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Urology · UK

Prostatectomy - the right operation for the right reason.

Removing the prostate - or the part of it that is causing trouble - for benign enlargement or for cancer. Simple or radical, open, laparoscopic, robotic or endoscopic.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What a private prostatectomy costs in the UK.

In short

Benign glands from £6,000; radical cancer surgery £13,000–£22,000.

Procedure Indicative range
Endoscopic enucleation (large benign gland) £6,000–£11,000
Simple open prostatectomy (very large benign gland) £9,000–£14,000
Robotic simple prostatectomy (benign) £11,000–£16,000
Radical prostatectomy for cancer - open £13,000–£19,000
Radical prostatectomy for cancer - robotic £15,000–£22,000
Staging MRI or flow assessment (if needed) £300–£900
Urology consultation only £250–£450

Prices vary by the operation itself, by hospital, by surgeon, and by approach. Radical cancer surgery and robotic cases sit at the top of the range; endoscopic benign procedures at the bottom.

The problem

One word, several very different operations.

Men often arrive told they need a prostatectomy without being told which one, whether a less invasive option would do, or how the approaches actually differ. We start by getting those three things straight.

  • Benign or cancer - it changes everything

    Simple prostatectomy relieves symptoms from an enlarged gland; radical prostatectomy removes cancer. Confusing the two leads to the wrong operation.

  • Is surgery even the answer yet?

    For benign disease, tablets, laser and lifts often work first. For cancer, radiotherapy and surveillance are real alternatives. We say so plainly.

  • The approach follows the anatomy

    Gland size, prior surgery, BMI and diagnosis decide whether open, laparoscopic, robotic or endoscopic is right - not a hospital’s marketing.

When it helps

When a prostatectomy is the right step.

The benign and the cancer situations that lead to surgery, plus the one red flag that means staging must come before any operation.

  • Localised prostate cancer

    Cancer confined to the gland in a man fit for surgery, where radical prostatectomy offers a strong chance of cure.

  • Very large benign enlargement

    A prostate too big for standard endoscopic surgery, causing poor flow, retention or recurrent infections - a simple prostatectomy removes the obstructing tissue.

  • Urinary retention or a failing bladder

    When the bladder can no longer empty, or a catheter cannot be removed, surgery to clear the obstruction protects the kidneys and bladder.

  • Bladder stones or recurrent bleeding

    Large stones or repeated blood in the urine from an enlarged gland can be dealt with at the same time as clearing the obstruction.

  • Medication no longer working

    Where tablets for benign enlargement have stopped helping, or their side effects are unacceptable, surgery is the definitive step.

  • When full pathology is wanted

    Removing tissue gives a histological diagnosis - for cancer, the grade, stage and margins that guide whether any further treatment is needed.

  • A younger man with long life expectancy

    For cancer, where decades of follow-up may favour definitive removal over surveillance and durable local control matters.

  • Red flag: signs of spread

    Bone pain, weight loss or a very high PSA can point to cancer beyond the gland - where staging must come first and surgery alone is not the answer.

Procedure options

Two operations, four ways to do them.

The extent (simple or radical) is set by your diagnosis; the approach (open, laparoscopic, robotic, endoscopic) is chosen to fit your anatomy and goals.

  • Simple prostatectomy

    For benign enlargement only. The obstructing inner part of the gland is removed while the outer capsule is left behind. It relieves urinary symptoms; it is not a cancer operation.

  • Radical prostatectomy

    For cancer. The whole prostate and the seminal vesicles are removed and the bladder rejoined to the urethra. This is the operation meant when prostatectomy is discussed in the context of cancer.

  • Open approach

    A lower-abdominal incision giving the surgeon direct, tactile access. Used for very large benign glands and in radical surgery where hands-on access is preferred.

  • Laparoscopic approach

    Keyhole ports and a camera, without a robot. Less common now that robotic surgery is widespread, but still offered by some experienced laparoscopic urologists.

  • Robotic approach

    The da Vinci console for both simple and radical surgery - magnified vision and wristed instruments through keyhole ports, with low blood loss and a short stay.

  • Endoscopic enucleation

    For benign glands, the obstructing tissue is enucleated from inside via the urethra using a laser - no external incision. Covered in detail on our HoLEP and GreenLight pages.

  • Nerve-sparing (radical only)

    In cancer surgery, the neurovascular bundles are preserved where the tumour allows, to protect erectile function. Sparing is always secondary to clear margins.

  • Pelvic lymph node dissection (radical only)

    For intermediate- and high-risk cancer, the draining lymph nodes are removed and examined to complete staging and guide further treatment.

Safety and recovery

What to expect afterwards - honestly.

Because prostatectomy covers several operations, the risks differ. Below are the ones worth understanding, flagged by whether they apply to simple, radical or both.

  • The risks depend on which prostatectomy

    A simple prostatectomy for benign disease and a radical prostatectomy for cancer are different operations with different risk profiles. We set out the ones that apply to your specific procedure.

