Radical Prostatectomy

Overview

A radical prostatectomy is surgery to remove the entire prostate gland along with some surrounding tissue and, usually, the seminal vesicles, most commonly to treat prostate cancer that is confined to the prostate. The prostate sits below the bladder and surrounds the urethra, and it is closely related to the nerves that control erections and the muscles that control urination.

The operation can be performed as robotic-assisted keyhole surgery, laparoscopically, or as open surgery. Where the cancer allows, a nerve-sparing technique may preserve the nerves important for erectile function. Because of the prostate’s position, surgery aims to remove the cancer while trying to protect urinary control and sexual function.

This page is an educational overview to help you understand radical prostatectomy and how care can be planned abroad. It is not medical advice, and every case is different — decisions about prostate cancer treatment should be made with a specialist multidisciplinary team.

Who May Need This

A radical prostatectomy may be recommended for men with localised prostate cancer — cancer that appears confined to the prostate — who are otherwise fit enough for surgery and have a reasonable life expectancy to benefit from removing the cancer. It is one of several effective options for suitable, localised disease.

It is generally not the first choice for very low-risk cancer that may be safely monitored, nor for cancer that has spread beyond the prostate, where other treatments are used. Suitability depends on the cancer’s stage and grade, your age, health, urinary and sexual function, and preferences, and is decided with a specialist team after full assessment.

When It May Be Recommended

Surgery may be recommended when localised prostate cancer is of sufficient risk that treatment is warranted and when the potential benefit of removing the prostate outweighs the risks and side effects for that individual. It is weighed against radiotherapy and, for low-risk disease, active surveillance.

The decision considers the cancer’s characteristics, your overall health and life expectancy, baseline urinary and sexual function, and your priorities. Because different treatments can offer similar cancer control with different side-effect profiles, shared decision-making is central. The recommendation is always individual and based on a full evaluation.

Diagnosis and Evaluation

Diagnosis usually involves a PSA blood test, examination, imaging such as MRI of the prostate, and a biopsy that confirms the cancer and its grade (Gleason score / grade group). This information determines the risk category and whether the cancer appears localised.

Further imaging may be used to check for spread if the cancer is higher risk. Your team assesses your general health, urinary and erectile function, and continence before surgery. This evaluation, reviewed by a multidisciplinary team, guides whether surgery is appropriate and whether nerve-sparing is likely to be safe, and forms the basis for an informed decision.

Treatment Options

Options for localised prostate cancer include active surveillance (careful monitoring for low-risk cancer, avoiding or delaying treatment), radical prostatectomy, and radiotherapy (external beam or brachytherapy), sometimes combined with hormone therapy. Focal therapies are available in some centres for selected cases.

Surgery itself can be robotic-assisted, laparoscopic, or open, with or without nerve-sparing depending on the cancer. Each option offers effective control for suitable disease but differs in side effects such as urinary and sexual function and in recovery. The right choice depends on the cancer, your health, and your preferences, decided with your specialist team.

How It Is Performed

A radical prostatectomy is performed under general anaesthesia. In the common robotic-assisted approach, the surgeon operates through several small incisions using a camera and instruments controlled from a console, removing the whole prostate and seminal vesicles and, where appropriate, sampling pelvic lymph nodes. Open surgery achieves the same through a single incision.

After the prostate is removed, the bladder is reconnected to the urethra, and a urinary catheter is left in place for a period to allow healing. Where the cancer permits, the surgeon uses a nerve-sparing technique to preserve the nerves for erectile function. The operation commonly takes a few hours, and keyhole and robotic approaches generally involve less blood loss and a quicker early recovery than open surgery.

Preparation

Preparation includes completing staging tests and imaging, reviewing your general health and medications (blood thinners are managed carefully), and discussing realistic expectations for cancer control and for urinary and sexual function. Pelvic floor exercises may be started before surgery to aid later continence, and fasting instructions are given.

If you are considering care abroad, plan for the in-country stay your team recommends, including the period with a catheter before its removal, and for continuing follow-up. Bring your biopsy, MRI, and records, arrange a companion, and confirm how long-term PSA monitoring and any further treatment will be coordinated with your local team before you travel home.

