What to Expect After Prostate Removal (Prostatectomy)

After your prostate is removed, you’ll have to spend a day in the hospital, followed by a week or more of home recovery with a urinary catheter inserted. Urinary incontinence and erectile dysfunction may be side effects of the surgery.

A prostatectomy is a surgical procedure for the partial or complete removal of the prostate, which is a small gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum in men. The prostate supplies part of the seminal fluid (semen), which mixes with sperm from the testes. Sperm needs this fluid to travel and survive for reproduction.

Prostate removal (prostatectomy) is usually performed to treat prostate cancer or benign prostatic hyperplasia (BPH).

Less common reasons for prostatectomy include:

• Frequent bleeding from the prostate 
• Inability to empty the bladder completely
• Bladder stones with prostate enlargement 
• Slow urination 
• Increased pressure on the ureters and kidneys from urinary retention (hydronephrosis)

During prostate removal (prostatectomy) the prostate gland and some tissue around the gland, including the seminal vesicles, are removed. A prostatectomy takes about two hours and is performed under general anesthesia.

There are two approaches used for a prostatectomy:

• Robotic surgery
  • Minimally invasive procedure with faster recovery time 
  • Uses smaller incisions and robotic technology 
• Open surgery
  • Uses traditional incisions and tools
  • May be used for more complex cases

The surgical process is as follows:

• The doctor will make a small incision to gain access to the prostate
• The prostate is removed
• The bladder is reconnected to the urethra 
• A catheter is connected to the bladder to allow urine to drain while the area heals

Following prostate removal (prostatectomy), you can expect to be in the hospital, usually for one night for monitoring. 

When patients are first sent home, activities are restricted and patients are usually advised not to drive. Over-the-counter (OTC) pain medicines such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) may be used. If OTC pain relievers are inadequate, a doctor may prescribe pain medications.  

About seven to 10 days after surgery, the catheter is removed, usually at the doctor’s office. The doctor will usually have pathology results around this time and can discuss if further treatment is needed. 

Patients are advised to avoid strenuous activity or heavy lifting for at least one month after surgery, and most patients take off work for three to four weeks. 

Some men experience may side effects during recovery, such as:

• Urinary incontinence 
• Erectile dysfunction (impotence)

These side effects are usually temporary.

Complications of prostate removal (prostatectomy) include: 

• Urinary incontinence
  • May take up to a year after surgery to resolve 
  • Urinary leakage or dribbling
  • Usually worse right after surgery and improves over time
• Erectile dysfunction
  • May take up to two years after surgery and may not be complete
• Sterility
  • A man may be able to have an orgasm, but there will be no ejaculate (a “dry” orgasm)
• Lymphedema (rare)
  • Fluid accumulation in the soft tissues, resulting in swelling
• Decrease in penis length
  • Occurs in a small percentage of surgeries