Cost of laparoscopic prostatectomy by state

What is a laparoscopic prostatectomy?

A laparoscopic prostatectomy is a surgery that is performed to remove the prostate. “Laparoscopic” refers to performing a surgery using a very small incision and surgical instruments/cameras on small sticks. “Prostatectomy” refers to the surgical removal of the prostate gland.

What is the prostate and why would it need to be removed?

The prostate is a walnut sized gland at the bottom of the bladder that surrounds the tube where urine leaves the bladder. It normally produces lubricating fluid that helps carry sperm through the urethra during ejaculation. The prostate can become enlarged with age which may block the exit of the bladder and cause issues with urination. Prostate cancer is also extremely common and can cause similar issues. 

Both prostate enlargement and cancer can be treated with surgical removal of the prostate. The reason why most of these surgeries are done laparoscopically is that they allow for a smaller incision, quicker recovery, and rescues the risk of damage to nearby structures.

Is prostate surgery major surgery?

Yes, prostate surgery requires general anesthesia (being put to sleep), an average of 2 - 4 hours of surgical time, a short stay in the hospital, placement of a catheter to drain the urine for about a week, and around three weeks for full recovery.

While this may sound extreme, the symptoms that lead surgeons to recommend prostatectomy are extremely difficult to live with. The prostate issues treated by prostatectomy can lead to kidney damage, constant leakage of urine, and severe pain if left untreated.

How long does it take to recover from laparoscopic prostate surgery?

Full recovery from prostate surgery requires 3 - 5 weeks. While this recovery is unique to each patient, a general timeline is as follows:

• 2 to 3 days in the hospital for recovery
• About one week with a urine catheter
• Two to three weeks of significant activity restrictions such as avoiding lifting more than 5-10lbs, avoiding physical activity, and avoiding significant straining while using the toilet. 
• After 3 - 5 weeks returning to most office style jobs is possible. More physically demanding jobs and activities may take several more weeks depending on the intensity of the activity.

How long does it take for the urethra to heal after prostatectomy?

The urethra heals extremely quickly. The urine catheter that is in place for about one week after the surgery allows healing to occur without urine passing over the healing urethra and damaging it. There is often some discomfort after catheter removal but this will resolve within several days.

What are the side effects of living without a prostate?

The most common post-prostatectomy side effects are issues with urination and sexual function. 

A large number of patients that undergo prostatectomy have issues with urination before surgery. This resolves in about 85% of men after surgery. In about 15% of cases, removing the prostate does not resolve these issues. In rare cases, issues with urination may develop only after removal of the prostate. 

The nerves that are critical for erections also run near the prostate. Due to this nearly all men have issues with obtaining and maintaining erections right after surgery. With physical therapy and time, 60% of men have a full return of sexual function. A larger percent have a partial return of sexual function.

What is the life expectancy after prostate surgery?

Life expectancy is not affected by prostate surgery. The prostate does not have any functions that are critical for life. The most common medical conditions that lead to prostatectomy do not typically shorten the lifespan. Even prostate cancer, a common cause of prostate removal, is not known to shorten the lifespan in most patients as it is a very slow growing cancer. Passing away naturally from old age is the most common cause of death in those with prostate problems.