A plain-English guide to surgical removal of the prostate, the open, laparoscopic and robotic options, and how to weigh continence and potency outcomes.
Written by our medical board, reviewed quarterlyUpdated 21 January 19709 min read
Who a prostatectomy is for
A radical prostatectomy is the surgical removal of the entire prostate gland and seminal vesicles, performed mainly to treat localised prostate cancer. It is one of two main curative options for cancer that has not spread beyond the gland, the other being radiotherapy. The right choice depends on your age, general health, cancer grade and stage, and your own priorities around side effects.
A simple prostatectomy is a different operation, used for a very large benign prostate causing obstruction when less invasive options such as TURP are unsuitable. Most patients researching travel are considering the radical version for cancer.
Because this is cancer surgery, a responsible pathway always starts with your biopsy result, PSA history and staging scans. Any clinic should review these before discussing surgery, and you should feel free to seek a second opinion on whether surgery is even the best option for you.
Open, laparoscopic and robotic techniques
There are three surgical approaches. Open retropubic prostatectomy uses a single lower-abdominal incision; it is well-proven but involves more blood loss and a longer recovery. Laparoscopic surgery uses several small ports and a camera. Robotic-assisted laparoscopic prostatectomy, now the most common approach in high-volume centres, gives the surgeon magnified 3D vision and fine instrument control.
For many patients the robotic and laparoscopic routes mean less blood loss, smaller scars and a quicker return to normal activity than open surgery. They do not, however, automatically guarantee better cancer control or fewer side effects — surgeon experience matters more than the platform.
A key technical point is nerve-sparing: where the cancer allows, the surgeon tries to preserve the nerve bundles beside the prostate that govern erections. Whether this is possible depends on your tumour, and it should be discussed honestly rather than promised.
What it costs and what is included
A prostatectomy package typically covers the surgeon and anaesthetist, the hospital stay (often two to four nights), theatre time, the robotic or laparoscopic equipment, catheter supplies, and the pathology that examines the removed gland. Pre-operative tests and a set of post-operative checks before you fly are usually included.
Prices vary by technique and country. Robotic prostatectomy is the most expensive option because of the equipment, and at major medical-tourism centres it typically runs into several thousand euros — frequently well below comparable private fees in higher-cost countries. Open surgery is generally cheaper than robotic.
Ask specifically whether the final pathology report, the cost of a longer stay if recovery is slow, and management of any complication are included. The pathology result is important because it can change whether you need further treatment such as radiotherapy.
Choosing a surgeon and hospital
Volume matters in prostatectomy more than in almost any other urological operation. Ask how many radical prostatectomies the surgeon performs each year and request their own data on positive surgical margins, continence recovery and erectile function — credible high-volume surgeons track these.
Prefer a hospital with recognised accreditation such as JCI, TEMOS or ISO 9001 and a urologist with national board certification and specific oncological training. Confirm there is an on-site pathology service and a multidisciplinary cancer team, because the operation is only one part of cancer care.
Finally, make sure the team will share your full pathology and operation notes with your home oncologist, since your follow-up — PSA monitoring and any further treatment — will happen at home.
Recovery and continence timeline
After surgery you will have a urinary catheter for roughly one to two weeks while the join between the bladder and urethra heals. It is removed before you should fly, so plan to stay in the destination country for one to two weeks. Most men go home from hospital after a few days.
Urinary control typically returns gradually over weeks to months. Many men leak at first, improve significantly within three months, and reach their final level of control by around a year; pelvic-floor exercises help. Erectile recovery is slower and less predictable, can take up to two years where nerves were spared, and may need medication or other aids.
Heavy lifting and strenuous exercise are usually off-limits for around four to six weeks. Because pelvic surgery carries a clot risk, discuss flight timing and any blood-thinning precautions with the team before booking your return.
Risks and follow-up after you return
The main long-term concerns are urinary incontinence and erectile dysfunction, and you should expect a frank discussion of your individual likelihood of each based on your anatomy and the planned surgery. Surgical risks include bleeding, infection, injury to nearby structures and, less commonly, a narrowing where the bladder and urethra were rejoined.
Follow-up is lifelong and centres on regular PSA blood tests; a rising PSA after surgery can signal cancer recurrence and the need for additional treatment. This monitoring will be done at home, so continuity of care with your own urologist or oncologist is essential.
Before travelling, agree in writing what the clinic will do if a complication appears after you fly home, and confirm your home team will accept the case for follow-up. Dedicated medical-travel insurance covering complications is strongly advisable for surgery of this scale.
Frequently asked
Is robotic prostatectomy better than open surgery?
Robotic surgery usually means less blood loss and a faster recovery, but cancer control and side-effect rates depend mainly on the surgeon's experience rather than the platform used.
Will I be incontinent after a prostatectomy?
Most men leak at first and improve over weeks to months, with the majority regaining good control within a year. Pelvic-floor exercises help, and a minority have longer-term issues.
Will the surgery affect my erections?
It often does. Where nerve-sparing is possible recovery can take up to two years and may need medication. Your individual outlook depends on your tumour and anatomy.
How long must I stay abroad after the operation?
Plan for one to two weeks, since the urinary catheter stays in for one to two weeks and should be removed, with a wound check, before you fly.
Do I still need follow-up after surgery?
Yes, lifelong PSA monitoring is essential to detect any recurrence. This is done at home, so arrange follow-up with your own urologist before travelling.
Is surgery always the best choice for prostate cancer?
Not always. Radiotherapy and, for low-risk cancer, active surveillance can be appropriate. Seek a clear opinion on all options before committing to surgery.
