Prostatectomy

Also known as: open prostatectomy, radical prostatectomy, prostate surgery, transurethral resection of the prostate (TURP)

A prostatectomy is the surgical removal of all or part of the prostate gland and is usually done by a urologist. This type of surgery is typically performed to treat cancer of the prostate or to reduce the symptoms caused by an enlarged prostate (difficulty passing urine, needing to go frequently). Before undergoing prostate surgery it is important to weigh all the pros and cons of surgery vs. other treatment options. For up to date information on treatment options available, talk to your physician.

Varying forms of the surgical procedure may be done depending on how much of the gland is removed and how the surgeon accesses the gland:

  • Transurethral resection of the prostate (TURP). A section of the prostate gland is removed through an instrument inserted into the urethra, up through the penis. This is the most common surgical procedure used to treat the non-cancerous condition called benign prostatic hyperplasia (BPH) which is a naturally occurring over enlargement of the prostate.
  • Open prostatectomy. A surgical incision is made, usually in the abdomen, to remove part or all of the prostate gland. This surgery may be performed utilizing traditional surgical techniques as well as minimally invasive or robotic-assisted, minimally invasive techniques. The prostate gland may be removed to relieve urinary symptoms caused by BPH or advanced prostate cancer.
  • A radical prostatectomy is the removal of the entire prostate gland, along with some of the surrounding tissue. The prostate gland is accessed through a surgical incision in the abdomen and may be performed utilizing traditional surgical techniques as well as minimally invasive or robotic-assisted, minimally invasive techniques. A radical prostatectomy may be done to treat early stage prostate cancer.

Risks and side effects of surgery
Risks include those associated with any type of major surgery such as bleeding, blood clots, infection and problems with anesthesia. There are also potential side effects associated specifically with surgery on the prostate gland, and they include:

  • Incontinence. Some men experience loss of bladder control after surgery. For most, this problem improves with time.
  • Dry orgasm. The lack of fluid ejected during orgasm is sometimes a side effect due to the removal of the prostate gland and seminal vesicles. This does not usually interfere with sexual pleasure.
  • Urinary tract infection.
  • Erectile dysfunction. Erectile function may improve over time for some men, but in others it may be permanent.
  • Urethra or bladder neck narrowing (contracture). Sometimes scar tissue after surgery can tighten around the urethra or bladder neck, making urination difficult. Additional surgery may be necessary to correct this problem.

Minimally invasive techniques generally use smaller incisions, which may result in less pain, quicker recovery and less scarring. Not all patients are candidates for minimally invasive surgery and there may be additional risks associated with these techniques. Patients must discuss their surgical options and the associated risks carefully with their surgeon.

Learn more
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