Prostate Surgery: How to Prepare

While the prostate gland itself is quite small, if you need surgery on this delicate organ, you will need to plan ahead. Prostate surgery is performed to remove all or part of the prostate due to enlargement that causes problems to other organs—like the bladder—or cancerous tumors. In general, preparation for prostate surgery will look pretty similar to preparations for other types of surgeries.

doctor patient discussion

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Location

The surgery to remove all or part of the prostate gland is called a prostatectomy. Most of the time, this surgery is done to treat localized prostate cancer—that is, to remove a cancerous tumor that is located in the prostate gland and has not spread to other parts of the body. Prostatectomy can be radical—where the entire prostate is removed—or simple.

With a simple prostatectomy, only the portion of the prostate that is causing problems is removed. In either case, prostatectomy is performed usually under general anesthesia, so it will take place in an operating room at a hospital or outpatient surgery center. In some cases, your doctor may be able to perform a minimally invasive prostate resection—where only part of the prostate is removed—under local anesthesia in a medical office. You can usually go home the same day after the effects of any anesthesia have worn off.

If you require a radical prostatectomy where the entire prostate is removed, this usually requires at least an overnight stay in the hospital after the procedure. Be sure to have your doctor explain how the procedure will be done before the day of surgery and what type of anesthesia will be used.

Types of Prostatectomy

Before the day of your surgery, your doctor will do some tests to see how much of your prostate gland needs to be removed. How you prepare and what your surgery is like will depend a lot on how much of the prostate gland needs to be removed and what technique your doctor plans to use.

Surgical techniques for prostatectomy include:

  • Robot-assisted radical prostatectomy: This technique is a minimally invasive way to remove the entire prostate gland. You surgeon uses robotic tools inserted through a number of small incisions. This technique allows for quicker recovery, and may allow your doctor to spare nerve sensation and sexual function compared with other techniques. With this method, you should expect to be in the hospital for about 24 hours after the surgery ends
  • Open radical prostatectomy: This method also removes the entire prostate gland, but it is done using a traditional, open technique. Your doctor will make an incision in your lower abdomen between the pubic bone and navel, or in the perineum between the scrotum and anus. Your doctor will separate the prostate gland from its surrounding tissue, blood vessels, and nerves. Your incision will be closed with sutures, and you should expect to be in the hospital for one to two days after your surgery
  • Simple prostatectomy: For this procedure, only a portion of the prostate gland is removed, and your doctor will be able to perform the procedure through a long flexible tool called a cytoscope. The cytoscope will be inserted through the penis and into the prostate area. The cytoscope allows the doctor to visualize the surgical area with a small camera, and is equipped with tools to remove the affected part of the prostate gland. You may be able to go home the same day after this procedure.

What to Wear

When you arrive at the hospital or outpatient center for your prostatectomy, you will be asked to remove your clothing and get into a hospital gown. Your skin will be prepared with an antibacterial solution. Since your doctor will likely use imaging tools to assist with the procedure, be sure to remove any piercings, jewelry, glasses, hearing aids, or other metal objects that could react with the imaging tools. You will want to bring comfortable, loose clothing to wear home after your surgery.

Food and Drink

Before your surgery, your doctor will give you specific instructions on how to prepare based on the technique that will be used during your procedure. You will probably be advised not to eat or drink anything after midnight the night before your procedure, especially if your doctor will be using general anesthesia.

If your doctor wants you to take any medications on the day of your surgery, you should do so with very small sips of water to minimize the amount of fluid in your body. Be sure to review regular prescriptions and supplements you take with your doctor well before your surgery day to ensure they won't interact with anesthesia or affect the procedure in any way.

Medications

Your doctor will review all of your regular medications and supplements with you before the day of your surgery. Some of you medications, like blood thinners, may be stopped briefly before you procedure to prevent complications. Others, such as diabetes or heart medications, are important to continue. Be sure to discuss any over-the-counter medications or supplements you take with your doctor too. Medications like ibuprofen and certain herbal supplements can affect blood pressure or increase your risk of bleeding.

In some cases, your doctor may also prescribe a laxative solution to clear your bowels before your procedure. This can include oral laxatives or an enema. Your doctor will give you specific instructions if this preparation is required.

What to Bring

Even if you plan to go home on the day of your surgery, there are a number of items you may want to bring with you on the day of the procedure, including:

  • Photo ID
  • Medical insurance card
  • Consent forms
  • A current medication list
  • A list of any allergies
  • Information on prior complications with surgery or anesthesia
  • Hearing aids, if you have them
  • Glasses
  • Loose, comfortable clothing to wear home

You may want to arrange to have someone drive you home after you surgery as well since you will be prohibited from doing so after the surgery.

Pre-Op Lifestyle Changes

You shouldn't have to make any big lifestyle changes before your surgery, but your doctor will want you to focus on health promotion to head off any surgical complications. You will be asked to quit smoking, and refrain from using alcohol or other drugs before your surgery. Using these substances can delay healing.

How you prepare for your prostate surgery depends a lot on how much of the gland your doctor needs to remove. Resections, where only a portion of the gland is removed, can be minimally invasive and you can go home the same day with little preparation. A radical prostatectomy, where the entire prostate gland is removed, takes more planning and usually involves a hospital stay. Make sure you discuss the technique that will be used with your doctor, and find out the best way to prepare and ensure a successful recovery.

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Article Sources
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  1. Johns Hopkins Medicine. Radical Prostatectomy.

  2. University of Wisconsin. Frequently Asked Questions About Robotic Prostatectomy.

  3. American Cancer Society. Surgery for Prostate Cancer. Updated August 1, 2019.

  4. Mayo Clinic. Prostatectomy. (Sept. 1, 2020.)

  5. National Institutes of Health. Prostate Resection. (April 2, 2019.)