What to Expect: Prostatectomy

A prostatectomy is a surgical procedure done to remove part or all of the prostate gland. The prostate gland is responsible for producing seminal fluid (a liquid needed to help transport sperm).

While prostatectomies may be performed for many conditions, it is often used as a treatment method for men who have prostate cancer. Prostatectomies can be used in conjunction with chemotherapy, radiation, or by itself. Depending on the extent of your cancer and overall risk, you may have lymph nodes removed as well.  

Types of Prostatectomy Procedures  

  • Open radical prostatectomy refers to the surgery where your entire prostate gland is removed. Often referred to as “traditional surgery,” this procedure involves a three to four inch incision on the lower abdomen to remove the prostate. Less commonly, the prostate may be removed through the area between the scrotum and the anus, which is called the perineum.  

  • Robotic or laparoscopic radical prostatectomy is a minimally invasive surgical procedure done to remove the prostate gland. Small incisions, usually about five or six, are made in the abdomen allowing the arms of a surgical robot to be inserted. A surgeon will control the robot arms through a computer. Recovery for this type of procedure is often shorter than with an open radical prostatectomy. Robotic assisted surgery is done more commonly in areas where they have a surgeon trained in this specialized technique. 

Potential complications from either surgery can include 

  • Bleeding 

  • Infection 

  • Urinary incontinence: This can be short term or long term (this is less common). Full control of the bladder can take months up to a year to return. 

  • Sexual dysfunction: This can include erectile dysfunction, changes to orgasm, and loss of fertility.

  • Narrowing of the urethra or bladder neck 

  • Lymphedema: Although rare, if lymph nodes are removed during your surgery, you may notice swelling or discomfort in the groin and genital region. 

Pro Tip

Write any questions you may have down and bring them to your pre-operative appointment to discuss with your surgeon. It is important to review any concerns regarding side effects or potential complications prior to the surgery so you can plan for your postoperative care at home.

How to Prepare for Post-Op Care  

The length of your hospital stay may vary depending on the type of surgical procedure you have done. Typical hospital stays range about one to three days for most patients. A catheter, a flexible tube to help drain urine, will likely be necessary for 10-14 days.  

  • Make sure you have a driver to take you home the day of your discharge from the hospital. You will likely still be on pain medications that will prevent you from being able to drive. 

  • If possible, have all the supplies at home to manage your urinary catheter. This should be set up through your hospital team or surgeon’s office prior to discharge. 

  • Keep some urinary pads or adult diapers on hand in case of urinary leakage or incontinence.

  • Expect to adjust your physical activity for the first four to six weeks post-surgery. Your activity level will advance gradually as you recover.  

  • Practice Kegel exercises once you receive clearance from your medical team. These exercises will help strengthen your pelvic floor muscles and help with bladder control. 

  • Keep your surgeon’s contact information in a visible area. If you have any questions or concerns after your surgical procedure, you will want to contact the appropriate medical staff. 

If you have any questions before or after your procedure, the Iris Nurses are here to help. We are available via messaging or phone call to answer any questions you may have.