Concierge urology · UK
Prostate cancer - removing the whole gland to cure it.
Open radical prostatectomy for localised prostate cancer - the whole prostate and seminal vesicles removed, nerves spared where the cancer allows, and complete histology to guide what comes next. A high-volume surgeon, cure first.
Why patients choose us
- 01
A high-volume prostate cancer surgeon
A consultant urological surgeon whose radical prostatectomy numbers are known and audited - not a general urologist doing the occasional case. Volume is the single clearest predictor of outcome.
- 02
Cure first, function second - in that order, honestly
The point of a radical prostatectomy is to remove the cancer completely. We are straight about when nerve-sparing is safe and when clear margins have to come first.
- 03
Independent, and free
We are paid by no hospital, so whether open surgery, radiotherapy or active surveillance suits you better is an impartial conversation, and it costs you nothing.
Indicative pricing
What a private radical prostatectomy costs in the UK.
Indicative ranges across our partner urology units. Send your diagnosis and we quote firm figures, with staging and cover checked.
In short
Open radical prostatectomy in our network: £13,000–£19,000, stay 2–4 nights.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| Open retropubic radical prostatectomy | £13,000–£18,000 | 2–3 hrs | 2–4 nights |
| Nerve-sparing open radical prostatectomy | £14,000–£19,000 | 2–3 hrs | 2–4 nights |
| Radical prostatectomy with pelvic lymph node dissection | £15,000–£21,000 | 3–4 hrs | 2–5 nights |
| Open radical (locally advanced / salvage) | £16,000–£23,000 | 3–4 hrs | 3–6 nights |
| Multiparametric MRI staging (if needed) | £450–£900 | 40–60 min | Report 2–5 days |
| PSMA PET-CT staging (if needed) | £1,800–£3,000 | 60–90 min | Report 3–7 days |
| Urology consultation only | £250–£450 | 30–45 min | Same visit |
Prices vary by hospital, by the surgeon, by whether lymph nodes are removed, and by staging imaging needed beforehand. Locally advanced and salvage cases sit at the top of the range. We come back with a firm quote within one working day.
The problem
Clear margins, an honest function forecast, and the right surgeon.
Radical prostatectomy lives or dies on three things - completeness of removal, realistic expectations, and who holds the instruments. We settle all three before you consent.
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Remove all of it, first
A positive margin is the strongest driver of recurrence. Nerve-sparing is worthwhile only when it does not compromise clearing the cancer - and we say so plainly.
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A function forecast you can trust
Continence and erections after surgery depend on your starting point, your age and the anatomy. We give you the numbers that apply to you, not a brochure average.
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Volume is the quiet variable
Outcomes track closely with how many radical prostatectomies your surgeon performs each year. We match you to a high-volume operator, not the next free list.
The journey
From diagnosis to follow-up - what happens, in order.
One team from your first message through staging, surgery, histology and PSA surveillance.
Phase 1 · Before your surgery
Staging, MDT and surgical planning
Phase 2 · On the day
Theatre and inpatient recovery
Phase 3 · After
Catheter, histology, PSA
- 01
Before
You send us your diagnosis
A short, confidential form. PSA history, biopsy Gleason and grade group, MRI stage, and any staging scans already done.
- 02
Before
We come back with a recommendation
Within one working day: whether radical surgery is the right treatment for your risk group, how it compares with radiotherapy and surveillance, and an indicative price.
- 03
Before
Staging and MDT review
Multiparametric MRI, and a PSMA PET-CT or bone scan for higher-risk disease. Your case is discussed at a urology cancer multidisciplinary team meeting before any decision is finalised.
- 04
Before
Surgical planning and consent
The surgeon discusses the extent of the operation, whether the nerves either side can be spared, whether lymph nodes need removing, and the realistic continence and erectile outlook for you.
- 05
On the day
The operation
Under general anaesthetic. Open retropubic radical prostatectomy removes the whole prostate and seminal vesicles through a lower-abdominal incision, joining the bladder to the urethra. Usually 2–3 hours.
- 06
On the day
Inpatient recovery
A urinary catheter and often a wound drain are placed. Most men stay 2–4 nights, mobilising the day after surgery, before going home with the catheter in.
- 07
After
Catheter, histology and PSA follow-up
The catheter comes out at 1–2 weeks. Full histology at 2–3 weeks confirms grade, stage and margins. The first PSA is checked at about 6 weeks, then on a defined schedule.
