A prostatectomy is a surgical procedure in which a urologist removes your prostate to treat prostate cancer or benign prostatic hyperplasia. The two main types include a simple prostatectomy and a radical prostatectomy. Risks include incontinence, erectile dysfunction and surgical risks. Most people recover after four to 10 weeks.
Overview
What is a prostatectomy?
A prostatectomy is a type of surgery in which a surgeon removes all or part of your prostate.
Your prostate is a small gland that’s part of the male reproductive system. It surrounds the urethra, which is the tube through which semen (ejaculate) and urine (pee) flow out of your body. It contributes extra fluid to your ejaculate. Fluid (semen) from your prostate enters the urethra during ejaculation, and muscles surrounding the urethra squeeze (contract) to push semen out of the urethra when you orgasm.
How many types of prostatectomy are there?
There are two primary types of prostatectomy.
Simple prostatectomy
Your prostate gland has two parts: an inner portion that grows as you get older and an outer part that forms a capsule. The inner portion is like the fruit of an orange, and the outer part is like the peel of an orange.
During a simple prostatectomy, a surgeon makes a vertical cut (incision) in your lower abdomen and removes the inner portion of your prostate through the cut while leaving the outer portion intact. They remove the inner portion in a similar way to how you may eat an orange. They scoop out the inner portion while leaving the outer portion intact.
They may also perform the procedure laparoscopically. Laparoscopic surgery is less invasive than traditional open surgery. The surgeon will make two to four small incisions (half an inch or less) in your abdomen. They then insert a thin rod with a camera at the end (laparoscope) into one incision to see inside your body. They insert surgical tools into the other incisions, then remove the inner portion of your prostate.
Radical prostatectomy
During a radical prostatectomy, a surgeon removes your entire prostate gland. They usually remove fat and tissues around your prostate, too. These may include seminal vesicles (glands that help make ejaculate) and lymph nodes. The surgeon then reattaches your urethra to your bladder using stitches and cuts your vas deferens, which is the tube that transports semen from your testicles to your urethra.
A radical prostatectomy may be an open surgery, or your surgeon may perform it laparoscopically.
During an open radical prostatectomy, the surgeon makes a vertical incision between your belly button and pubic bone to remove your prostate.
During a laparoscopic radical prostatectomy, the surgeon makes several small incisions through which they insert a laparoscope to see inside your body. They insert surgical tools into the other incisions.
You may be a candidate for a robotic laparoscopic radical prostatectomy. This is a robotic-assisted surgery. Your surgeon “pilots” a robot’s arms, which allows them to move much more carefully in hard-to-reach areas inside your body.
A laparoscopic radical prostatectomy and a robotic laparoscopic radical prostatectomy are less invasive than an open prostatectomy.
Some people may be candidates for a single port radical prostatectomy. This is a type of robot-assisted radical prostatectomy in which the instruments enter through one small incision in the lower abdomen. It’s a newer technique than traditional laparoscopic prostatectomy and robotic radical prostatectomy, which have incisions. It’s also less invasive, allows for a faster recovery and creates less scarring. However, because this is a newer procedure, it might not be an option in as many hospitals.
Is a prostatectomy a major surgery?
Yes, healthcare providers generally consider a prostatectomy to be a major surgery. A surgeon will surgically remove part or all of your prostate. Some surgery techniques are less invasive than others. Your surgeon will explain which technique they recommend and why.
Although prostatectomy is a major surgery, providers also consider it safe in people who are healthy enough to undergo surgery without major heart or lung problems.
Who needs to have a prostatectomy?
Healthcare providers most often recommend a radical prostatectomy to treat prostate cancer confined to the prostate in men.
A healthcare provider may also recommend a simple prostatectomy if you have a condition that blocks your urethra and affects how you pee, such as benign prostatic hyperplasia.
How common are prostatectomies?
Prostatectomies are a very common surgery for prostate cancer that hasn’t spread outside your prostate. The total number of Prostatectomy Procedures performed in India was 2,420,415 in 2022.
Prostate cancer is the second most common cancer that affects men, behind skin cancer. It affects about 1 in 8 men, at an average age of 66.