Radical Prostatectomy: What to Expect
A radical prostatectomy removes the whole prostate to treat prostate cancer, usually with robot assistance through small openings. You go home with a catheter for a short time while you heal.
Before your procedure
- Follow any bowel-prep and skin-wash instructions.
- Take only the medicines your care team approved. If you take a blood thinner, aspirin, or a supplement and were not told what to do, call the office — do not stop anything on your own.
- Arrange a ride home, since you may receive sedation or anesthesia. Arrange help at home for the first days.
- Practicing Kegel (pelvic floor) exercises before surgery can help your recovery.
The day of
Under anesthesia, your care team removes the prostate through small openings (or one larger one). A catheter is placed to drain urine while the area heals. Most people stay in the hospital about one night.
The first few days
You go home with the catheter in place, usually for about 7 to 10 days. Expect:
- Some blood-tinged urine and a little leaking around the catheter
- Bloating, tiredness, and soreness at the small incisions
- Instructions to walk often to prevent blood clots
Take short walks, avoid heavy lifting for about 4 weeks, and care for the catheter using the Catheter Care Guide.
The first few weeks
The catheter is removed at a follow-up visit. After that, here is what is usually true:
- Urine leaking (incontinence) is common at first and improves over weeks to months. Keep doing your Kegel exercises.
- Erections take longer to recover. Your care team may offer a formal penile rehab plan, often with a PDE5 inhibitor medicine (such as sildenafil or tadalafil). Recovery can continue over many months.
- PSA blood test: your care team usually checks it about 6 weeks after surgery. With the prostate removed, it should become very low or undetectable, and it is followed over time.
- The final pathology (what the removed tissue showed) is discussed at follow-up.
Recovery is a gradual process. Give leaking and erections time, and lean on your care team for support along the way.
When to call your care team
Call the office number on your discharge paperwork right away, or seek emergency care, if you have any of these:
- Fever of 100.4°F (38°C) or higher, or shaking chills
- Calf pain or swelling, or chest pain or trouble breathing — possible blood clot; treat as an emergency
- The catheter stops draining or falls out
- Heavy bleeding, or redness, swelling, or drainage from an incision
- You cannot urinate at all after the catheter is removed
For calf/leg swelling with chest pain or trouble breathing, or another life-threatening emergency, call 911.
MyUrologyCare — Radical ProstatectomyRead or reprint this guide at: myurologycare.org/procedures/radical-prostatectomy.html
Educational only — not medical advice and not a substitute for your care team. Follow your own discharge instructions. Call the office number on your discharge paperwork with questions. For an emergency, call 911.