Can the Prostate Be Removed? What Experts Say

Yes, the prostate can be removed. This surgery is called a prostatectomy. It is a common treatment for prostate cancer. The goal is to take out the entire prostate gland to stop cancer from spreading. Doctors also remove nearby tissue sometimes. This is major surgery. It is not done lightly. Recovery takes time. And there are real side effects to know about.

Prostate removal is not for everyone. Some men with slow-growing cancer may never need it. Others might choose different treatments like radiation or active surveillance. The decision depends on many things. Your age matters. Your overall health matters. And the stage of your cancer matters most of all.

This article explains what prostate removal involves. It covers who needs it, what the research shows, and what side effects to expect. It also clears up common myths. If you or someone you know is facing this decision, here is what the evidence actually says.

What Exactly Happens During Prostate Removal Surgery?

Prostate removal surgery is called a radical prostatectomy. The surgeon removes the entire prostate gland. They also take out the seminal vesicles, which are small glands near the prostate. Sometimes they remove nearby lymph nodes too. This is to check if the cancer has spread.

There are two main ways to do this surgery. One is open surgery. The surgeon makes a cut in the lower belly. The other is robotic-assisted laparoscopic surgery. The surgeon uses a robot with small tools through tiny cuts. Research shows robotic surgery often means less blood loss and a shorter hospital stay. But long-term cancer outcomes are similar between both methods.

The surgery usually takes two to four hours. You are under general anesthesia. Most men stay in the hospital one to two days. A catheter, which is a tube to drain urine, stays in for about one to two weeks after surgery. This gives the connection between the bladder and urethra time to heal.

Who Is a Good Candidate for Prostate Removal?

Not every man with prostate cancer needs his prostate removed. The best candidates are men with cancer that has not spread outside the prostate. Doctors call this localized prostate cancer. If the cancer has spread to bones or other organs, removing the prostate usually does not help.

Your age and health matter a lot. Most surgeons prefer to do this surgery on men who are younger than 75 and in good health. But age alone is not the only factor. A 70-year-old in excellent health may be a better candidate than a 55-year-old with serious heart disease. Doctors look at your overall fitness for surgery and anesthesia.

The type of cancer also matters. Men with aggressive, fast-growing cancer are more likely to benefit from surgery. Men with very slow-growing, low-risk cancer may do just as well with active surveillance. That means monitoring the cancer with regular tests instead of treating it right away. Current research suggests many men with low-risk prostate cancer can safely avoid surgery for years.

What Does Research Show About Success Rates?

Prostate removal is very effective for cancer that is still inside the prostate. Studies have found that 10 years after surgery, about 90 percent of men with localized prostate cancer have no signs of cancer returning. This number drops if the cancer has started to break through the prostate capsule.

One major study called the Scandinavian Prostate Cancer Group Study followed men for over 20 years. It found that men who had surgery lived longer than men who did not. The benefit was biggest for men under 65 and those with more aggressive cancers. For men over 65 with low-risk cancer, the survival benefit was much smaller.

It is important to understand that “success” means different things. For some men, success means being cancer-free. For others, it means avoiding the side effects of treatment. Surgery offers the best chance of curing aggressive cancer. But it also comes with the highest risk of side effects like incontinence and erectile dysfunction. There is no perfect choice. Every option has trade-offs.

What Are the Side Effects of Prostate Removal?

The two most common side effects are urinary incontinence and erectile dysfunction. These are not rare. They happen to most men to some degree. How bad they are depends on your age, your health before surgery, and the skill of your surgeon.

Urinary incontinence means leaking urine. Most men have some leakage right after the catheter is removed. For many, this improves over weeks or months. Studies suggest that after one year, about 10 to 20 percent of men still need to wear a pad for leakage. Kegel exercises before and after surgery can help strengthen the muscles that control urine flow.

Erectile dysfunction is also very common. The nerves that control erections run right next to the prostate. Surgeons try to save these nerves during surgery. This is called nerve-sparing surgery. But even with the best technique, about 50 percent of men under 60 and up to 80 percent of men over 70 will have trouble getting erections after surgery. Some men recover over time. Others use medications like sildenafil, which is Viagra, or other treatments.

Other side effects include changes in orgasm. Some men have dry orgasms, meaning no fluid comes out. This is because the seminal vesicles are removed. The feeling of orgasm is still there, but there is no ejaculate. Some men also notice their penis looks shorter. This is usually temporary and caused by changes in blood flow and tissue healing.

How Does Prostate Removal Compare to Other Treatments?

Surgery is not the only option for prostate cancer. Radiation therapy is another common treatment. It uses high-energy beams to kill cancer cells. It can be as effective as surgery for some types of prostate cancer. But it has different side effects. Radiation can cause bowel problems and bladder irritation. It also causes erectile dysfunction, but usually not right away. It tends to develop over months or years.

Active surveillance is another option. This means no treatment right away. Instead, you get regular PSA blood tests, digital rectal exams, and sometimes biopsies. The goal is to only treat if the cancer starts to grow. For men with low-risk prostate cancer, this is a very reasonable choice. Studies show that after 10 years, most men on active surveillance have not needed treatment.

Here is a quick comparison of the main options:

There is no single best treatment. Each has advantages and disadvantages. Your doctor should explain the risks and benefits of each option based on your specific situation. If they push one treatment without discussing others, that is a red flag. Get a second opinion.

Common Misconceptions About Prostate Removal

One common myth is that removing the prostate always cures prostate cancer. This is not true. Surgery removes the cancer that is visible. But if cancer cells have already spread to other parts of the body, removing the prostate will not cure you. That is why doctors do scans and tests before surgery to check for spread.

Another myth is that you cannot live a normal life without a prostate. This is false. You do not need a prostate to live. The prostate makes some fluid for semen, but you do not need it for survival. Men who have their prostate removed can still have sex, though erections may be different. They can still exercise and work. The body adapts.

Some men also believe that surgery is the only option for aggressive cancer. That is not true either. Radiation combined with hormone therapy can be just as effective for some men. A large study called the ProtecT trial found that after 10 years, surgery and radiation had similar survival rates for men with localized prostate cancer. The choice depends on your priorities and your tolerance for side effects.

As of 2026, current research suggests that for many men with intermediate-risk prostate cancer, both surgery and radiation are reasonable options. The best choice is the one that fits your life and your values.