Cancer Information

Prostate Cancer: Surgery

Radical (total) prostatectomy is surgery to remove the entire prostate. It may be done if diagnostic tests show that the cancer is confined to the prostate. Your surgeon will give you detailed instructions on preparing for surgery. After surgery, you’ll be told how to care for yourself at home as you recover. Be sure to ask any questions you have about the procedure and recovery.

The prostate, the seminal vesicles, and a portion of the urethra are removed.
The urethra is reattached to the bladder. A catheter is inserted to drain urine while you heal. A balloon holds the catheter in place.

Before Surgery

  • Don’t eat or drink after midnight the night before surgery.
  • You may be given a laxative or have an enema one day before surgery.

How Surgery Is Performed

  • Surgery may be performed through an incision in the abdomen (retropubic approach) or behind the scrotum (perineal approach). Or surgery may be done laparoscopically, with surgical tools inserted through tiny incisions in the abdomen. Robotic-assisted procedures allow more complex surgeries to be done through very small incisions.
  • The urologist may remove and check the lymph nodes near the prostate to see if cancer has spread. (If the cancer has spread, the urologist may decide not to remove the prostate.)
  • The prostate, the seminal vesicles, and a portion of urethra will then be removed.
  • Nerve-sparing techniques may be used to help preserve erectile function (the ability to achieve and maintain an erection).

After Surgery

  • Urine will drain through the catheter into a sterile bag. The urine may be bloody or cloudy at first.
  • You may return home in 1-3 days.
  • Medications to control pain will be prescribed.
  • The catheter will be left in place when you go home. You’ll be given instructions on how to manage it.
  • The catheter and stitches will be removed at a follow-up visit. This is often 1-2 weeks after surgery.
  • Bladder control often takes a few weeks to several months to return. Improvement can continue for up to a year.

Call Your Doctor If

  • You have fever or chills.
  • The incision is draining or increasingly painful or red.
  • Your leg or ankle begins to swell.>
  • Urine isn’t draining from the catheter.
  • You can’t urinate after the catheter has been removed.

Risks and Complications of Prostatectomy

  • Erectile dysfunction (difficulty achieving or maintaining an erection)
  • Incontinence (loss of bladder control)
  • Infection
  • Excessive bleeding
  • Difficulty urinating
  • Pneumonia
  • Blood clots
  • Bowel perforation