[1] A radical prostatectomy, the removal of the entire prostate gland, the seminal vesicles and the vas deferens, is performed for cancer.

For intermediate and high risk prostate cancers, radical prostatectomy is often recommended in addition to other treatment options.

Radical prostatectomy is not recommended in the setting of known metastases when the cancer has spread through the prostate, to the lymph nodes or other parts of the body.

When performed by a surgeon who is specifically trained and well experienced in computer-assisted laparoscopy (CALP), there can be similar advantages over open prostatectomy, including smaller incisions, less pain, less bleeding, less risk of infection, faster healing time, and shorter hospital stay.

However, the experience and the skill of the nerve-sparing surgeon are critical determinants of the likelihood of positive erectile function of the patient.

[16][better source needed] Following a prostatectomy, patients will not be able to ejaculate semen due to the nature of the procedure, resulting in the permanent necessity of assisted reproductive techniques in case of desires of future fertility.

Prostatectomy patients have an increased risk of leaking small amounts of urine immediately after surgery, and for the long-term, often requiring urinary incontinence devices such as condom catheters or diaper pads.

Factors associated with increased risk of long-term urinary incontinence include older age, higher BMI, more comorbidities, larger prostates surgically excised, as well as experience and technique of the surgeon.

[21][22] In a retrospective study the success rate of perineal sling placement in urinary incontinence following prostatectomy achieved 86% at a median follow-up of 22 months.

[26] Remedies to the problem of post-operative sexual dysfunction include:[27] The use of radical prostatectomy as treatment for prostate cancer increased significantly from 1980 to 1990.

[28] Though a very common procedure, the experience level of the surgeon performing the operation is important in determining the outcomes, rate of complications, and side effects.

[30] William Belfield, MD is generally credited for performing the first intentional prostatectomy via the suprapubic route in 1885, 1886 or 1887 at Cook County Hospital in Chicago.

[34] American urologist Patrick C. Walsh, MD (1938—present) developed the modern nerve-sparing, retropubic prostatectomy with minimal blood loss.