Can you live without a prostate? Yes, and many men do after prostate removal surgery to treat prostate cancer or an enlarged prostate caused by benign prostatic hyperplasia (BPH). Removing the prostate gland is a standard and effective treatment option, mainly when cancer cells are found early. This surgery called a radical prostatectomy, can be performed using open, laparoscopic, or robotic-assisted techniques.

While prostate removal may cause side effects like erectile dysfunction or urinary incontinence, many men are able to recover with appropriate treatment and support, resuming normal activities and maintaining overall quality of life. This article explains what happens after prostate removal and what to expect when living prostate-free.

Prostate removal is usually done when other treatments are not enough to control symptoms or stop the spread of cancer. The entire prostate gland may be removed to prevent future health problems and improve quality of life.

Doctors may recommend removing the prostate gland when other treatments are no longer effective or when there’s a serious health risk. Below are the most common medical reasons for prostate removal:

• Prostate cancer: Surgery may be recommended to treat localized prostate cancer and help prevent the spread of cancer cells.

• Severe benign prostatic hyperplasia (BPH): Surgery may be needed if an enlarged prostate causes serious urinary symptoms that do not respond to other treatments.

• Recurring urinary tract infections (UTIs): Chronic infections related to prostate issues may require prostate removal to prevent further complications.

• Benign prostate enlargement: Non-cancerous growths, such as BPH, may require surgery if they press on the bladder or cause ongoing urinary symptoms.

• Complications from previous prostate treatments: Damage from earlier procedures may make prostate removal the most effective option.

A prostatectomy is a major surgery performed to remove the prostate. It may also involve eliminating nearby tissue, such as the seminal vesicles and pelvic lymph nodes, depending on how far the cancer has spread. When there's a higher risk of cancer reaching other areas, a pelvic lymph node dissection may be performed during the same surgery for prostate cancer to check if the disease has spread beyond the prostate.

There are several surgical options for removing the prostate, and the best choice often depends on the stage of the cancer, overall health, and the surgeon’s expertise:

• Open radical prostatectomy:  Traditional surgery with a single large incision in the lower abdomen to remove the prostate gland.

• Laparoscopic radical prostatectomy:  Minimally invasive surgery using small incisions and a camera to guide the procedure.

• Robot-assisted prostatectomy (robotic prostatectomy):  Performed using a robotic system for greater precision and control through small incisions.

• Radical perineal prostatectomy:  A less common approach where the prostate is removed through an incision between the anus and scrotum.

These techniques offer various options based on the patient's condition and the extent of the cancer.

Life after prostate removal is possible, and many men continue to enjoy everyday activities after surgery. The body adjusts, and other organs take over some of the prostate’s functions. In many cases, removing the prostate for localized prostate cancer does not significantly impact life expectancy, especially when cancer is detected early and treated appropriately. However, individual outcomes can vary.

The prostate helps make semen, so its removal affects how ejaculation works. Although it's often referred to as a single gland, the prostate is made up of many smaller glands that work together to produce fluid that nourishes and protects sperm.

In prostate removal surgery, also known as a radical prostatectomy, the entire prostate gland is removed. This includes all of the glandular tissue along with parts of the surrounding structures. During surgery, the seminal vesicles, which also contribute to semen production, are often removed as well.

In procedures like an open prostatectomy, where a larger incision is used to access the prostate and surrounding tissues, these structures are typically removed to ensure all affected areas are treated.

After surgery, men no longer produce semen, but this does not affect the ability to feel pleasure during sex. The bladder and pelvic floor muscles manage urinary function, though some men may need time and therapy to regain complete control. Regular checkups and a healthy lifestyle help support long-term recovery.

Recovery comes with changes, but most men adjust well with time, care, and support. Two of the most common challenges involve urinary and sexual function.

Some men experience urinary incontinence once the prostate is removed because the prostate sits just below the bladder and surrounds the urethra, which helps control the flow of urine. During prostate surgery, the muscles and nerves that support bladder control can be affected, leading to temporary or ongoing leakage. This is especially common in the early weeks following surgery, but long-term outcomes vary depending on the individual and the extent of nerve or muscle involvement.

Urinary incontinence is the inability to fully control the release of urine, which can lead to unintentional leaks. It can range from mild dribbling to more significant loss of bladder control, depending on how the pelvic muscles and urinary system are affected during surgery.

One common type is stress incontinence, where urine leaks during activities like coughing, laughing, lifting, or exercising due to weakened pelvic floor muscles. The pelvic floor also connects near the pubic bone, and strain in this area during surgery can sometimes cause discomfort or slow muscle recovery.

Many men experience improvement over time with bladder training, pelvic floor exercises, and physical therapy, although results can vary. In more severe cases, an artificial urinary sphincter may be surgically placed to help control urine flow and improve quality of life.

Prostate removal can affect the nerves that control erections because these nerves run very close to the prostate gland. During surgery, especially if cancer has spread near the edges, these delicate nerves may be damaged or removed to ensure all cancer cells are eliminated. This can lead to erectile dysfunction, where it becomes challenging to get or keep an erection.

