What is Prostatectomy: Purpose, Procedure, Results & Costs in India

For many Indian men, understanding prostate health becomes crucial as they age. The prostate gland, a small, walnut-sized organ located just below the bladder, plays a vital role in male reproductive health. However, it can also be a source of significant health concerns, primarily prostate cancer and benign prostatic hyperplasia (BPH), or an enlarged prostate. When these conditions become severe or life-threatening, a surgical procedure called prostatectomy often becomes a necessary and effective treatment option.

India has rapidly emerged as a leading hub for advanced prostatectomy procedures, attracting patients not only from within the country but also globally. This is largely due to a powerful combination of highly skilled medical professionals, state-of-the-art technology, and competitive pricing, making high-quality healthcare accessible. This blog aims to demystify prostatectomy, providing a comprehensive guide for Indian men and their families, covering its purpose, preparation, various procedural types, expected results, potential risks, and the associated costs in India.

What is Prostatectomy?

Prostatectomy is a surgical procedure involving the partial or complete removal of the prostate gland. It is a definitive treatment primarily used to address prostate cancer and severe cases of benign prostatic hyperplasia (BPH). The choice between removing part or all of the prostate depends on the underlying condition, its severity, and the patient's overall health.

This surgery is a significant intervention designed to alleviate symptoms, prevent disease progression, and, in many cases of localized cancer, offer a cure. Over the years, advancements in surgical techniques have transformed prostatectomy from a highly invasive procedure into one that can often be performed with minimally invasive methods, leading to better patient outcomes and quicker recovery times. In India, these advanced techniques are widely available, ensuring patients have access to world-class care.

Why is Prostatectomy Performed?

The primary reasons for undergoing a prostatectomy are rooted in the need to treat serious prostate conditions that cannot be managed through less invasive means.

Treating Prostate Cancer

The most common reason for a prostatectomy is to treat prostate cancer. This is particularly true when the cancer is:

• Localized: Meaning the cancer cells are confined within the prostate gland and have not spread to other parts of the body.
• Early-stage: Detected at a point where surgical removal can be curative.

For men diagnosed with early-stage, localized prostate cancer, radical prostatectomy—the complete removal of the prostate gland along with surrounding tissues and lymph nodes—can offer a complete cure. It aims to eliminate all cancerous cells and prevent their spread, significantly improving long-term survival rates. The decision to proceed with surgery is often made after a thorough evaluation of the cancer's aggressiveness, the patient's age, overall health, and personal preferences, in consultation with a multidisciplinary medical team.

Managing Benign Prostatic Hyperplasia (BPH)

While primarily known for cancer treatment, prostatectomy is also a crucial option for severe cases of benign prostatic hyperplasia (BPH), a non-cancerous enlargement of the prostate gland. BPH is a common condition among older men, and while often managed with medication, some men experience symptoms so severe that surgery becomes necessary. These symptoms and complications can include:

• Difficulty urinating: A weak urine stream, straining to urinate, or a feeling of incomplete bladder emptying.
• Frequent urination: Especially at night (nocturia).
• Sudden urges to urinate.
• Recurrent urinary tract infections (UTIs): Due to urine retention.
• Bladder stones: Formation of stones in the bladder due to stagnant urine.
• Kidney problems: In severe, untreated cases, BPH can lead to kidney damage.
• Acute urinary retention: A sudden inability to urinate, which is a medical emergency.

In such situations, prostatectomy aims to:

• Restore normal urine flow: By removing the obstructive prostate tissue.
• Prevent damage to the kidneys and bladder: By alleviating backpressure and improving bladder emptying.
• Relieve pain and discomfort: Associated with severe urinary symptoms.

For BPH, the surgery typically involves removing only the enlarged portion of the prostate that is obstructing the urethra, rather than the entire gland. This distinction is important in understanding the various types of prostatectomy procedures available.

Preparation for Prostatectomy

Proper preparation is fundamental to ensuring a successful prostatectomy and minimizing potential complications. In India, medical teams emphasize a comprehensive pre-operative assessment and patient education to ensure men are fully ready for the procedure.

