Can Prostate Be Removed? What Happens After? Survival Rate

Since the prostate can cause so many problems in men’s health, can the prostate be removed? The answer is yes. Here’s what happens after and the survival rate.

If you are looking to reduce your chances of developing prostate cancer, this procedure can help you do just that!

Keep reading to learn more about how to remove your prostate.

How to remove prostate?

man holding his behind

The process of removing your prostate gland is called a prostatectomy.

A prostatectomy is a surgery where part of the prostate or all of the prostate is removed from your body. It may be done to treat cancer or something called benign prostatic hyperplasia.

Common surgery for the prostate is to cut it out. There are two ways to do this. One way is through your lower abdomen, and the other one is right below your scrotum.

Before you have a prostatectomy, you will need to get a prostate biopsy. It is usually done before the surgery. It will help your doctor know more about your prostate.

Types of prostatectomy

  • Radical prostatectomy with retropubic. The most common surgical approach is used by doctors who specialize in diseases and surgery of the urinary tract. If there’s an indication that cancer has spread to lymph nodes, then your doctor will remove those nodes as well as your prostate gland. Cancer has spread beyond the prostate gland if it is found in the lymph nodes. In this situation, surgery may be stopped because it won’t treat cancer adequately. Additional treatments may be used instead.
  • Nerve-sparing prostatectomy approach. Sometimes it is not possible to save the nerve, and you will need surgery. Cutting two nerves can affect how a man has an erection. If only one side of the nerves is cut or removed, the man may have a less erectile function. This may be the case if only one side of the nerve bundle is cut for whether there will be any function left depends on if both sides of the bundle were still intact during surgery or not. If either side was not disrupted during surgery, then there might be some normal function afterward. But it sometimes takes months to know for sure what will happen because surgeons handle these nerves, and it could take a while before they can work again after surgery.
  • Laparoscopic radical prostatectomy. The surgeon makes cuts, and long tools go in. They put a thin tube (laparoscope) and instruments in the cuts. This helps them see inside when they do the procedure.
  • Robotic-assisted laparoscopic prostatectomy. Surgeons will sometimes use a robot system to do surgery. The surgeon sits at a computer and moves the arms of the robot. This is only possible with special equipment and training. Not all hospitals can do this type of surgery.
  • Radical prostatectomy with perineal approach. Radical prostatectomy is when the doctor removes the prostate gland. Radical perineal prostatectomy has some downsides. This surgery can be done if doctors need to remove something else, like lymph nodes. This may be different than a retropubic approach. With the retropubic approach, there is a smaller and hidden incision that can make it look better. The muscle groups are also avoided, which means less pain and faster recovery time.

What happens when you have your prostate removed?

Radical prostatectomy can cause urinary incontinence and erectile dysfunction. Also, these side effects are common with other treatments for prostate cancer.

Urinary incontinence

You may unable to control your pee, or you might leak pee. If this happens, it can affect you emotionally and socially too. There are different types of incontinence:

  • Stress incontinence. Men can leak urine when they do certain things, like sneeze, laugh, or exercise. Stress incontinence is common after prostate surgery. It is due to problems with the valve that holds urine in the bladder. Prostate cancer surgery and treatments can damage this valve or the nerves that keep it working.
  • Overflow incontinence. Men with overflow incontinence have a difficult time getting rid of their urine. It may take a long time to urinate, and they have to pee in tiny drops. Overflow incontinence may be caused by scar tissue blocking the way out of the bladder.
  • Urge incontinence. Men with urge incontinence need to urinate when their bladder becomes too sensitive. When the bladder is complete, they cannot hold it in.
  • Continous incontinence. Rarely after surgery, men lose all control of their urine. This is called continuous incontinence.

When you have prostate surgery, you will usually be able to control your bladder again. This happens over time and slowly.

Prostate surgery is complicated. Men with it might have more problems with peeing. Also, older men might have more of these problems than younger men. Doctors can’t predict exactly how any man will be affected after the surgery. Still, they know that most doctors who do this operation often report fewer peeing problems for older men with prostate cancer.

There is a treatment for incontinence. Even if the incontinence cannot be corrected completely, it can still be helped. To learn more about managing and living with this condition, see Bladder and Bowel Incontinence.

Impotence or Erectile Dysfunction

This means your penis cannot get hard enough for sex.

An erection is a way your penis gets hard. If you can have an erection before surgery, the doctor will try not to hurt it during the surgery. This is called a nerve-sparing approach. But if the cancer is too close to or growing into these nerves, they will need to be removed.

If you have both nerves removed, then you won’t be able to have spontaneous erections. If only one side is removed, you might still have erections, but it would be less likely. If neither are removed, then maybe your erections will go back to normal after surgery.

After surgery, you will have an erection if you were able to before the operation and if the nerves were not cut. But, if you had an issue with your erection before surgery and the nerves were cut, you will probably lose this ability after surgery too.

Doctors who do many radical prostatectomies tend to report lower impotence rates than doctors who do the surgery less often. There are many different rates of impotence in the medical literature, but every man is other, so it is best to ask your doctor about their success rates and what will happen if you have this surgery.

If your ability to get erections returns after surgery, it often takes a while before you can do it yourself. It might take up to two years. During the first few months, you may not get an erection at all and will need help from medicines or other treatments.

Doctors feel that getting an erection will help you have an everyday life again. Therefore, you should try to have an erection as soon as the body has healed. This is called penile rehabilitation. Some medicines can help with this, but you should talk to your doctor about your situation first.

Orgasmic changes

After surgery, the feeling of orgasm should be pleasurable, but it won’t have any semen. This is because some glands were removed during the prostatectomy, and some pathways used by sperm were cut. As a result, sometimes, the feeling of orgasm will not be as intense or go away completely. It may also cause pain with orgasm.

You might become infertile

Radical prostatectomy cuts the tubes that carry sperm. The testicles make sperm, but they can no longer come out in the semen. If this is a concern for you, talk to your doctor about banking your sperm before surgery.

Lymphedema

This is a possible complication that happens when you remove lymph nodes. When they are removed, fluid can collect in the legs or genital area over time. It causes swelling and pain. It usually goes away when people do physical therapy for it or when it causes more problems. You can learn more about this on our lymphedema page.

Your penis may change in size

There is a chance that you will have a slight decrease in your penis length after surgery. This might have happened because the urethra was shortened when part of it was removed along with your prostate.

Inguinal hernia

A prostatectomy can lead to a hernia in the groin.

The success rate of prostate surgery

Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.

Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they don’t tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.

A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.

Prostate cancer 5-year relative survival rates

These numbers are based on men diagnosed with prostate cancer between 2010 and 2016.

SEER Stage5-year Relative Survival Rate
Localized – Cancer has not spread outside of the prostate.Nearly 100%
Regional – Cancer has spread to other parts of the body, like near the prostate.Nearly 100%
Distant – Cancer has spread to other parts of the body. It is in the chest, stomach, or legs.30%
All SEER stages combined98%
[source: Prostate Cancer Survival Rate]

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