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An open prostatectomy is usually done only when necessary, as it is a major surgery that can take longer to heal. It’s typically recommended for men with a very large prostate, about four times the size of a healthy prostate (usually over 80 mL).
During the surgery, the prostate is removed through a cut in your lower abdomen. You’ll be given a general anaesthetic, which will make you sleep through the surgery, or a spinal anaesthetic, which will numb you from the waist down while you stay awake.
At the end of the surgery, a catheter is placed in your bladder to help drain urine. The catheter is inserted through the opening in the penis, down the urethra, and into the bladder. Since you’ll still be asleep or numb when the catheter is placed, you won’t feel discomfort.
You will not need to use the toilet to urinate while a catheter is in place as it drains urine out of the bladder, down the catheter tube and into a bag that your medical team will empty for you, as needed. The catheter also helps flush the bladder and urethra to prevent blood clots.
You may need to keep the catheter in for a week or longer until you’re able to urinate on your own. A nurse will remove it, and it’s a simple process that usually doesn’t cause much discomfort.
After the prostate is removed, you won’t ejaculate when you orgasm. You’ll still feel the pleasure of an orgasm, but there won’t be any semen produced. It might feel a bit different at first, but you can still enjoy sexual pleasure.
This chapter provides general information about open prostatectomy for BPE. It is not a replacement for professional medical advice or treatment. Always consult your doctor or healthcare provider for guidance on your individual medical situation.
Last updated: May 2025