Typical end-to-end: 3–5 weeks from diagnosis to surgery. Back to full activity: 4–6 weeks, with continence and potency recovery over months.
When it helps
When radical prostatectomy is the right step.
The situations where removing the prostate makes sense, plus the one red flag that means staging before any operation.
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Localised intermediate-risk cancer
Grade group 2–3 disease still confined to the prostate, where surgery offers a strong chance of cure in a man fit for an operation.
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High-risk but operable disease
Higher Gleason grade or a raised PSA where removing the prostate, often with lymph nodes, is part of a curative plan.
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A younger man with long life expectancy
Where decades of follow-up favour definitive removal of the cancer over surveillance, and durable local control matters.
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A large prostate or previous TURP
Situations where a minimally invasive approach is harder, and an open operation gives the surgeon the most reliable access.
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Preference for surgery over radiotherapy
Some men choose to have the cancer removed and the tissue examined, keeping radiotherapy in reserve should it ever be needed.
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When the pathology is wanted
Removing the whole gland gives a full histology - grade, stage and margins - that guides whether any further treatment is required.
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Locally advanced disease in a fit man
Selected T3 tumours where extended open surgery, sometimes followed by radiotherapy, forms part of a multimodal plan.
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Red flag: spread beyond the prostate
Bone pain, weight loss or a very high PSA can point to disease outside the gland - where surgery alone is not the answer and staging must come first.
Procedure options
Approach and extent both depend on the cancer.
What each variation involves - the surgical route, whether nerves are spared, and whether lymph nodes are removed.
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Open retropubic approach
The classic radical prostatectomy through a lower midline incision from the navel to the pubic bone. Direct access to the prostate, bladder neck and lymph nodes, with the surgeon operating by hand and feel.
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Open perineal approach
A less common route through an incision between the scrotum and anus. Avoids the abdomen and can suit some men, though it gives poorer access to the pelvic lymph nodes.
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Nerve-sparing radical prostatectomy
Where cancer position allows, the neurovascular bundles running alongside the prostate are preserved to protect erectile function. Sparing is always secondary to complete cancer removal.
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Non-nerve-sparing (wide excision)
When the tumour sits close to or involves the nerves, they are removed with the prostate to secure clear margins. Erections are unlikely to recover naturally, and this is discussed frankly beforehand.
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Pelvic lymph node dissection
For intermediate and high-risk disease, the lymph nodes draining the prostate are removed and examined to complete staging and guide any further treatment.
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Bladder neck reconstruction
After the prostate is removed the bladder neck is reshaped and joined to the urethra over a catheter - the anastomosis that heals during the first two weeks.
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Salvage radical prostatectomy
Removal of the prostate after radiotherapy has failed to control the cancer. Technically demanding, with higher complication rates, and offered only in selected men.
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Open vs minimally invasive
Open surgery gives tactile feedback and reliable access; robotic and laparoscopic approaches reduce blood loss and stay. Cancer outcomes are broadly comparable in expert hands - the surgeon matters more than the tool.
Our vetted UK network
A small panel of urological surgeons, we picked them.
High-volume prostate cancer surgeons across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every surgeon in our network.
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Consultant urological surgeons with high, audited radical prostatectomy volumes and published outcomes
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Access to a urology cancer MDT, PSMA PET-CT and multiparametric MRI staging
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Continence and erectile rehabilitation pathways in place before, not after, surgery
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A defined PSA surveillance schedule and a clear plan for adjuvant or salvage treatment if needed
Safety and recovery
What to expect afterwards - honestly.
Radical prostatectomy is a well-established cancer operation. The things worth planning are continence, erections, and the PSA surveillance that follows you for years.
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A major operation under general anaesthetic
Radical prostatectomy is a significant abdominal operation, typically 2–3 hours, with a 2–4 night stay and a catheter for one to two weeks. It is not a minor or day-case procedure.
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Bleeding and transfusion
The prostate has a rich blood supply and open surgery carries a higher blood loss than robotic. Transfusion is occasionally needed; your surgeon plans for it.
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Urinary incontinence
Leakage is common in the early weeks and improves with pelvic floor exercises. Most men regain good control within 6–12 months; a minority have longer-lasting leakage needing further treatment.
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Erectile dysfunction
Even with nerve-sparing, erections take months to recover and may need medication or devices. Where nerves are removed for cancer clearance, natural erections are unlikely - planned for honestly beforehand.