The risk of erectile problems depends on the type of prostate surgery performed and whether nerve-sparing techniques were used. Surgeries like robotic radical prostatectomy may offer better chances of preserving these nerves. Treatment options include penile rehabilitation, vacuum devices, penile implants, and medications that improve blood flow, such as PDE5 inhibitors.

With early support and treatment, some men regain erectile function and may return to a satisfying sex life, though outcomes differ based on several factors.

Recovery varies, but most men return to regular routines within a few weeks. Healing depends on the type of treatment for prostate cancer, including the specific surgery performed, and overall health before the procedure.

This timeline outlines typical recovery milestones following radical prostatectomy for early-stage prostate cancer, based on a longitudinal study assessing health-related quality of life (HRQOL) over one year.

• Days 1–2: Hospital stay for monitoring and early recovery.

• Week 1: Catheter in place to support bladder drainage.

• Weeks 1–2: Gentle walking is encouraged to support healing.

• Weeks 2–4: Light daily activities resume; avoid heavy lifting.

• Month 3: 30–40% of patients recover baseline physical, mental, and social functioning.

• Months 5–6:

  • 70%+ recover baseline general and bowel health

  • Average recovery times (for those who do recover):

    • Bowel: 5 months

    • Sexual: 6 months

    • Urinary: 7 months

• Month 12:

  • 86–97% return to baseline across most domains

  • Urinary recovery: 61%

  • Sexual recovery: 31%

These findings are based on the study by Litwin et al. (1999), which utilized validated quality-of-life questionnaires to assess recovery over a one-year period following radical prostatectomy.

Recovering after the prostate is removed takes time, but specific steps can make the process easier and safer. These tips can help support healing, manage side effects, and improve overall well-being:

• Do pelvic floor exercises daily to strengthen muscles and improve urinary control.

• Take pain medications as prescribed to manage discomfort at the surgery site.

• Avoid heavy lifting and strenuous activity until your doctor gives the all-clear.

• Stay active with light walking to help prevent blood clots and boost circulation.

• Eat a balanced diet and drink plenty of water to support healing and reduce constipation.

• Avoid blood thinning medications unless approved by your healthcare provider.

• Keep all follow-up appointments to monitor progress and check for any complications.

Living prostate-free comes with some changes, but most men adjust with the proper care and support. It’s essential to stay informed and keep up with medical care.

Urinary symptoms and changes in sexual function may continue long after surgery. Regardless, many men return to daily routines and maintain an active lifestyle. Doctors may recommend or prescribe medications to help manage erectile dysfunction or bladder control issues, depending on individual needs. Regular bladder training and open conversations about sexual health help men and their partners adapt to life after prostate cancer treatment.

Ongoing care following prostate surgery helps catch problems early and supports long-term health. Regular check-ins with your doctor can guide recovery and reduce the risk of complications:

• Schedule routine PSA blood tests to check for signs of prostate cancer returning.

• Attend all follow-up visits so your doctor can track your healing and adjust your treatment if needed.

• Immediately report any new or ongoing symptoms like urinary problems or pain to your healthcare team.

• Ask about physical therapy if you're having trouble with urinary control or sexual function.

• Follow your doctor’s advice on lifestyle changes such as exercise, diet, or quitting smoking to support recovery and overall health.

Click here to learn more about Alerna's Prostate Support Supplements to enhance your prostate health and overall well-being!

Prostate removal is often needed to treat prostate cancer or severe benign prostatic hyperplasia. While it can lead to side effects like erectile dysfunction or urinary incontinence, most men recover well with the proper care. Surgical procedures such as robot-assisted radical prostatectomy and open radical prostatectomy can remove the entire prostate gland while preserving as much function as possible. With support from a medical team, follow-up care, and healthy habits, men can live whole, active lives after prostate removal.

The information provided in this article is for educational and informational purposes only and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Please consult with your healthcare provider before starting any new dietary supplement, especially if you are pregnant, nursing, have a medical condition, or are taking other medications. Never disregard professional medical advice or delay in seeking it because of something you have read in this article.

1. Haiquel, L., Cathelineau, X., Sanchez-Salas, R., Macek, P., & Secin, F. (2022). Pelvic lymph node dissection in high-risk prostate cancer. International braz j urol : official journal of the Brazilian Society of Urology, 48(1), 54–66. https://doi.org/10.1590/S1677-5538.IBJU.2020.1063

2. Lee, J., Song, J., Jung, G., Song, S. H., & Hong, S. K. (2024). Prognosis after radical prostatectomy in men older than 75 years: long-term results from a single tertiary center. Prostate international, 12(1), 15–19. https://doi.org/10.1016/j.prnil.2023.09.004

3. Litwin, M. S., McGuigan, K. A., Shpall, A. I., & Dhanani, N. (1999). Recovery of health related quality of life in the year after radical prostatectomy: early experience. The Journal of urology, 161(2), 515–519.

4. Peterson, A. C., & Webster, G. D. (2011). Artificial urinary sphincter: lessons learned. The Urologic clinics of North America, 38(1), 83–vii. https://doi.org/10.1016/j.ucl.2010.12.011