BPH, or benign prostatic hyperplasia, is a glandular condition that commonly appears in men past the age of 50. While it’s possible to develop an enlarged prostate at any age, BPH becomes increasingly common as men age. Simple prostatectomy is one of the surgical procedures used to address cases of an enlarged prostate from BPH. Below we’re going to talk about this surgery, when it’s performed, and how it may affect you.

Understanding Simple Prostatectomy And Its Risk

This procedure is generally reserved for men with a very large prostate whose urinary symptoms have not responded to medication, or who have complications such as urinary retention, recurrent urinary infections, bladder stones, bleeding, or kidney damage. Laser enucleation through the urethra (such as HoLEP) is another surgical option, but it requires anesthesia, a hospital stay and a catheter; for most men with large prostates, Dr. Shusterman recommends prostate artery embolization (PAE), which is less invasive and usually needs no catheter. Simple prostatectomies are generally performed using either open surgery or robot-assisted surgical techniques. RAS is used whenever possible, as open surgery requires a large incision to be made in the abdomen to make the prostate accessible. This increases the risk of blood loss and other complications from the procedure.

Robotic surgery is performed by making small incisions, called ports, in the necessary areas. Small surgical tools, including a camera known as an endoscope, are inserted into these ports and threaded to the surgery site. RAS comes with multiple benefits for the patient, including reduced hospital stays and recovery times. The benefits and outcomes of both types of procedure are similar, which is one more reason why RAS is preferred over open surgery.

While robot-assisted surgical techniques are largely preferred over open surgeries, both are commonly performed procedures. The common risks associated with this procedure include:

  • Anesthesia allergy or side-effect
  • Bleeding, sometimes requiring a blood transfusion, and blood clots
  • Infection
  • Development of scar tissue
  • Erectile dysfunction
  • Retrograde ejaculation, or dry orgasms
  • UTI (Urinary Tract Infection)
  • Incontinence (leaking urine)
  • Frequent urinary urges
  • Trouble while attempting to urinate
  • Blood or painful urination
  • Narrowed urethra

As mentioned above, recovery after robot-assisted techniques is generally faster than after open surgery. After open surgery, most men stay in the hospital for about two to four days, while robot-assisted surgery often allows a shorter stay. In either case, you will usually go home with a urinary catheter for a short time. Return visits to the doctor depend heavily on the type of procedure you received. Open surgeries will require a return to have the staples removed from the incision in your abdomen.

Robot-assisted surgeries often require fewer check-ins after the surgery. Of those required, many may be relegated to a telehealth visit to ensure you’re not experiencing any unexpected symptoms.

Speak To Your Prostate Specialist To Learn More

Your physician will speak to you about your treatment options prior to settling on the one to use. During your consultation, they’ll let you know if you’re eligible for robotic-assisted surgery. Most men who need surgery for an enlarged prostate are treated with procedures performed through the urethra, such as TURP or laser enucleation; simple prostatectomy is typically reserved for very large glands, and many of those cases can be performed robotically. However, in those cases where open surgery is required, they’ll let you know how to prepare. Recovery times from open surgery are often on the order of a month to six weeks in length. Reach out to your specialist to learn more.

Sources

  1. Management of Lower Urinary Tract Symptoms Attributed to Benign Prostatic Hyperplasia: AUA Guideline (2026). American Urological Association, 2026.
  2. EAU Guidelines on the Management of Non-neurogenic Male LUTS. European Association of Urology, 2026.
  3. Perioperative Outcomes of Robotic and Laparoscopic Simple Prostatectomy: A European-American Multi-institutional Analysis. Eur Urol, 2015.
  4. An Outcomes Comparison Between Holmium Laser Enucleation of the Prostate, Open Simple Prostatectomy, and Robotic Simple Prostatectomy for Large Gland Benign Prostatic Hypertrophy. Urology, 2023.
  5. Simple prostatectomy: MedlinePlus Medical Encyclopedia. MedlinePlus (U.S. National Library of Medicine).

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