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Prostatectomy (radical prostate removal)
Category: Urology Procedures & Tests · All urology procedures & tests
What it is
Radical prostatectomy removes the whole prostate gland and seminal vesicles, usually with surrounding tissue and sometimes pelvic lymph nodes, to treat prostate cancer confined to the gland area. Most operations today are robot-assisted keyhole surgery; open surgery is still used in some cases.
Why it is done
It is a curative-intent option for localised and some locally advanced prostate cancers in people fit for surgery, as an alternative to radiotherapy-based treatment — the choice is made with full discussion of the different side-effect profiles.
How to prepare
Staging includes MRI, bone scan or PSMA PET as advised, blood tests and anaesthetic assessment. You will discuss continence and erection expectations frankly, and may be given pelvic floor exercises to start before surgery. Fasting applies; blood thinners are planned.
What happens during the procedure
Under general anaesthetic, using robotic or laparoscopic instruments through small cuts (or one open cut), the surgeon removes the prostate and reconnects the bladder directly to the urine tube over a catheter, carefully trying to preserve the erection nerves where cancer control allows. Surgery takes about two to four hours.
Afterwards — recovery & results
Stay is usually one to two nights with robotic surgery. The catheter stays for about one to two weeks and is removed after a check. Continence recovers over weeks to months with pelvic floor training; most men use pads initially. Erections, if nerves are spared, recover gradually over months to two years and medicines or devices can help. PSA is monitored to confirm the cancer is controlled.
Risks & considerations
Risks include bleeding, infection, blood clots, urine leak at the join, narrowing at the bladder neck, lymph fluid collections if nodes are removed, incontinence (usually temporary; persistent severe incontinence is uncommon) and erectile dysfunction (likelihood depends on age, baseline function and nerve sparing). Your surgeon will give your individual estimates.
Watch: Prostatectomy (radical prostate removal) videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Related guides on MedicalVideos.com
Frequently asked questions
Surgery or radiotherapy?
Both can cure localised prostate cancer; they differ mainly in side-effect patterns (surgery: early incontinence and erection effects; radiotherapy: bowel and urinary irritation over time, hormone therapy often added). Take time with both specialists if you can.
Will I be incontinent forever?
Most men regain continence progressively over the first year with exercises. A small minority have lasting leakage needing further treatment.
Related procedures — Urology Procedures & Tests
Browse the P section of the A–Z list or return to the Procedures & Tests hub.