Benefits and Expected Goals

The goal of a radical prostatectomy is to remove localised prostate cancer and, with follow-up, to control the disease, while trying to preserve urinary control and, where possible, erectile function. Removing the whole prostate also allows accurate staging from the removed tissue and makes PSA a sensitive marker for follow-up.

Benefits and outcomes depend on the cancer’s characteristics and the surgeon’s experience, and cannot be guaranteed. Some men need additional treatment afterwards, and side effects on continence and sexual function vary and may take months to improve. Your team can explain realistic expectations and your individual outlook.

Risks and Possible Complications

A radical prostatectomy is major surgery and carries real risks that should be understood before deciding.

• Urinary incontinence, usually improving over months but sometimes lasting
• Erectile dysfunction, more likely if nerves cannot be spared
• Bleeding, infection, or a leak where the bladder is rejoined to the urethra
• Narrowing at the join (stricture) affecting urine flow later
• Blood clots and anaesthetic risks
• The possible need for additional treatment if the cancer is more advanced than expected

Your team will explain the risks specific to you and how they are minimised. Report fever, heavy bleeding, or inability to pass urine after catheter removal promptly.

Recovery, Follow-up & Aftercare

Hospital stays are commonly a couple of days for keyhole or robotic surgery and longer for open surgery. A urinary catheter stays in for a period (often around one to two weeks) and is then removed. Heavy lifting and strenuous activity are avoided for several weeks while healing progresses.

Pelvic floor exercises help restore urinary control, and recovery of continence and erectile function typically improves gradually over months, sometimes with the help of medications or other treatments. Long-term PSA monitoring is essential to watch for any recurrence. Because this follow-up is ongoing, arrange it with your local team; coordinating it before travelling home is important if you have surgery abroad.

Medical Tourism Planning

If you are considering prostatectomy abroad, choose a JCI- or ISO-accredited hospital with a dedicated urology and oncology programme and, if you want robotic surgery, an experienced robotic team. Verify the surgeon’s qualifications and case volume, since experience strongly influences both cancer control and functional recovery.

Plan for the in-country stay including the catheter period, and confirm how ongoing PSA follow-up and any further treatment such as radiotherapy would be coordinated with your local team. Bring complete records, arrange a companion, and consider medical travel insurance covering cancer surgery and complications.

Estimated Cost Factors

The cost of a radical prostatectomy depends on the country and hospital, the surgeon’s and anaesthetist’s fees, whether the approach is robotic, laparoscopic, or open (robotic surgery may cost more), the length of stay, imaging and pathology, and any additional treatment needed. Follow-up and travel and accommodation also add to the total.

Many international cancer centres offer prostatectomy at a fraction of typical US prices, but figures vary with the technique and the overall treatment plan. Prices online are only estimates — always request a personalized written quote that lists the surgical approach and included follow-up before deciding.

Choosing a Hospital or Specialist

Look for a hospital with recognised accreditation and a comprehensive urological cancer programme, a multidisciplinary team, and, for robotic surgery, a high-volume, experienced surgeon. Confirm the surgeon’s qualifications and ask about their experience with nerve-sparing and their functional outcomes.

Good centres provide clear international patient services, transparent written cost and treatment plans, and a defined pathway for PSA follow-up and any further treatment. A surgeon who discusses cancer control and the risks to continence and sexual function honestly is an important sign of quality.

Alternatives

Alternatives to surgery for localised prostate cancer include active surveillance for low-risk disease, radiotherapy (external beam or brachytherapy) sometimes with hormone therapy, and, in selected centres, focal therapies. For cancer that has spread, systemic treatments such as hormone therapy are used.

Each option can offer effective control for suitable disease but differs in side effects and recovery. The right choice depends on the cancer’s risk, your age and health, and your priorities regarding urinary and sexual function, and should be made with a specialist team rather than by cost alone.

Questions to Ask Your Doctor

• Is surgery the best option for my cancer, or would surveillance or radiotherapy suit me?
• Would you use a robotic, laparoscopic, or open approach, and can the nerves be spared?
• What are my realistic chances of recovering urinary control and erectile function?
• How long will I have a catheter, and how long is the in-country stay?
• How will long-term PSA follow-up and any further treatment be coordinated at home?
• What are my specific risks, and might I need additional treatment afterwards?
• What is included in the written cost estimate?