What Is a Prostatectomy?

Removal of the prostate may be necessary due to cancer or severe urinary problems.

A prostatectomy is surgery to remove all or part of the prostate.

The prostate is a walnut-sized gland that's located between a man's bladder and penis.

You may need a prostatectomy if you have prostate cancer, severe urinary symptoms, or an enlarged prostate (benign prostatic hyperplasia, or BPH).

Types of Prostatectomy

There are two main types of prostatectomy: a radical prostatectomy, and an open simple prostatectomy.

In a radical prostatectomy, your surgeon will remove the entire prostate gland along with surrounding tissue, including lymph nodes.

This procedure is commonly done in men with prostate cancer.

There are different ways to perform a radical prostatectomy:

• Laparoscopic approach (prostate is removed using special tools inserted through very small incisions)
• Robotic approach (similar to laparoscopic approach, but uses a mechanical device)
• Open approach (prostate is removed through an incision in your lower abdomen or between your anus and scrotum)

In an open simple prostatectomy, your surgeon will remove only the problematic part of the prostate, not the entire gland.

This procedure is usually recommended for men who suffer from an enlarged prostate.

The Prostatectomy Procedure

Your doctor will give you general anesthesia (you won't be conscious) or a spinal block (you'll be numb from the waist down) before your prostatectomy.

If you're having a radical prostatectomy, a surgeon will use one of several techniques to remove the prostate gland and surrounding tissue.

The surgeon will then reattach the urethra (tube that carries urine from the bladder out through the penis) to your bladder neck.

Your surgeon may also remove lymph nodes to check for cancer.

If you're having an open simple prostatectomy, your surgeon will make a cut below your navel, and possibly through the bladder.

Then, parts of the prostate that are causing problems will be removed.

Before a Prostatectomy

Before the procedure, your doctor may want to perform a cystoscopy (procedure that looks inside your urethra and bladder).

You may also be given an antibiotic before the surgery to lower your risk of infection.

Tell your doctor about any medications you're taking prior to having a prostatectomy.

You may need to stop taking certain drugs, such as aspirin, Coumadin (warfarin), Plavix (clopidogrel bisulfate), Advil (ibuprofen), or Aleve (naproxen) a couple of weeks before your surgery.

Tell your doctor if you smoke. Smoking may interfere with healing after surgery.

You'll probably be told not to eat or drink anything for several hours before the procedure. Follow your doctor's instructions carefully.

You may be asked to use an enema or take a laxative prior to your surgery.

After a Prostatectomy

You may have special tubes inserted in your body to drain extra fluid after your surgery.

You'll probably also have a catheter in your bladder to drain your urine for a few days.

You'll be given a pain medication to make you more comfortable.

Most people stay in the hospital for one to four days after a prostatectomy.

The length of your stay will depend on your condition and the type of procedure you had.

Be sure to have someone else drive you home. Don't drive until your doctor tells you it's safe.

You'll probably need to keep your urinary catheter in place for 5 to 10 days.

It will most likely be about four to six weeks before you can resume your normal activities.

Prostatectomy Risks

Potential risks of a prostatectomy include:

• Loss of bladder or bowel control
• Urinary leakage
• Erectile dysfunction
• Change in penis length
• Becoming sterile
• Injury to the rectum
• Bleeding
• Tightening of the urinary opening due to scar tissue