Medical Evaluation

This is the cornerstone of preparation, involving a thorough review of the patient's health status:

• Detailed Medical History: Discussing past illnesses, surgeries, allergies, and existing medical conditions.
• Physical Examination: A complete physical check-up, including a digital rectal examination (DRE) to assess the prostate.
• Diagnostic Tests:
  • Blood Tests:
    • Prostate-Specific Antigen (PSA): To screen for prostate cancer or monitor its progression.
    • Complete Blood Count (CBC): To check for anemia or infection.
    • Kidney Function Tests (Creatinine, Urea): To assess kidney health.
    • Liver Function Tests (LFTs): To check liver health.
    • Blood Sugar (Glucose): Especially important for diabetic patients.
    • Coagulation Profile (PT, INR, APTT): To assess blood clotting ability.
  • Urine Tests:
    • Urinalysis: To detect urinary tract infections or other abnormalities.
    • Urine Culture: If infection is suspected.
  • Imaging Scans:
    • Transrectal Ultrasound (TRUS): To visualize the prostate, measure its size, and guide biopsies.
    • Magnetic Resonance Imaging (MRI): Often used to stage prostate cancer, assess local spread, and aid surgical planning.
    • Bone Scan: If cancer is suspected to have spread to the bones.
    • CT Scan: To check for spread to lymph nodes or other organs.
  • Prostate Biopsy: If cancer is suspected, a biopsy is essential to confirm the diagnosis and determine the cancer's grade (Gleason score).
  • Cystoscopy: A procedure where a thin, flexible tube with a camera is inserted into the urethra to examine the bladder and prostate for any blockages or abnormalities.
  • Electrocardiogram (ECG) and Chest X-ray: To assess heart and lung health, especially important before general anesthesia.

Medication Review

Patients are typically advised to:

• Stop Blood Thinners: Medications such as Aspirin, Warfarin, Clopidogrel, and NSAIDs (like Ibuprofen) must be stopped typically 7-10 days before surgery to reduce the risk of excessive bleeding. Specific guidance will be provided by the surgeon and anesthesiologist.
• Avoid Certain Supplements: Vitamin E, fish oil, and herbal supplements (e.g., Ginko Biloba, Garlic, Ginseng) can also affect blood clotting and should be discontinued.
• Manage Chronic Medications: Discuss all regular medications with the doctor. Adjustments may be made for blood pressure, diabetes, or other chronic conditions.

Bowel Preparation

To reduce the risk of infection and improve surgical visibility, a bowel prep is often recommended, especially for radical prostatectomy. This may involve:

• Laxatives: Prescribed to empty the bowels.
• Enemas: Used to clear the lower bowel.
• Clear Liquid Diet: Often advised for the day before surgery.

Dietary Modifications

• Hydration: Consuming plenty of fluids in the days leading up to surgery is generally encouraged.
• Fasting: Patients are typically asked to avoid all food and drinks (including water) after midnight on the day before the procedure to prevent aspiration during anesthesia.

Lifestyle Adjustments

• Smoking Cessation: If the patient smokes, it is strongly advised to stop at least two weeks before surgery. Smoking impairs wound healing, increases the risk of respiratory complications, and can affect overall recovery.
• Alcohol Consumption: Limiting or stopping alcohol intake before surgery is also recommended.

Sperm Banking

For younger men undergoing radical prostatectomy, which involves the removal of the seminal vesicles and often leads to the loss of ejaculatory function (and thus fertility), sperm banking may be recommended as an option for future fertility preservation. Patients should discuss this with their doctor if they have concerns about future fertility.

Understanding the Procedure

The medical team will provide a detailed explanation of:

• The planned type of prostatectomy: Based on the diagnosis and patient profile.
• The surgical steps: What will happen during the operation.
• Anesthesia: The type of anesthesia that will be used.
• Recovery expectations: What to expect immediately after surgery and during the healing process.
• Potential risks and complications: A thorough discussion of all possible adverse outcomes, ensuring informed consent.
• Post-operative care: Instructions regarding pain management, catheter care, activity restrictions, and follow-up appointments.

This comprehensive preparation ensures that patients are physically and mentally ready, well-informed, and actively involved in their treatment journey.

The Prostatectomy Procedure

India offers a wide spectrum of prostatectomy procedures, leveraging modern technology and surgical expertise. The choice of procedure is highly individualized, depending on factors such as the patient's specific condition (cancer vs. BPH), the size of the prostate, the stage of cancer, and the surgeon's experience.

