Radical prostatectomy describes the operation to remove the prostate. Surgery is carried out under a general anesthetic. Patients are in the hospital for one to three days postoperatively and are sent home with a catheter (urinary drainage tube in the bladder) which is removed after one to two weeks.

The main benefit of this operation is that it offers the potential to remove all cancer. Treatment by radical prostatectomy offers the man with cancer that has not spread outside the prostate the possibility of freedom from the disease for the rest of his life. If cancer has already spread beyond the prostate, then removing the prostate may not lead to a cancer cure and additional therapy may be needed.

The main disadvantages of radical prostatectomy are the hazards associated with the procedure. Erectile dysfunction and urinary incontinence are the problems reported most often. The chance of having erectile dysfunction depends on a man’s age and health, his sexual function before treatment, the stage of cancer, and the ability to save the nerves that control erection during the surgery. Younger men (those under 60 years of age) are less likely to have issues with their erections than are older men. If erectile dysfunction does occur after surgery, erections may return to normal over time. There are also medications and devices to treat the problem that may also be helpful.

Unwanted loss of urine after radical prostatectomy occurs in a subset of men, but usually lessens or stops with time. Other issues associated with radical prostatectomy include irritation of the bladder, gastrointestinal symptoms, bladder infection, and blockage of the urine flow from the bladder. Rarely, scarring may occur at the junction of the bladder and the urethra and may require an outpatient procedure to address.