How it is performed
The prostate and seminal vesicles are removed completely, pelvic lymph nodes are sampled where the risk profile requires it, and the bladder neck is reconnected to the urethra. A robot-assisted or laparoscopic approach through small ports gives magnified vision of the nerve bundles and the urethral sphincter, which is the part of the operation that governs continence and potency.
- Keyhole ports instead of a long abdominal incision
- Magnified view for precise nerve-sparing
- Less blood loss and shorter hospital stay
- Catheter for about a week
- Histopathology of the whole specimen guides further treatment
Nerve-sparing — honestly explained
The nerves responsible for erection run on the surface of the prostate. They can be preserved when the cancer is not close to them. If the tumour is bulky or on the capsule, clearing the cancer must come first — a nerve spared at the cost of a positive margin helps nobody. The pre-operative MRI and biopsy map guide this decision, and you will be told what is and is not likely in your case.
Recovery and follow-up
Hospital stay is typically two to three days. The catheter comes out after about a week. Continence improves over weeks to months and pelvic floor exercises started before surgery genuinely help. PSA is checked six weeks after surgery and then at intervals — after complete removal it should be undetectable, and that number is the single best marker of cure.
Radical Prostatectomy — common questions
Robotic or open prostatectomy — does it matter?
Cancer control is comparable in experienced hands. Robotic surgery offers less blood loss, smaller incisions and faster recovery, which is why it is the preferred route where available.
How long is recovery after radical prostatectomy?
Two to three days in hospital, catheter out at about a week, desk work in two to three weeks, and full activity by six weeks.
Will I need radiotherapy as well?
Only if the pathology shows features such as a positive margin or node involvement, or if PSA rises during follow-up. Most men with organ-confined disease need nothing further.
Can erectile function return after surgery?
If nerves were spared, function often recovers gradually over six to eighteen months, and penile rehabilitation with medication helps. If nerves had to be removed for cancer clearance, treatments including implants remain available.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains radical prostatectomy in general terms; your own treatment plan depends on your reports and examination.