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The most common surgery for prostate cancer is a radical prostatectomy, which removes the entire prostate gland.

In a radical prostatectomy, our surgeons remove the prostate gland and surrounding small structures connected to the prostate. These structures, called seminal vesicles, produce most of the fluid that makes up semen. If there is a risk that the cancer has spread beyond the prostate, surgeons may also remove the pelvic lymph nodes through a procedure called pelvic lymphadenectomy.

During prostate removal, our surgeons may be able to spare the cavernous nerves, the bundle of nerves close to the prostate that control erectile and urinary functions. A nerve-sparing prostatectomy can be safely performed if it does not interfere with the doctor’s ability to control the cancer. Our surgeons may remove the cavernous nerves if the cancer is growing through the connective tissue surrounding the prostate gland.

Our urologic oncologists may perform an open radical retropubic prostatectomy or robot-assisted prostatectomy.

In open radical retropubic prostatectomy, a surgeon makes a vertical incision between the belly button and the pubic bone. This provides a full view of the prostate and the surrounding area.

Before surgery, patients are put under general anesthesia. A urologist inserts a catheter to drain urine from the bladder into a bag outside of the body. Open radical retropubic prostatectomies take two to four hours to complete.

Once surgery is complete, the incision is closed with stitches or staples. A draining tube may also be placed near the surgical wound to remove fluids.

This surgery is not recommended for people whose cancer has spread to the bladder, sphincter, or rectum. Our doctors may take a lymph node sample to confirm that the cancer has not spread beyond the prostate and can be treated with surgery.

Robot-assisted prostatectomy, sometimes called laparoscopic or robotic prostatectomy, is a minimally invasive surgery for removing the prostate through a small incision in the abdomen. Our doctors at the Robotic Surgery Center use a device called the da Vinci^® Surgical System to perform this procedure.

Once patients are placed under general anesthesia, surgeons make several small incisions in the abdomen, usually no more than three quarters of an inch long. Our doctors insert a small camera, called a laparoscope, and slim surgical tools into the incisions. These are mounted on several robotic arms.

Surgery is performed from a computer, where the surgeon operates the robotic arms and has a detailed, magnified view of the treatment area. The procedure takes about two to three hours. Stitches are placed under the skin and dissolve over time, and the incisions are covered with a specialized glue that wears off in about three to four weeks.

People who have undergone previous abdominal or pelvic surgery may not be eligible for this procedure.

Robotic and open radical prostatectomy offer similar long-term outcomes. Both are effective in removing prostate cancer and minimizing the chances that the cancer will return.

The main difference between the two options is the short-term results. Those who undergo robot-assisted prostatectomy typically experience less pain following the procedure, shorter hospital stays, and shorter recovery times.

One of the most important factors in prostatectomy success is the surgeon’s skill level. Our surgeons use the technique with which they are most experienced.

Following surgery, our urologists ensure the patient’s catheter is placed comfortably and explain the required care for keeping the catheter secured to the leg. This helps ensure that the bladder and urethra heal properly. It can also prevent narrowing of the urethra during recovery. We schedule a follow-up appointment to remove the catheter seven to 10 days after surgery.

At NYU Langone, about 90 percent of men who have open or robot-assisted radical prostatectomy can return home after one day in the hospital. Patients must remain on a liquid diet until they can pass intestinal gas and have a bowel movement. This usually takes several days.

You should avoid heavy lifting, exercise, or strenuous activity for several weeks after surgery. This gives the incision sites time to heal properly. However, you may resume simple activities, such as walking, climbing stairs, and showering immediately following the procedure.

Most men can make a full return to everyday activities after three weeks. Patients can typically return to work that does not require heavy lifting in seven to 10 days. Those with more physically demanding jobs should be able to resume work after three weeks.

At Perlmutter �鶹��Ƶapp Center, we work with you to minimize any potential side effects from surgery and provide support services to help with any physical or mental effects you may experience.

After a prostatectomy, patients may experience nausea from the anesthesia, swelling in the scrotum and penis, itching around incision sites, and bladder discomfort. Other potential side effects include exhaustion, lowered orgasm intensity, pain during ejaculation, loss of fertility, change in penis length, and in some cases, depression.

Early in their recovery, almost all men experience erectile dysfunction and some form of urinary incontinence, including the following:

• urge incontinence, a sudden strong urge to urinate, which may cause urine to leak involuntarily
• stress incontinence, or urine leakage caused by activity that puts pressure on the bladder, such as coughing, sneezing, or laughing
• overflow incontinence, a sudden or ongoing urine leakage caused by the bladder being too full
• continuous incontinence, or a constant urine leakage, which is rare after prostatectomy

Over time, most men regain both erectile and urinary function. The Smilow Comprehensive Prostate �鶹��Ƶapp Center team works closely with our male sexual health team to design penile rehabilitation programs that help patients recover erectile function.

For those who do not regain erectile function or who continue to experience incontinence, our urologists can advise treatment through medications, devices, or surgery.