Is Prostate Surgery Major Surgery?

Reviewed on 6/3/2021

Prostate surgery (prostatectomy) is a procedure used to remove the prostate (or part of the prostate), and is most often performed to treat prostate cancer or benign prostatic hyperplasia (BPH). Prostate surgery is a major surgery with an extended recovery period.
Prostate surgery (prostatectomy) is a procedure used to remove the prostate (or part of the prostate), and is most often performed to treat prostate cancer or benign prostatic hyperplasia (BPH). Prostate surgery is a major surgery with an extended recovery period.

Prostate surgery (prostatectomy) is a procedure that either partially or completely removes the prostate, 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 to travel and survive for reproduction. 

What Is Prostate Surgery Used For?

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

Less common reasons for prostate surgery 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) 

What to Expect in a Prostate Operation

Prostate surgery is a major surgery because it involves opening up the body and an extended recovery period. Following prostate removal (radical prostatectomy), patients usually stay overnight in the hospital for monitoring. 

When patients first return home, activities are restricted and patients are usually advised not to drive for a few weeks. 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, often at the doctor’s office. Pathology results are usually available around this time and the doctor can recommend further treatment, if needed. 

Patients are advised to avoid strenuous activity or heavy lifting for several weeks after surgery, and most patients are advised to take off work for about four weeks. It can take about 6 weeks to get back to regular activities.

What Are the Side Effects of Prostatectomy?

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

These side effects are usually temporary.

What Are the Types of Prostate Surgery?

A simple prostatectomy is used to treat severe urinary symptoms and enlarged benign prostate glands in men, and only the obstructing part of the prostate that's blocking the flow of urine is removed. 

A radical prostatectomy is not the same procedure as a simple prostatectomy. A radical prostatectomy, in which the entire prostate gland is removed, is used to treat localized prostate cancer

How Do Doctors Perform Prostate Surgery?

During prostate surgery (radical 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:

  1. The doctor makes a small incision to gain access to the prostate
  2. The prostate is removed
  3. The bladder is reconnected to the urethra 
  4. A catheter is connected to the bladder to allow urine to drain while the area heals

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What Are Risks and Complications of Prostate Surgery?

Complications of prostate removal (radical prostatectomy) include: 

  • Urinary incontinence
    • Can take up to a year after surgery to resolve 
  • Urinary leakage or dribbling
    • Is usually worse immediately following surgery and improves over time
  • Erectile dysfunction
    • May take up to two years after surgery and may not be complete
  • Sterility
  • Lymphedema (rare)
    • Fluid accumulation in the soft tissues, resulting in swelling
  • Decrease in penis length
    • Occurs in a small percentage of surgeries 

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Reviewed on 6/3/2021
References
https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/prostatectomy-what-to-expect-during-surgery-and-recovery

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/radical-prostatectomy

https://www.pcf.org/about-prostate-cancer/what-is-prostate-cancer/prostate-gland/

https://www.topdoctors.co.uk/medical-articles/radical-prostatectomy-what-is-it

https://www.seattlecca.org/diseases/prostate-cancer/after-surgery