Can You Remove a Prostate? What You Should Know

Yes, a prostate can be removed. The surgery is called a radical prostatectomy, and surgeons have performed it for more than a century. It is a major operation with real trade-offs, and it is not the right choice for every prostate problem. Most enlarged prostates are never removed at all.

The prostate is a small gland that sits below the bladder and surrounds the tube that carries urine out of the body. It produces fluid that makes up part of semen. Removing it is done almost exclusively to treat prostate cancer, not the benign enlargement that affects many older men. Understanding who actually needs this surgery, and what changes afterward, matters more than the procedure itself.

What Does It Mean to Remove a Prostate?

A radical prostatectomy is surgery to take out the entire prostate gland. In most cases the surgeon also removes the seminal vesicles, the small glands that supply fluid to semen, and part of the vas deferens. The bladder is then reconnected directly to the urethra so urine can still leave the body.

This is different from procedures that treat an enlarged prostate without removing it. Surgeries like TURP (transurethral resection of the prostate) scrape away obstructing tissue from inside the gland and leave the outer shell in place. Those operations are for benign prostatic hyperplasia, not cancer. The gland stays. Only a radical prostatectomy removes the whole thing.

There is also a simpler operation called simple prostatectomy, used for very large benign prostates. It removes the inner portion of the gland but not the entire capsule. When people say “remove a prostate,” they usually mean the radical version done for cancer.

Who Actually Needs a Prostate Removed?

Radical prostatectomy is offered mainly to men with prostate cancer that has not spread beyond the gland. It is one of several treatment options, not the only one. Others include radiation therapy, active surveillance, and in some cases hormone therapy.

Active surveillance deserves attention because it is often misunderstood. For many men with low-risk prostate cancer, monitoring with regular PSA tests, exams, and repeat biopsies is a legitimate path. Some prostate cancers grow so slowly that they may never cause harm during a man’s lifetime. Research published in the New England Journal of Medicine followed men with localized prostate cancer for years and found that surgery, radiation, and monitoring produced similar death rates from prostate cancer in many lower-risk cases, though surgery and radiation reduced the chance of the cancer spreading.

Surgery tends to be favored when the cancer is higher risk, when the man is younger and expected to live many more years, or when monitoring is not practical or acceptable to the patient. Age, overall health, and the specific features of the tumor all factor in. This is a decision made with a urologist, often after a second opinion.

How Is the Surgery Performed?

There are two main approaches, and both aim to remove the gland completely while sparing nearby nerves and structures when possible.

• Open surgery. A single incision in the lower abdomen. This is the traditional method and remains common.
• Robot-assisted surgery. The surgeon controls robotic arms through small incisions. It is the most widely used approach in the United States today.

Both remove the same gland. The main question researchers have studied is whether one approach produces better cancer control or fewer side effects. Large trials comparing open and robotic surgery have generally found similar cancer outcomes and similar rates of urinary and sexual side effects, with some differences in blood loss and recovery time favoring the robotic approach. The skill and experience of the surgeon matter at least as much as the technique.

Surgery usually takes a few hours and requires a hospital stay. A catheter stays in place for a short period afterward while the reconnection between bladder and urethra heals.

What Are the Side Effects of Removing a Prostate?

The two most common long-term side effects are urinary leakage and erectile dysfunction. Both are common enough that men should expect to discuss them before surgery, not after.

Urinary control. Some leakage after surgery is very common in the weeks that follow. For many men it improves substantially over months as the pelvic floor muscles and the new connection adapt. A smaller number have ongoing leakage. Pelvic floor exercises, often taught by a physical therapist, are the mainstay of managing this.

Erection problems. The nerves that control erections run along the outside of the prostate and can be injured or removed during surgery. Surgeons try to spare these nerves when the cancer’s location allows. Nerve-sparing surgery improves the odds of recovering erections, but recovery can take many months and sometimes does not return to prior function. Age and erectile function before surgery are strong predictors of what happens after.

Other possible effects include a change in orgasm (men still orgasm but no longer ejaculate semen), shortening of the penis in some men, and a small risk of hernia or scar tissue narrowing the urethra. Infertility is certain, since the prostate and seminal vesicles are gone and semen no longer leaves the body the same way.

One point that surprises many men: removing the prostate does not end sexual sensation or orgasm. The gland makes fluid, but the nerves and muscles involved in orgasm are elsewhere. What changes is ejaculation.

Radical Prostatectomy vs Other Treatments: How Do They Compare?

No single treatment is best for every man. The table below summarizes general differences, not a recommendation for any individual.

Studies comparing surgery and radiation for localized prostate cancer have generally found similar survival outcomes for many men, with side effect profiles that differ. Surgery removes the gland and allows precise staging of the tumor afterward. Radiation avoids an operation but leaves the prostate in place. The right choice depends on the cancer’s risk level, the man’s health, and his priorities about side effects.

What Is Recovery Like After Prostate Removal?

Most men leave the hospital within a day or two. A catheter is typically removed within one to two weeks, and urinary control gradually returns over weeks to months. Full recovery of erectile function, when it happens, usually takes much longer.

Light activity is encouraged early. Heavy lifting and strenuous exercise are usually limited for several weeks while incisions and internal healing progress. Follow-up PSA testing begins after surgery, since the gland that produced most of the PSA is gone. A rising PSA after surgery can signal that cancer cells remain somewhere in the body.

Recovery timelines vary widely between men. Age, fitness, nerve-sparing status, and the extent of surgery all influence how quickly function returns.

Can the Prostate Grow Back After Removal?

The prostate itself does not grow back after a radical prostatectomy. The gland is gone. What can happen is that some cancer cells were already outside the gland at the time of surgery, or microscopic amounts remained behind, and these can cause a rise in PSA later. That is called biochemical recurrence, and it is not the same as the prostate returning.

This distinction matters because some men hear “the cancer came back” and assume the surgery failed. In many cases recurrence is detected early through PSA monitoring and managed with additional treatment, such as radiation or hormone therapy, sometimes with good long-term outcomes. Not everyone with a rising PSA needs immediate treatment, and the decision is made with a specialist.