Prostatectomy: Types, Surgery, Risks and Recovery
Updated: 2 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer
A prostatectomy is surgery to remove part or all of the prostate gland, most often to treat prostate cancer or benign prostatic hyperplasia (BPH). A simple prostatectomy removes the inner part for BPH; a radical prostatectomy removes the entire prostate for cancer. Possible side effects include loss of bladder control and erectile dysfunction, which often improve over months.
What the research says
Surgery halved the spread of cancer: in the ProtecT trial of 1,643 men with localized prostate cancer followed for 15 years, prostate cancer deaths were low and similar across treatments (2.2% after prostatectomy vs. 3.1% with monitoring), but prostatectomy halved the rate of cancer spreading (4.7% vs. 9.4%) (Hamdy FC et al., New England Journal of Medicine, 2023) [2]
Surgery prevented prostate cancer deaths long term: in the SPCG-4 trial of 695 men followed for 23 years, radical prostatectomy cut prostate cancer deaths from 99 to 63 compared with watchful waiting, with the biggest benefit in men under 65 (Bill-Axelson A et al., New England Journal of Medicine, 2014) [3]
Key takeaways
A prostatectomy removes part or all of the prostate.
Simple prostatectomy treats BPH; radical prostatectomy treats cancer.
Surgery can be open or robotic.
A catheter usually stays in for 10 to 14 days.
Bladder control and erections often improve over months.
What is a prostatectomy?
Your prostate is a gland below the bladder. Prostate cancer is the second most common cancer in males after skin cancer, and it's common in males 50 and older. Surgeons perform tens of thousands of prostatectomies each year in the U.S. Sources: [1]
Why it's done
It's most often done for prostate cancer that hasn't spread or for BPH. It's major surgery but generally safe if you're healthy enough, without major heart or lung problems. Sources: [1]
Types of prostatectomy
Your surgeon recommends the best approach for you.
Type | What's removed | Used for |
Simple | The inner part of the prostate | BPH |
Radical | The entire prostate and seminal vesicles, sometimes lymph nodes | Prostate cancer |
Approach | How it's done |
Open | One cut from below the belly button to the pubic bone |
Robotic | Four to seven small cuts, half an inch or less |
Single-port robotic | One small cut; newer and not available everywhere |
Laser enucleation | For simple prostatectomy, such as HoLEP |
Sources: [1]
How to prepare
Meet your team to choose the procedure and review your health.
Tell your team about medicines that raise bleeding risk and any allergies.
Follow your fasting instructions; take medicines with water if told. Sources: [1]
What happens during surgery
Radical prostatectomy takes about two to four hours.
You get general anesthesia and a urinary catheter.
The surgeon makes one larger cut or a few small cuts for robotic surgery.
In robotic surgery, the surgeon controls the instruments; it isn't AI or a preprogrammed system.
The prostate is removed; in a radical prostatectomy, the urethra is reattached to the bladder.
The cuts are closed, and a drain may be placed. Sources: [1]
Risks
Type | Risks |
General | Anesthesia problems, infection, bleeding needing transfusion, blood clots, hematoma, seroma, healing problems, depression |
Both types | Loss of bladder control, dry orgasm (little or no semen), urinoma |
Radical only | Erectile dysfunction, penile shrinkage, lymphocele |
Sources: [1]
Recovery
Full recovery of erections may take two years or longer.
When | What to expect |
Day of surgery | Start walking |
Same day to 2 days | Go home (same day for some robotic surgery) |
4 to 5 days | Bowel function returns |
10 to 14 days | Catheter removed |
2 to 3 weeks | Many return to work |
4 to 10 weeks | Normal activities |
6 to 12 weeks | Bladder control returns for most; up to 12 to 18 months after radical surgery |
3 to 6 months | Erections begin to improve; full recovery may take 2 years or longer |
Treatments such as sildenafil, tadalafil, injections or a penis pump can help with erections. Sources: [1]
Results
Prostatectomy can treat cancer that hasn't spread and can successfully treat BPH. In the ProtecT trial, about 2% of men who had surgery died of prostate cancer within 15 years. After cancer surgery, your PSA is checked regularly. Sources: [1, 2, 3]
When to call your provider
Heavy bleeding or discolored drainage from the incision.
A fever of 101°F (38.3°C) or higher, chills or headache.
A foul smell or the skin separating.
Increasing pain.
No urine flowing into the catheter bag.
Heavy blood in your urine. Sources: [1]
Conclusion
A prostatectomy is an effective treatment for prostate cancer and an enlarged prostate. Knowing what to expect during recovery, especially with bladder control and erections, helps you plan and get the support you need.
Frequently asked questions
What is a prostatectomy?
Surgery to remove part or all of the prostate.
What's the difference between simple and radical prostatectomy?
Simple removes the inner prostate for BPH; radical removes the whole prostate for cancer.
How long does a prostatectomy take?
A radical prostatectomy takes about two to four hours.
How long is the hospital stay?
Same day to two days, depending on the approach.
How long will I have a catheter?
Usually 10 to 14 days.
When can I go back to work?
Many people return in two to three weeks.
Will I have bladder control problems?
Leaking is common at first but usually improves within weeks to months.
Will I be able to have erections?
Erections often improve starting three to six months after surgery.
Is robotic surgery done by a robot?
No. Your surgeon controls the robotic instruments.
How successful is prostatectomy for cancer?
One study found 10-year survival over 90%.
Related Reading
Prostate Cryotherapy: Procedure, Side Effects and Results explains prostate cryotherapy.
Single-Port Surgery: Uses, Benefits and Recovery explains single-port surgery.
Active Surveillance for Prostate Cancer: Tests, Benefits and Risks explains active surveillance for prostate cancer.
Penile Implant: Types, Surgery, Recovery and Results explains penile implants for erectile dysfunction.
Benign Prostatic Hyperplasia (BPH): Symptoms, Causes, and Treatment an enlarged prostate.
PSA Test: Normal Levels by Age, How to Prepare and What High Results Mean the blood test used after surgery.
Erectile Dysfunction: Symptoms, Causes, and Treatment a possible side effect of surgery.
Holmium Laser Enucleation of the Prostate (HoLEP): Procedure, Recovery, Risks and Results a laser option for BPH.
Prostate Brachytherapy: Procedure, Benefits, and Long-Term Outlook a radiation option for prostate cancer.
References
Cleveland Clinic. Prostatectomy: Purpose, Types, Procedure, Risks & Recovery. Cleveland Clinic. Last updated April 29, 2026. https://my.clevelandclinic.org/health/treatments/24294-prostatectomy
Hamdy FC, Donovan JL, Lane JA, et al. Fifteen-year outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2023;388(17):1547-1558. PMID 36912538. https://doi.org/10.1056/NEJMoa2214122
Bill-Axelson A, Holmberg L, Garmo H, et al. Radical prostatectomy or watchful waiting in early prostate cancer. N Engl J Med. 2014;370(10):932-942. PMID 24597866. https://doi.org/10.1056/NEJMoa1311593
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own diagnosis and treatment, and seek emergency care right away for severe or sudden symptoms.
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