Here are the main types of prostatectomy procedures available:

1. Open Prostatectomy

This is the traditional surgical approach, involving a larger incision:

• Method: The surgeon makes an incision in the lower abdomen (retropubic approach) or between the anus and scrotum (perineal approach) to directly access and remove the prostate gland.
• Indications: Often recommended for very large prostates, complex cases, or when other minimally invasive approaches are not suitable.
• Open Radical Prostatectomy: For prostate cancer, this involves the complete removal of the prostate gland, along with the seminal vesicles and sometimes nearby lymph nodes. This method allows for a tactile assessment of the prostate and surrounding tissues.
• Recovery: Generally involves a longer hospital stay (several days) and a more extended recovery period compared to minimally invasive techniques due to the larger incision.

2. Laparoscopic Prostatectomy

This is a minimally invasive technique that uses small incisions:

• Method: Several small incisions (typically 0.5-1 cm) are made in the abdomen. A laparoscope (a thin tube with a camera) is inserted through one incision to provide a magnified view of the surgical field on a monitor. Specialized long instruments are inserted through other incisions to perform the surgery.
• Advantages:
  • Smaller incisions lead to less pain and scarring.
  • Reduced blood loss.
  • Shorter hospital stays (typically 2-3 days).
  • Quicker recovery compared to open surgery.
• Laparoscopic Radical Prostatectomy: Considered feasible and effective for high-risk prostate cancer in Indian patients, offering comparable oncological outcomes to open surgery with the benefits of a minimally invasive approach.

3. Robotic-Assisted Prostatectomy (RALP)

This is the most advanced and increasingly preferred minimally invasive technique, widely available in major Indian hospitals:

• Method: Utilizes a sophisticated surgical robot system, such as the Da Vinci system. The surgeon sits at a console, viewing a high-definition 3D image of the surgical area, and controls robotic arms equipped with tiny instruments that mimic human wrist movements.
• Advantages:
  • Enhanced Precision and Dexterity: The robotic instruments offer a greater range of motion and precision than human hands, allowing for meticulous dissection and suturing.
  • 3D Visualization: The surgeon gets a magnified, high-definition 3D view, improving depth perception and anatomical clarity.
  • Smaller Incisions: Similar to laparoscopic surgery, leading to less pain, scarring, and reduced risk of infection.
  • Less Blood Loss: Due to enhanced precision and clear visualization.
  • Reduced Pain: Post-operative discomfort is generally lower.
  • Shorter Hospital Stays: Typically 1-2 nights.
  • Quicker Recovery: Patients often return to normal activities sooner.
  • Improved Functional Outcomes: The precision of RALP can facilitate nerve-sparing techniques, potentially preserving nerves responsible for erectile function and improving urinary continence outcomes. Studies on elderly Indian men (70 years and above) undergoing RALP have shown no significant differences in complications, length of stay, pathological stage, positive surgical margins, or nodal involvement compared to younger men, highlighting its safety and efficacy across age groups.
• Indications: Primarily used for radical prostatectomy in prostate cancer treatment, offering excellent oncological and functional outcomes.

4. Laser Prostatectomy

Primarily used for treating BPH, this technique uses laser energy to remove or shrink prostate tissue:

• Method: A scope is inserted through the urethra to reach the prostate. A laser fiber is then passed through the scope to vaporize (photoselective vaporization of the prostate - PVP) or enucleate (holmium laser enucleation of the prostate - HoLEP) the excess prostate tissue.
• Advantages:
  • Lower risk of bleeding, making it suitable for patients on blood thinners.
  • Shorter hospital stay (often outpatient or one night).
  • Quicker recovery and return to normal activities.
  • Effective relief of urinary symptoms.
• Indications: Best for BPH, especially for patients with moderate to large prostates.

5. Transurethral Resection of the Prostate (TURP)

Often considered the "gold standard" for treating BPH:

• Method: A resectoscope, a thin tube with a light, camera, and an electrical wire loop, is inserted through the urethra. The wire loop is used to shave away small pieces of the enlarged prostate tissue that are blocking urine flow.
• Advantages:
  • Immediate and significant relief of urinary symptoms.
  • No external incisions.
  • Relatively short hospital stay (1-2 days).
• Indications: Effective for moderate to large prostates causing significant BPH symptoms.

6. Transurethral Incision of the Prostate (TUIP)

A less invasive option than TURP for certain BPH cases:

• Method: A scope is inserted through the urethra, and small incisions are made in the prostate gland and the bladder neck. These incisions widen the urethra, allowing urine to flow more easily. No prostate tissue is removed.
• Advantages:
  • Less invasive than TURP.
  • Lower risk of certain side effects like retrograde ejaculation.
  • Often an outpatient procedure.
• Indications: Typically reserved for men with smaller prostates affected by BPH.

