A prostatectomy can help alleviate certain urinary symptoms and conditions associated with prostate cancer and other prostate conditions. At MU Health Care, our urology experts use advanced techniques to provide effective treatment, support your recovery and help you maintain your quality of life.

A prostatectomy is surgery to remove part or all the prostate, a small gland located below the bladder and surrounding the urethra. Your urologist or urologic surgeon may recommend a prostatectomy to treat prostate cancer. The surgery can also help reduce urinary symptoms from an enlarged prostate, or benign prostate hyperplasia (BPH). 

At MU Health Care, our urologic surgeons perform a high volume of prostatectomies. Our team specializes in minimally invasive laparoscopic and robot-assisted prostate removal to help reduce side effects of treatment and minimize recovery times. We also perform complex prostate removals like salvage prostatectomies for prostate cancer that returns after initial radiation treatment.

Types of Prostatectomy at MU Health Care

MU Health Care’s urologic surgeons offer a full range of prostate surgeries. Most are performed using minimally invasive techniques, which helps reduce discomfort and allows for a faster recovery.

Simple Prostatectomy

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.

Radical Prostatectomy

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

Nerve-Sparing Prostatectomy

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.

Bladder Suspension Prostatectomy

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.

Open Prostatectomy

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.

Salvage Prostatectomy

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.

Am I a Candidate for Prostatectomy?

You may be a candidate for prostate removal if you have:

  • Prostate cancer, particularly if it is localized, meaning it hasn’t spread beyond your prostate
  • Enlarged prostate that causes urinary symptoms which have not improved with other treatments

If you are considering a prostatectomy, our urology team can help you determine if it’s the best option for you.

Our Approach to Prostate Surgery

Prostate removal is a common treatment for prostate cancer and BPH, but it is not the only option. For prostate cancer, some patients may only need radiation treatment. For BPH, some men find symptom relief from medications and other treatments. 

Our urologic surgeons and radiation oncologists work with you to determine if a prostatectomy is right for you. We’ll also collaborate with your primary care doctor on a personalized treatment and follow-up plan.

Robot-Assisted 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.

Prostatectomy for Prostate Cancer

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.

Prostatectomy for Enlarged Prostate

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.

Support for Managing Side Effects After Surgery

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.

Benefits of Robotic-Assisted Prostate Removal

Robotic-assisted prostatectomy is a specialty at MU Health Care. Our urologic surgeons perform more robotic prostatectomies than any other hospital in mid-Missouri. Compared with traditional, “open” surgeries, these minimally invasive procedures have many benefits, including: 

  • Smaller incisions
  • Less tissue and nerve damage
  • Less bleeding
  • Lower risk of infection
  • Faster recover

What to Expect with Prostatectomy

Our team is here to help walk you through each step of a prostatectomy.

What to Expect Before Prostate Surgery

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.

What to Expect During Prostate Surgery

  • 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.

What to Expect After Prostate 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.

Can I Live a Normal Life Without a Prostate?

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.

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