Definition | Reasons for Procedure | Possible Complications | What to Expect | Call Your Doctor

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Definition

A prostatectomy is a surgery to remove the prostate gland. The prostate gland is part of the male reproductive system. It makes and stores the milky fluid that forms part of semen. The gland sits below the bladder and in front of the rectum. The tube that urine flows out through also runs through the prostate.

The procedure may be:

  • Simple prostatectomy—removal of part of prostate
  • Radical prostatectomy—removal of entire prostate and some surrounding tissue

Anatomy of the Prostate

Anatomy of the Prostate Gland
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Reasons for Procedure

A simple prostatectomy may be done to remove an enlarged prostate that is non-cancerous. A common cause of this type of growth is called benign prostatic hyperplasia (BPH). It can interfere with the flow of urine out of the body. The surgery is done to allow urine to flow through again.

A radical prostatectomy may be done to remove a prostate gland containing cancer.

Possible Complications

If you are planning to have a prostatectomy, your doctor will review a list of possible complications, which may include:

Factors that may increase the risk of complications include:

What to Expect

Before surgery your doctor may do the following:

Leading up to the procedure:

  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Aspirin or other anti-inflammatory drugs
    • Blood thinners, such as clopidogrel (Plavix) or warfarin (Coumadin)
  • The night before, have a light meal. Do not eat or drink anything after midnight.

General or spinal anesthesia will be used. With general anesthesia, you will be asleep. Spinal anesthesia will make a section of your body numb.

The procedure can be done as:

An incision is made in the lower abdomen. The doctor will be able to see the prostate through this incision. The inner part of your prostate gland will then be removed. This procedure is not as common in the United States. It is considered when you have a non-cancerous enlargement of the prostate.

An incision will be made in the lower abdomen between the belly button and pubic bone. The prostate gland and pelvic lymph nodes will be visible through this incision. The prostate will be detached from the bladder and urethra. The urethra is then re-attached to the bladder. A main goal of treatment is to try to preserve nerve function related to bladder function and erections. Lymph node tissue may also be removed for testing. Your doctor may use these test results to decide whether or not to remove more tissue.

An incision is made in the skin between your anus and your scrotum. The prostate can be detached and removed through this incision. This is a less common surgical option because of some limits such as:

  • Lack of access to the lymph nodes
  • Higher risk of nerve damage

Five small, keyhole incisions are made in the abdomen. Robotic arms and a small camera will be passed through these incisions. The robotic tools allow wider and more flexible range of motion. The robotic arms will be controlled by a doctor at a console. The prostate and other tissue will be cut out with these robotic arms. This type of procedure may cause less scarring than other methods.

A catheter tube will be inserted to drain your bladder. Water may be flushed through the catheter to reduce blood in the urine.

The catheter may be left in place for up to 3 weeks. This will let you urinate more easily during the healing period. After a radical prostatectomy, a drain may also be placed to help fluid drain from the surgery site.

  • Simple prostatectomy—2-4 hours
  • Radical prostatectomy—2-4 hours

Anesthesia prevents pain during the procedure. You can expect some pain and discomfort for:

  • 7-10 days after open surgery
  • 3-4 days after laparoscopic surgery

The usual length of stay is 2-3 days. Your doctor may choose to keep you longer if complications arise.

When you return home, do the following to help ensure a smooth recovery:

  • Take medicines as directed.
  • When resting in bed, keep legs elevated and moving. This will help to prevent blood clots from forming in your legs.
  • To promote healing, resume normal activities as soon as possible.
  • Drink plenty of liquids. Doing so will help to clear your bladder of urine and blood.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Wash the incision gently with mild soap and water.
  • Do not drive unless your doctor has given you permission to do so. You may need to wait up to one month.
  • Avoid vigorous exercise for six weeks after surgery.
  • Resume sexual activity when able.
  • Avoid caffeine, alcohol, spicy foods, or any other food or drink that might aggravate your stomach, intestines, bladder, or urinary tract.
  • Be sure to follow your doctor’s instructions.

Complete healing from surgery usually occurs within six weeks.

Call Your Doctor

After you leave the hospital, call your doctor if any of the following occur:

In case of an emergency, call for medical help right away.