Prostatectomy

Prostatectomy is a surgical procedure that removes all or part of the prostate gland. It is primarily used to treat prostate cancer and, less often, benign prostatic hyperplasia (BPH) when obstruction or symptoms persist despite medical therapy. The operation may be radical or simple.

Radical prostatectomy removes the entire gland and nearby tissues and is usually performed for cancer. Simple prostatectomy removes part of the prostate to relieve obstruction in BPH. Procedures may be done open, laparoscopically, or with robot-assisted techniques, with nerve-sparing options pursued to preserve erectile function when feasible.

Procedure overview: After anesthesia, the surgeon accesses the prostate through an abdominal or perineal approach. The prostate and, when indicated, the seminal vesicles and surrounding tissue are removed. Lymph nodes may be sampled. The urethra is reconnected to the bladder, and a catheter is placed to drain urine.

Recovery and outcomes: Hospital stays vary; many patients go home within a few days after minimally invasive approaches. Urinary catheters remain for about 1–3 weeks. Continence often improves within weeks to months; erectile function recovery depends on age, baseline function, and nerve preservation. Cancer outcomes depend on tumor stage and surgical margins.

Risks and alternatives: Risks include bleeding, infection, clot formation, injury to nearby structures, incontinence, and erectile dysfunction. Alternatives for cancer include radiation therapy, hormonal therapy, and active surveillance in select cases. For BPH, options include medications, TURP, laser therapies, or other minimally invasive procedures.