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Positive surgical margins
Cancer cells at the edge of the removed specimen raise the chance of recurrence and may prompt radiotherapy. Margins are reported in your histology and reviewed at MDT.
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Infection, DVT and hernia
Wound or urinary infection, blood clots in the legs or lungs, and later incisional hernia are recognised risks. DVT prophylaxis and early mobilisation are standard.
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Loss of ejaculation and fertility
Removing the prostate and seminal vesicles ends ejaculation and natural fertility permanently. Sperm banking beforehand is an option for men who may want children.
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PSA and the meaning of recurrence
After surgery PSA should fall to undetectable. A rising PSA on follow-up signals biochemical recurrence and triggers restaging and a discussion about salvage radiotherapy.
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Red flags after surgery
Fever, spreading wound redness, calf pain or breathlessness, heavy bleeding, or the catheter stopping draining need the same-day team or A&E, not a routine call.
Reading your histology report
Your histology report in four parts. Read the last one first.
Whatever the approach - open, laparoscopic or robotic - the pathology report the surgeon sends you keeps to the same shape.
A quiet reminder
Pathology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the histology and the PSA plan before your review, just ask.
- 01 Header
Grade, stage and margins
The confirmed Gleason grade group, the pathological stage (whether the cancer was contained), and whether the surgical margins were clear or positive.
- 02 Technique
Extent and nerve-sparing
Whether the operation was nerve-sparing on one side, both or neither, whether lymph nodes were removed, and how the bladder was rejoined to the urethra.
- 03 Findings
Lymph nodes and seminal vesicles
Whether the removed lymph nodes contained cancer, and whether the seminal vesicles were involved - both key to planning any further treatment.
- 04 Impression
PSA plan and next steps
Read this first: your PSA surveillance schedule, whether adjuvant radiotherapy is advised, and the continence and erectile rehabilitation plan.
Recognised by major UK insurers
Radical prostatectomy for diagnosed prostate cancer is usually covered when medically indicated, including staging scans. Cover levels vary by policy and excess. We confirm cover before booking.
Frequently asked
Everything we get asked about radical prostatectomy.
Quick answers on cure rates, continence, erections, recovery, PSA and cost.
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Is open radical prostatectomy as good as robotic surgery for curing prostate cancer?
For cancer control, yes - large studies show comparable oncological outcomes between open, laparoscopic and robotic radical prostatectomy when done by experienced surgeons. Robotic surgery tends to mean less blood loss and a shorter stay, while open surgery gives the surgeon direct tactile feedback and reliable access, which can matter for large glands or after previous surgery. The surgeon’s experience and volume influence your result more than the approach itself.
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Will I be able to control my bladder afterwards?
Leakage is common in the first weeks after the catheter comes out and improves steadily with pelvic floor exercises started before surgery. Most men regain good urinary control within six to twelve months. A minority have longer-lasting leakage that can be helped with further physiotherapy or, occasionally, a small procedure.
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What are the chances of keeping erections?
This depends on your erections before surgery, your age, and whether the nerves either side of the prostate can be spared. With bilateral nerve-sparing in a younger man, recovery is common but takes months and often needs medication for a time. Where the nerves must be removed to clear the cancer, natural erections are unlikely, and we discuss this honestly before you decide.
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How long is the recovery from open surgery?
Expect a 2–4 night hospital stay and a catheter for one to two weeks. Most men are back to light activity in 3–4 weeks and to full activity, including driving and desk work, by 4–6 weeks. Heavy lifting is avoided for about six weeks while the wound and internal join heal.
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What does my PSA mean after the prostate is removed?
Once the whole prostate is gone, PSA should become undetectable within about six weeks. It is then checked on a schedule. A PSA that rises above a defined threshold signals biochemical recurrence and prompts restaging and a discussion about salvage radiotherapy, which can still be curative.
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How much does a private radical prostatectomy cost in the UK, and does the NHS offer it?
Privately, open radical prostatectomy typically runs £13,000–£19,000, rising to £21,000 or more with extended lymph node dissection or for locally advanced and salvage cases, plus any staging scans. The NHS provides radical prostatectomy free of charge for suitable men, most commonly robotically at specialist centres; the private route mainly offers choice of surgeon and timing. We confirm a firm figure within one working day.
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All tests & procedures
Every test and procedure we arrange.
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