The evolution of these procedures, particularly the rise of robotic-assisted surgery, underscores India's commitment to providing advanced and patient-centric prostate care.

Understanding Results

The outcomes of prostatectomy in India are generally very positive, especially with the widespread adoption of advanced surgical techniques. Patients can expect significant improvements in their quality of life, although it's crucial to be aware of potential side effects and the recovery journey.

Cancer Treatment Outcomes

• Cure for Localized Cancer: For men with localized prostate cancer, radical prostatectomy offers a high chance of a complete cure. Success rates are highest when the cancer is detected and treated in its early stages.
• Oncological Efficacy in Indian Patients: Studies conducted in India affirm these positive outcomes. For instance, a study on Indian patients undergoing laparoscopic radical prostatectomy for high-risk prostate cancer demonstrated:
  • A 5-year biochemical recurrence-free survival of 68.3%.
  • Cancer-specific survival of 89.2%.
  • Overall survival of 78.7%. These figures highlight the procedure's effectiveness in controlling cancer and improving patient longevity.
• PSA Monitoring: Post-surgery, regular monitoring of PSA levels is crucial. A persistently low or undetectable PSA indicates successful cancer removal, while a rising PSA may suggest recurrence and necessitate further evaluation or treatment.

Urinary Continence

Restoring normal urinary function is a key outcome, but some temporary issues are common:

• Temporary Incontinence: It is common for men to experience some degree of urinary incontinence immediately after surgery, particularly stress incontinence (leaking urine with coughing, sneezing, or lifting). This is often due to the bladder and sphincter muscles adjusting to the changes.
• Regaining Bladder Control: Most patients gradually regain bladder control within a few weeks to months. Pelvic floor (Kegel) exercises are highly recommended and effective in strengthening the muscles that control urine flow, significantly aiding recovery.
• Continence Rates in Indian Patients:
  • A study on elderly Indian men undergoing robotic radical prostatectomy reported impressive continence rates: 66.7% at 1 month, 87.9% at 6 months, and 94.8% at 1 year of follow-up. This indicates that continence levels can return to those of younger men after approximately 4 weeks, with continued improvement over time.
  • For high-risk prostate cancer patients undergoing laparoscopic radical prostatectomy, 89.3% were continent after 1 year of follow-up.

Erectile Function

Erectile dysfunction (ED) is a potential side effect due to the close proximity of the nerves responsible for erections to the prostate gland:

• Nerve Damage: Even with careful surgical techniques, these delicate nerves can be bruised or damaged during removal of the prostate.
• Impact Varies: The degree of impact on erectile function varies widely among individuals, depending on factors such as pre-operative erectile function, age, and whether nerve-sparing techniques were feasible.
• Recovery Over Time: Some men gradually recover erectile function over several months to a couple of years.
• Treatments: Various treatments are available to assist with erectile function, including oral medications (e.g., PDE5 inhibitors like Sildenafil), vacuum erection devices, penile injections, or penile implants.
• Nerve-Sparing Techniques: Particularly with robotic-assisted surgery, surgeons strive to preserve these nerves (nerve-sparing radical prostatectomy) whenever oncologically safe, significantly improving the chances of retaining post-operative erectile function.

Recovery

The recovery timeline largely depends on the type of prostatectomy performed:

• Hospital Stay:
  • Robotic Prostatectomy: Typically 1-2 nights.
  • Laparoscopic/TURP: Usually 2-3 nights.
  • Open Prostatectomy: Several days (3-7 nights).
• Catheterization: A urinary catheter is usually in place for 1-3 weeks (longer for radical prostatectomy) to allow the bladder and urethra to heal.
• Pain Management: Pain is generally manageable with prescribed medications.
• Activity Restrictions:
  • Light activities (walking) can usually be resumed within a week or two.
  • Avoidance of heavy lifting, strenuous activities, and prolonged sitting for several weeks (typically 4-6 weeks) is crucial to prevent complications and aid healing.
• Full Recovery: While much of the physical recovery occurs within a few weeks, full recovery of urinary control and erectile function can take up to a year or even longer.
• Follow-up: Regular follow-up appointments with the urologist are essential for monitoring recovery, managing side effects, and, in cancer cases, detecting any recurrence through PSA tests.

