up from anesthesia. Pain management will be provided to help you recover. 
• You’ll stay in the hospital for a day or two. The urinary catheter will remain in place for about a week as your surgery site heals. Your provider will talk to you about what to expect when you go home. 

Once you go home, it’s important to attend all your follow-up appointments with your surgical team so they can monitor your recovery and discuss any further monitoring or additional care that may be needed. 

Recovery from prostate removal can vary from person to person and may take several weeks to months. Most patients can return to normal day-to-day life, including sexual activities, within four to six weeks. Sex may be slightly different than before surgery—you can still have an orgasm, but your ejaculate will contain little to no semen. 

It’s common to experience temporary incontinence after a prostatectomy, meaning you may have a sudden urge to urinate, or you may not have complete control of when urine leaks from your body. This side effect typically lasts around six to 12 weeks. 

Remember to be patient with yourself and give your body the time it needs to heal. If you have concerns or questions during your recovery, don’t hesitate to contact your Penn Medicine provider for guidance and support. 

When you partner with Penn Medicine specialists, you can expect:

• Experienced prostate cancer surgeons: Our team includes surgeons who perform more than double the average number of procedures. Greater surgical experience translates to reduced complications and better outcomes for our patients. 
• Robotic prostate surgery expertise: Skill and experience in robotic procedures are critical for good outcomes. Some of our surgeons focus exclusively on doing robotic-assisted prostatectomies. Their efforts have led to Penn Medicine being one of the highest-volume robotic prostatectomy centers in the nation. 
• Focus on your quality of life: Our surgeons’ skill helps reduce your risks for complications like urination and erection issues. If complications do happen, we have doctors who specialize in managing these issues to improve your quality of life. 
• Advanced technology: You have access to clinical trials that improve prostate cancer surgery’s effectiveness. TumorGlow® is one of these advanced technologies. With TumorGlow, your surgeon injects you with a dye that lights up the cancer cells, making it easier to remove the cancer and spare healthy tissue. 
• Continuing support: Your well-being remains our priority post-prostate surgery. If you need further assistance, our dedicated team offers specialized care for prostate cancer survivors. They address issues such as urinary leakage and sexual health concerns following surgery.