What to Expect During and After Prostate Removal

During a prostatectomy, all or part of the prostate gland is removed, usually to treat one of several conditions related to the prostate, most commonly, localized prostate cancer. In some cases, the procedure is used to treat men with benign prostatic hyperplasia (BPH), also known as noncancerous prostate gland enlargement.

The methods used to perform a prostatectomy vary depending on the condition that is being treated. Some prostatectomies involve minimally invasive techniques and robotic assistance, while others are done through traditional, open surgery.

What happens during surgery

There are three main types of prostatectomy: robot-assisted radical prostatectomy, open radical prostatectomy and simple prostatectomy.

During a robot-assisted radical prostatectomy, the surgeon makes five or six small incisions in the lower abdomen to remove the prostate. A computer-assisted robot holds the surgical instruments, and the surgeon controls the instruments from a console, which allows for greater precision than could be achieved by hand.

An open radical prostatectomy is done by making a single incision in the lower abdomen to remove the prostate.

Simple prostatectomies are less common and typically recommended for men with severe urinary symptoms and a severely enlarged prostate gland, according to the Mayo Clinic. During this procedure, typically carried out with robotic assistance, the prostate is accessed via the bladder through an incision in the abdomen. Rather than remove the entire prostate, the surgeon removes the inner part of the gland, then closes the outer “shell” with stitches.

Patients are typically put under general anesthesia during a prostatectomy and in some cases stay in the hospital for one to two days after the procedure.

Recovering from a prostatectomy

Recovery after a prostatectomy will occur gradually, usually over several weeks.

Immediately after the surgery, your doctor will likely give you intravenous (IV) pain medications and place you on a course of prescription pain pills to take once you leave the hospital. You can expect your doctor to have you get up and walk around in a day or two following your surgery, because it’s important to get used to moving around again after the procedure. In addition, the gentle movement of walking can help prevent blood clots.

The usual hospital stay following a prostatectomy is only a couple of days, though it varies from patient to patient. Before you go home, your doctor will likely install a urinary tract catheter for you to use for seven to 10 days after surgery.

Be sure to find out about any activity restrictions you should follow in the first few weeks after the surgery. Doctors typically recommend that patients avoid lifting heavy objects and gradually resume normal activities in the four to six weeks after a prostatectomy.

Another key aspect of recovering from a prostatectomy is to attend all follow-up appointments. Your doctor will likely want to check on the surgery site and your overall health a few weeks after the prostatectomy, and then periodically throughout the next year or so.

Most men are able to safely resume their normal sex life one to two months after getting a prostatectomy, although you should consult your doctor before resuming sex.

Adjusting to sex after a prostatectomy may take some time. Men who have undergone a simple prostatectomy can still orgasm but may have less ejaculate volume or no ejaculate at all.

Note that for up to 18 months after a radical prostatectomy, it’s not uncommon for men to have trouble achieving and maintaining an erection. If this problem persists longer than that time frame, talk to your doctor about potential strategies to restore your sexual function.