Risks

Like any major surgical procedure, prostatectomy carries certain risks and potential complications, which are thoroughly discussed with the patient before surgery:

• Bleeding: Some blood loss is expected during surgery. Rarely, a blood transfusion may be required.
• Infection: Risk of infection at the surgical site (wound infection) or in the urinary tract (urinary tract infection), usually managed with antibiotics.
• Urinary Incontinence: As detailed above, difficulty controlling urine flow is common, often temporary, but can be persistent in some cases.
• Erectile Dysfunction: As detailed above, difficulty achieving or maintaining an erection.
• Lymphoceles: These are collections of lymph fluid that can develop in the pelvic area, particularly after lymph node dissection. They may require drainage if symptomatic.
• Blood Clotting: Deep vein thrombosis (DVT) in the legs or pulmonary embolism (blood clot in the lungs) are rare but serious risks, though lower with minimally invasive techniques. Preventative measures like compression stockings and early ambulation are used.
• Hernia: A rare complication, particularly incisional hernia at the surgical site.
• Heart Attack/Stroke: A rare occurrence, especially in patients with pre-existing cardiovascular conditions, due to the stress of surgery and anesthesia.
• Scar Tissue Formation: Strictures (narrowing) can develop in the urethra or at the anastomosis site (where the bladder is reconnected to the urethra), potentially causing blockages or difficulty urinating.
• Anastomotic Site Leak: A minor leak at the surgical connection point between the bladder and urethra is sometimes detected. It usually resolves with prolonged catheter drainage but can rarely require intervention.
• Ileus: A temporary lack of normal movement in the intestines, causing nausea, vomiting, and abdominal distension.
• Reactions to Anesthesia: General anesthesia carries its own set of risks, including allergic reactions, breathing problems, or cardiac events.
• Rectal Injury: A very rare but serious complication due to the prostate's proximity to the rectum.

Surgeons take every precaution to minimize these risks, and patients are carefully monitored throughout the perioperative period.

Costs in India

One of India's most compelling advantages in medical tourism, especially for procedures like prostatectomy, is its significantly lower cost compared to many developed countries, without compromising on quality or technology. The overall cost of a prostatectomy in India can vary widely based on several critical factors:

Factors Influencing Cost:

1. Type of Procedure: The choice of surgical technique (open, laparoscopic, robotic, laser, TURP, TUIP) is the most significant determinant of cost.
2. Surgeon's Expertise: Highly experienced and renowned surgeons may command higher fees.
3. Surgical Facility: The hospital's geographical location (metro vs. tier-2 city), accreditation status (e.g., NABH, JCI), infrastructure, and the level of technology available (e.g., advanced robotic systems) all play a role in pricing.
4. City: Costs can differ significantly between major metropolitan cities (like Mumbai, Delhi, Bengaluru, Chennai, Hyderabad) and smaller cities.
5. Pre- and Post-operative Costs: These include expenses for:
   • Diagnostic Tests: Initial consultations, blood tests, urine tests, imaging scans, and biopsies.
   • Medications: Before, during, and after surgery.
   • Anesthesia Fees: For the anesthesiologist.
   • Follow-up Sessions: Post-operative consultations and PSA monitoring.
6. Length of Hospital Stay: The number of days spent in the hospital directly impacts the total cost, including room charges, nursing care, and other amenities.
7. Type of Room: Choosing a private room, semi-private room, or general ward will affect expenses.
8. Complications: Any unforeseen complications arising during or after surgery can lead to additional costs for extended hospital stays, further treatments, or medications.

Estimated Costs for Prostatectomy Procedures in India (in Indian Rupees - INR):

It's important to note that these are approximate ranges and actual costs can vary. It's always best to obtain a detailed cost estimate directly from the hospital or healthcare provider.

• Transurethral Incision of the Prostate (TUIP):

  • Typically ranges from ₹1,50,000 to ₹2,50,000. (Approx. $1,800 to $3,000 USD)

• Transurethral Resection of the Prostate (TURP):

  • Generally costs between ₹2,00,000 to ₹3,50,000. (Approx. $2,400 to $4,200 USD)

• Radical Prostatectomy (Open):

  • Ranges from ₹3,00,000 to ₹5,00,000. (Approx. $3,600 to $6,000 USD)

• Robotic-Assisted Prostatectomy (RALP):

  • This advanced procedure typically ranges from ₹4,00,000 to ₹6,00,000. (Approx. $4,800 to $7,200 USD)
  • Specific data indicates that radical prostatectomy in India can start from around ₹3,90,000 (approximately $4,700 USD). The average cost for radical prostatectomy in India is approximately ₹5,11,268 (around $6,100 USD, though this can vary with exchange rates).
  • In cities like Hyderabad, costs can sometimes range more broadly from ₹80,000 to ₹2,20,000 for certain types of prostatectomy (likely BPH-related, depending on the hospital and specific technique).

