Prostatectomy

At your first consultation, you will be seen by a consultant urologist, a doctor specialising in conditions affecting the urinary system.

Your consultant will ask you about your symptoms, general health, and medical history. They may perform a physical examination.

Your consultant may ask to see your previous test or scan results, or they may order them on the day. These may include a blood test, biopsy, MRI, CT, or PET scan.

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your surgery, so please ask your consultant any questions you may have.

At the end of your appointment, your consultant will decide if a prostatectomy is a suitable treatment for you based on your symptoms, diagnosis and general health. They will explain the procedure to you including any possible risks and complications so that you can make an informed decision.

Before your operation, you will need to have some tests to check that you are fit for surgery including a blood test, ECG, and chest X-ray.

Your consultant will tell you everything you need to do to prepare for your prostatectomy. If there's anything you're not sure about, or if you have any questions about how to prepare for your surgery, speak to your consultant or call the hospital for advice. Being well-prepared for your surgery will help to ease any anxiety you may have as well as allow your surgery and recovery to go more smoothly.

Before your surgery, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your operation. This is to reduce the risk of bleeding during and after your surgery.

You will not be able to eat or drink anything from midnight on the day of your operation.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

Prostatectomy is performed under general anaesthetic, meaning you'll be asleep for the procedure. The operation normally takes between two and four hours.

There are two main types of prostatectomy: radical prostatectomy and simple prostatectomy. They may be performed as laparoscopic surgery using a camera and special instruments inserted through several small incisions in the skin, or through a larger incision as open surgery.

Your consultant will let you know exactly will happen during your surgery.

Simple prostatectomy

The prostate consists of two parts, inner and outer. During a simple prostatectomy, your consultant removes the inner part of your prostate and leaves the outer part intact. This type of prostatectomy is normally performed to treat benign prostatic hypertrophy (BPH) but does not treat prostate cancer.

Radical prostatectomy

During a radical prostatectomy, your consultant removes your entire prostate, surrounding tissue, and seminal vesicles (glands that produce semen). They may also remove some lymph nodes. This is the type of prostatectomy used for prostate cancer.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery. Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your surgery, you will be taken to the recovery room where you will be monitored closely until the effects of the anaesthetic have worn off. You will then be taken to your room.

You will have a urinary catheter (a tube in your penis to drain urine) when you wake up from your prostatectomy. This is normally removed two to three weeks after your surgery.

You may experience some post-operative pain and feel sick after your operation. Your healthcare team will give you medication to help with this. Please tell a member of your healthcare team if you have pain or nausea after your surgery.

How many nights will I need to stay in hospital?

Most people spend two to four days in hospital after a prostatectomy.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your prostatectomy. Please arrange for someone to come and collect you. We can organise a taxi if you prefer, however you will probably need someone to look after you when you first get home.

How soon can I go back to work?

How soon you can go back to work after your prostatectomy depends on your recovery and the type of job you do. Recovery is usually faster after a laparoscopic prostatectomy than an open procedure. If your job is sedentary, you may feel ready to return to work within a week or two, but if you have a manual, or strenuous job it may be four to six weeks before you can return to work.

Talk to your consultant about when you can expect to return to work after your prostatectomy.

How soon can I drive?

You should not drive until you can safely control your vehicle and perform an emergency stop comfortably. This is normally around ten days after your surgery. Driving before you are ready could be dangerous and may invalidate your insurance. Make sure you get the all-clear from your consultant and your insurance company before driving after your prostatectomy.

When will I be back to normal?

Recovery from surgery is a gradual process that is different for everyone. You can aid your recovery by following your consultant's instructions carefully after your surgery and allowing yourself to recover at your own pace. Call the hospital if you have any questions or concerns during your recovery. Your consultant will arrange follow-up appointments to check your progress during your recovery.

Most people are able to resume normal activities around three weeks after a laparoscopic prostatectomy, whereas recovery takes a few weeks longer after an open prostatectomy.

As with all types of surgery, a prostatectomy carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure. Being as well-informed as possible about what to expect from your surgery will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clot
• Adverse reactions to the anaesthetic

Possible complications specific to prostatectomy include:

• Urinary tract infection (UTI)
• Urinary incontinence
• Narrowing of the neck of the bladder or urethra
• Erectile dysfunction (impotence)
• Injury to nearby tissues or organs
• Cysts containing lymph (lymphocele)

When you have your prostatectomy, your prostate gland and seminal vesicle are sent to the laboratory to check that all the cancer has been removed. In about 10 to 15% of patients cancer cells are found in the outer margin of the removed prostate. Around half of these patients will need further treatment such as radiotherapy or hormone therapy.

You will also need regular follow-up appointments to check your levels of prostate-specific antigen (PSA), a marker for prostate cancer. PSA levels are checked with a simple blood test. Initially, you will have follow-up appointments every three months for the first year, every six months for five years and then once a year for the next fifteen years.

We answer some of your most commonly asked questions about prostatectomy.

Does a prostatectomy make you impotent?

Erectile dysfunction (impotence) is a known complication of radical prostatectomy and occurs when the nerves that supply the penis are damaged or removed. A type of surgery called nerve-sparing surgery can lower the risk of nerve damage, but if your cancer is close to the nerves they will need to be removed. Erectile dysfunction may be temporary, but in some cases it can take months or even years to resolve. In other cases the condition is permanent. Talk to your consultant or healthcare provider if you are worried about impotence after your prostatectomy.

Are lymph nodes removed during a prostatectomy?

During a radical prostatectomy, your prostate, surrounding tissue and seminal vesicle are removed. Your consultant may also remove some lymph nodes from the area between your hip bones. This is to reduce the risk of your cancer coming back. How many lymph nodes are removed depends on the risk of your cancer returning.

Can you ejaculate after a prostatectomy?

You will not be able to ejaculate after your prostatectomy so will not be able to make someone pregnant. You will still be able to experience orgasm after your prostatectomy.

Can prostate cancer spread after a prostatectomy?

In some cases, prostate cancer can come back after a prostatectomy. This is known as biochemical recurrence and occurs when cancer cells have spread to other parts of your body. You will have regular follow-up appointments after your prostatectomy to check that your cancer has not spread or come back.

Can the prostate grow back after a prostatectomy?

Your prostate gland cannot grow back after your prostatectomy, but your prostate cancer can come back if cancer cells have spread to other parts of your body.

Can sperm be harvested after a prostatectomy?

In some cases, it may be possible to take sperm directly from your testicles after your radical prostatectomy. If you would like to have children in the future your consultant can refer you to a fertility specialist to discuss your options.

How long after prostatectomy can you drink alcohol?

Alcohol can irritate the bladder and it is recommended that you abstain from alcohol for several weeks after your prostatectomy. Talk to your consultant about when you can safely drink alcohol after your prostatectomy.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about prostatectomy surgery, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in April 2023. Next review due April 2026.

1. Prostatectomy for prostate cancer, Macmillan Cancer Research
2. Surgery: radical prostatectomy, Prostate Cancer UK
3. Radical Prostatectomy, Prostate Cancer Foundation