  • Bleeding and transfusion

    The prostate has a rich blood supply. Blood loss is highest with open simple and open radical surgery, lower with robotic and endoscopic approaches; transfusion is occasionally needed.

  • Urinary incontinence

    Leakage is uncommon after simple prostatectomy but a recognised issue after radical surgery, usually improving over 6–12 months with pelvic floor exercises.

  • Retrograde ejaculation

    After simple prostatectomy and endoscopic enucleation, semen commonly passes backward into the bladder at climax. Sensation is preserved, but natural fertility is affected.

  • Erectile dysfunction

    A particular concern in radical cancer surgery, where nerve-sparing and honest planning matter. It is less common, though still possible, after simple prostatectomy.

  • Infection, DVT and hernia

    Wound or urinary infection, blood clots and later hernia are recognised risks across approaches. DVT prophylaxis and early mobilisation are standard.

  • Cancer-specific outcomes (radical only)

    For cancer, positive surgical margins and lymph node involvement guide whether radiotherapy or other treatment follows, and are reviewed at MDT.

  • PSA after surgery (radical only)

    Once the whole gland is removed for cancer, PSA should fall to undetectable; a rising PSA later signals recurrence and triggers restaging.

  • Red flags after surgery

    Fever, spreading redness, heavy bleeding, calf pain or breathlessness, or a catheter that stops draining need the same-day team or A&E, not a routine call.

Reading your operation note

Your operation note in four parts. Read the last one first.

Whichever prostatectomy you had - simple or radical, and by whatever route - the note you receive keeps to the same shape.

A UK consultant urologist reviewing a patient’s operation notes

A quiet reminder

Surgical language is precise and can read coldly - ask your care team to explain anything that is unclear.

Ask your care team to explain anything that is unclear.

  1. 01 Header

    Which prostatectomy, and why

    Whether the operation was simple (benign) or radical (cancer), the approach used, and the indication that led to surgery.

  2. 02 Technique

    Extent and approach

    What was removed - inner gland only, or the whole prostate and seminal vesicles - the route taken, and, for cancer, whether nerves were spared and nodes taken.

  3. 03 Findings

    Histology and diagnosis

    What the pathologist reported. For benign glands, confirmation of the diagnosis; for cancer, the grade, stage, margins and node status.

  4. 04 Impression

    Follow-up and next steps

    Read this first: catheter and continence plan, and - for cancer - the PSA schedule and whether any further treatment is advised.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Prostatectomy is usually covered when medically indicated, whether for benign obstruction or cancer.

Frequently asked

Everything we get asked about prostatectomy.

Quick answers on simple versus radical, the alternatives, approaches, sex life, recovery and cost.

  • What is the difference between a simple and a radical prostatectomy?

    A simple prostatectomy removes only the enlarged inner part of the prostate to relieve urinary obstruction from benign enlargement - the outer capsule and, importantly, most of the gland stay in place. A radical prostatectomy removes the entire prostate and the seminal vesicles to treat cancer, and the bladder is rejoined to the urethra. They share a name but are different operations with different aims, risks and recoveries.

  • Do I really need my prostate removed, or is there a less invasive option?

    It depends on the diagnosis. For benign enlargement, less invasive treatments such as endoscopic enucleation, GreenLight laser or a prostatic urethral lift often relieve symptoms without removing the whole gland - simple prostatectomy is reserved for very large glands or complicating factors. For localised cancer, radical prostatectomy is one of several curative options alongside radiotherapy, focal therapy and active surveillance. We lay out the alternatives honestly before recommending surgery.

  • Which surgical approach is best - open, laparoscopic or robotic?

    No single approach is best for everyone. Robotic surgery offers low blood loss and a short stay and is now the most common route for radical surgery; open surgery gives direct tactile access useful for very large glands or complex cases; laparoscopic sits between the two. Cancer and symptom outcomes are broadly comparable in expert hands, so the surgeon’s experience with the specific operation matters more than the tool.

  • Will a prostatectomy affect my sex life and fertility?

    Very likely, though how depends on the operation. Simple prostatectomy and endoscopic enucleation commonly cause retrograde ejaculation, where semen passes into the bladder - this affects fertility but not sensation. Radical cancer surgery ends ejaculation permanently and carries a real risk of erectile dysfunction, which is why nerve-sparing and rehabilitation are planned in advance. Sperm banking beforehand is an option where children may be wanted.

  • How long does recovery take?

    This varies by procedure. Endoscopic and robotic operations often mean a single overnight stay, a catheter for a few days to two weeks, and a return to desk work within a couple of weeks. Open surgery means a 2–4 night stay and a longer recovery of 4–6 weeks. Heavy lifting is avoided for around six weeks while the internal healing completes.

  • How much does a prostatectomy cost privately in the UK, and does the NHS offer it?

    Privately, benign endoscopic enucleation runs roughly £6,000–£11,000, simple prostatectomy £9,000–£16,000 depending on approach, and radical cancer surgery £13,000–£22,000 depending on open or robotic, plus any staging scans. The NHS provides all of these free of charge for suitable patients; the private route mainly offers choice of surgeon and timing.

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