• General BPH-related surgeries (e.g., laser prostatectomy, TURP):

  • A broader range for these procedures can be between ₹60,000 to ₹1,50,000. (Approx. $720 to $1,800 USD)

• Overall Prostatectomy Costs (Broadest Range):

  • Considering all types and variables, prostatectomy costs in India can broadly range from around ₹3,75,000 to ₹10,00,000 (approximately $4,500 to $12,000 USD).

Costs of Diagnostic Tests (Examples):

• PSA test: ₹400-600
• Ultrasound (USG): ₹600-1200
• MRI Prostate: ₹3,000-8,000
• Prostate Biopsy: ₹4,000-10,000
• Cystoscopy: ₹25,000-40,000

Many hospitals and healthcare providers in India offer comprehensive packages that aim to be inclusive and affordable. These packages often cover the surgeon's fee, anesthesia, hospital stay, standard medications, and sometimes even initial diagnostic tests, providing transparency and predictability for patients.

How Ayu Helps

Ayu, as your trusted medical records app, simplifies your healthcare journey by securely storing all your prostatectomy-related documents—from diagnostic reports and surgical notes to follow-up schedules and medication lists—making them easily accessible whenever and wherever you need them. This ensures seamless continuity of care and empowers you with complete control over your health information.

FAQ (Frequently Asked Questions)

1. What is the difference between prostatectomy for cancer and for BPH? For prostate cancer, a radical prostatectomy involves removing the entire prostate gland, seminal vesicles, and sometimes lymph nodes, aiming for a cure. For BPH, the surgery (like TURP or laser prostatectomy) typically removes only the enlarged part of the prostate that is blocking urine flow, preserving the rest of the gland.

2. How long does the recovery process take after prostatectomy? Recovery varies by procedure type. For minimally invasive surgeries (robotic or laparoscopic), hospital stays are usually 1-2 days, with light activities resuming in 1-2 weeks. Full recovery, including urinary control and erectile function, can take several months to a year. Open surgery involves a longer hospital stay and recovery period.

3. Will I experience urinary incontinence or erectile dysfunction after prostatectomy? Both are potential side effects. Temporary urinary incontinence is common but often improves over time, aided by pelvic floor exercises. Erectile dysfunction can occur due to nerve damage, but nerve-sparing techniques (especially with robotic surgery) aim to preserve function. Medications and other treatments are available to manage ED.

4. What are the advantages of robotic-assisted prostatectomy (RALP)? RALP offers several benefits, including smaller incisions, less blood loss, reduced pain, shorter hospital stays, quicker recovery, and enhanced precision with 3D visualization. This precision can lead to better preservation of nerves responsible for erectile function and improved urinary continence outcomes.

5. How often will I need follow-up appointments after prostatectomy for prostate cancer? Regular follow-up appointments are crucial, typically involving physical examinations and PSA blood tests. For cancer, PSA levels are usually monitored every 3-6 months for the first few years, then annually, to detect any potential recurrence.

6. What are the cost implications of choosing a specific type of prostatectomy in India? Robotic-assisted prostatectomy is generally the most expensive due to advanced technology, followed by laparoscopic and open radical prostatectomy. Procedures for BPH, such as TURP or TUIP, are typically less costly. Factors like hospital, surgeon's experience, and city also significantly influence the final cost.

7. Can I still have children after a prostatectomy? Radical prostatectomy involves the removal of the seminal vesicles, leading to the absence of semen production (dry orgasm) and infertility. For younger men, sperm banking before the surgery is an option to preserve fertility. Procedures for BPH usually do not impact fertility but can cause retrograde ejaculation (semen enters the bladder instead of exiting the penis).

8. What are the alternatives to prostatectomy for prostate cancer? Alternatives for prostate cancer include radiation therapy (external beam radiation or brachytherapy), active surveillance (monitoring without immediate treatment for low-risk cancers), hormone therapy, and chemotherapy. The choice depends on cancer stage, aggressiveness, patient age, and overall health.