A simple prostatectomy removes the inner portion of your prostate gland, while leaving the outside. This procedure is often used to treat an enlarged prostate.

A radical prostatectomy removes your entire prostate. This surgery may also involve taking out lymph nodes and seminal vesicles, which produce fluid for semen.

We also offer nerve-sparing robot-assisted prostatectomy, which involves advanced surgical techniques that avoid cutting nerves. Nerve-sparing surgery can help reduce damage to nerves that cause erections.

A bladder suspension (bladder tuck) procedure can be performed at the same time as robot-assisted prostatectomy to manage urinary incontinence. It involves moving pelvic floor muscles to support the bladder, so urinary control can return more quickly.

An open simple or radical prostatectomy is traditional prostate removal using one large incision. Because open prostatectomy can cause more complications, our team uses minimally invasive approaches whenever possible. That being said, MU Health Care surgeons have extensive experience in performing effective open prostatectomies and have had many successful outcomes in patients.

If your prostate cancer has returned after initial treatment with radiation, you may be a candidate for salvage prostatectomy. Salvage prostatectomies are more difficult to perform than other prostate removals because of tissue scarring from radiation. Our surgeons are experts in robot-assisted surgical techniques to help reduce complications after salvage prostatectomy.

When performing a prostatectomy, our goal is to offer the most effective surgery while minimizing complications from treatment. To achieve this, we offer minimally invasive approaches like robotic and laparoscopic techniques. 

Robot-assisted prostatectomy uses surgical instruments and cameras on mechanical arms for greater precision. This minimally invasive surgery is a specialty at MU Health Care.

Our team may suggest surgery after a routine screening ordered by your primary care doctor shows signs of prostate cancer. If you have prostate cancer, you will meet with our team at Ellis Fischel Cancer Center or Goldschmidt Cancer Center to determine next steps.

If you have BPH, surgery to remove your prostate can help manage symptoms of urinary incontinence. Your urologist may recommend a prostatectomy after medications or other procedures have not improved your symptoms.

After prostatectomy, some men experience side effects such as urinary incontinence and erectile dysfunction, that last several months or longer.

If you have side effects following a prostatectomy, our team can develop a personalized plan to reduce your symptoms. Options include:

• Pelvic floor therapy, which can help improve urinary control and sexual function after surgery. This type of physical therapy may also reduce pain and speed up recovery after prostatectomy.
• Bladder sling surgery, which can be performed during or after prostatectomy to help reduce urinary incontinence.
• Medications, devices and penile implants, which can address erectile dysfunction.

When you first meet with our team, we will review your family and medical history and conduct a physical examination. Before a prostatectomy, you will have several tests to confirm your diagnosis. These may include:

• Prostate symptom score test: A questionnaire to check for signs of BPH
• Prostate-specific antigen (PSA) blood test: Checks for a protein to help diagnose prostate cancer
• Urine tests: Help identify high-risk prostate cancers
• Digital rectal exam (DRE): Involves a doctor inserting a gloved finger in your rectum to feel your prostate
• Biopsy: Taking a tissue sample to look for cancer cells in the prostate
• Genetic tests: Check for mutations associated with prostate cancer and help guide treatment
• Imaging tests: Determine if cancer has spread beyond your prostate

Your care team may include a patient navigator, who can help you coordinate your tests and treatments.

• Two days before surgery, you will start a liquid diet and bowel prep to clear your bowels.
• On the day of your surgery, you’ll be admitted to the hospital.
• You will receive general anesthesia to put you to sleep.
• Our team will insert a catheter into your urethra.
• For a robot-assisted surgery, we will typically make six incisions less than a half-inch long on your lower abdomen. Your surgeon will insert robotic instruments through these incisions.
• During a simple prostatectomy, our team will remove the inside portion of your prostate.
• During a radical prostatectomy, we will remove the entire prostate.
• A prostatectomy typically takes three to four hours.
• We will help you get up and start walking the same day or the day after surgery to help speed your recovery.
• You can expect to spend one night in the hospital, but you may stay longer depending on your surgery.

• You can eat normal food the day after surgery.
• You will go home with a catheter, which will stay in place for one to two weeks until you return to the clinic.
• The week after surgery, you may have some pain around your incisions. You may also have bruising and swelling. Pain medications can help reduce your discomfort.
• We encourage you to move around while recovering at home.
• You may have urinary leakage that lasts three to six months after surgery. For a small percentage of men, this leakage may persist over the long term. Our team can suggest nonsurgical and surgical options for urinary incontinence that doesn’t improve over time.
• After surgery, you may not be able to achieve an erection for several months. Our team can suggest treatments to help with erectile dysfunction. Following prostatectomy, you will no longer ejaculate semen.
• Our team will schedule follow-up appointments every few months for the first year after surgery to monitor your recovery.

Having your prostate removed will not affect your life span. However, you may have some side effects that will resolve on their own or require treatment. 

The most common side effects include urinary incontinence and erectile dysfunction. The treatment also results in male infertility. 

Patients having robotic prostate removal surgery at a high-volume center like MU Health Care typically have fewer side effects and better outcomes.