If you’re preparing for robotic prostate surgery, you may be wondering what actually happens once your prostate is removed, including what fills the space afterwards and how you are still able to pass urine. These are common and understandable questions when you’re trying to picture how your body will work after surgery.
During a robotic radical prostatectomy, your prostate and usually your seminal vesicles are removed, while your bladder, penis and testes remain in place. Your surgeon reconnects your bladder to your remaining urethra, and the surrounding tissues heal around this new connection. These changes also explain why you temporarily need a catheter and why your urinary control, erections, ejaculation and PSA can be different after surgery.
Is the Whole Prostate Removed During Robotic Prostate Surgery?
Yes. During robotic radical prostatectomy, your surgeon removes the entire prostate rather than only the visible cancer. Your prostate does not grow back. You can still pass urine because your bladder and urethra remain, while your testes continue to produce testosterone.
Your surgeon aims to preserve nearby structures where it is safe to do so. After surgery, the main changes you may notice relate to urinary control, erections, ejaculation and your PSA level.
Where Is the Prostate Before Surgery?
Before surgery, your prostate sits below your bladder and in front of your rectum, with your urethra passing through it. It is also close to the nerves, blood vessels and urinary sphincter involved in sexual and bladder function.
During robotic surgery, your surgeon carefully separates and removes the prostate while preserving nearby structures where it is safe to do so. Your bladder and urethra are then reconnected so urine can continue to pass through your urinary tract after healing.
What Else Is Removed With the Prostate?
During robotic radical prostatectomy, your seminal vesicles are usually removed along with your prostate. The sperm-carrying pathways are also divided, which means natural conception through sexual intercourse is no longer possible after surgery.
Your surgeon may also remove nearby pelvic lymph nodes if your cancer risk makes this appropriate. Your bladder, testes and penis are not routinely removed during radical prostatectomy.
What Happens to the Prostate Once It Has Been Removed?
Once your prostate is removed, it is sent to a pathology laboratory where it is examined under a microscope. Your pathologist can assess the cancer’s grade, stage, spread beyond the prostate and whether cancer reaches the surgical margins.
Your seminal vesicles and any removed lymph nodes can also be examined. These results give your team a clearer picture of your cancer and help guide your follow-up treatment and PSA monitoring.
What Happens to Your Bladder When the Prostate Is Removed?
Your bladder stays in place after robotic prostate surgery. Once the prostate is removed, your surgeon reconnects the bladder directly to the remaining urethra.
- Bladder stays in place: Your bladder is not routinely removed during radical prostatectomy.
- New connection: The bladder neck is joined to the remaining urethra so urine can continue to pass normally.
- Temporary catheter: A catheter supports this new connection while it heals.
- No replacement prostate: You do not need an artificial prostate because your kidneys, bladder and urethra continue to work.
Once healing is complete, urine can pass through the reconstructed urinary pathway. Your urinary control may take time to recover as the surrounding muscles and tissues adapt.
How Is the Urethra Reconnected After Prostate Removal?
After your prostate is removed, your surgeon reconnects your bladder neck to the remaining urethra. This creates a secure connection that allows urine to pass from your bladder through your urethra once it has healed.
You will usually have a catheter while this new connection heals. Once it is removed, you can pass urine through the reconstructed pathway, which becomes a permanent part of your urinary anatomy.
What Happens to the Space Where the Prostate Used to Be?
You are not left with a permanent hollow space after your prostate is removed. Your bladder neck is connected to your remaining urethra, while the surrounding pelvic tissues heal around the reconstructed area.
You do not need an artificial prostate or replacement tissue after surgery. Instead, the new bladder-to-urethra connection heals within the pelvis and becomes the permanent route through which urine leaves your bladder.
What Changes After the Prostate Is Removed?
| Structure / Function | What Happens After Surgery? |
| Prostate | Completely and permanently removed |
| Seminal vesicles | Usually removed with the prostate |
| Bladder | Remains in place |
| Urethra | Reconnected directly to the bladder neck |
| Testes | Remain in place and continue producing testosterone |
| Penis | Remains in place |
| Pelvic tissues | Heal and settle around the reconstructed area |
| Empty space | No permanent hollow cavity is left; surrounding tissues heal around the reconstructed area |
Why Do You Need a Catheter After Surgery?
After your prostate is removed, you usually need a urinary catheter while your bladder and urethra heal together. The catheter drains urine and helps protect the new surgical connection while it heals.
Your catheter commonly stays in place for around 7 to 14 days, although the exact timing depends on your healing and your surgical team’s protocol. Once your surgeon is satisfied that the connection has healed sufficiently, the catheter is removed and you can pass urine through your reconstructed urinary tract.
Can the New Bladder-to-Urethra Connection Leak?
Yes, a small leak can occasionally occur while your new bladder-to-urethra connection is healing. If this happens, your catheter may need to stay in longer to give the area more time to heal.
Your surgical team may use an imaging test, such as a cystogram, if they are concerned about a leak. Follow your surgical team’s instructions about catheter care, and do not remove or adjust your catheter unless they have specifically told you how and when to do so.
Evidence Note
BAUS explains that a urinary catheter is used while the new connection between the bladder and urethra heals. Its patient information also recognises leakage from this new join as a possible complication that may require the catheter to remain in place for longer. This is why catheter removal should be guided by your surgical team rather than by a fixed number of days.
Can You Still Pass Urine Without a Prostate?
Yes. Your kidneys and bladder continue to function after your prostate is removed, and urine can still pass through the new bladder-to-urethra connection and out through your penis.
You may initially notice leakage, urgency or changes in urinary control while you heal. These changes usually relate to your urinary sphincter and pelvic floor adapting to the surgery, rather than an inability to urinate without a prostate.
Why Can Urinary Leakage Happen After the Prostate Is Removed?
Removing the prostate changes the support around your urethra and urinary sphincter, so your sphincter and pelvic floor muscles become particularly important for continence during recovery. Surgery can temporarily affect these structures, so leakage is common after your catheter is removed.
You may notice leakage when you cough, sneeze, stand, exercise or lift. Your control usually improves as you heal, although your recovery time can vary depending on your age, continence before surgery and other individual factors.
What Role Does the Pelvic Floor Have After Prostate Removal?
Your pelvic floor muscles help you control urine after your prostate is removed. Strengthening these muscles through pelvic floor exercises can support your continence recovery once your specialist says it is safe to begin.
You may be taught these exercises before surgery so you know how to do them afterwards. Your urinary control can improve gradually as your muscles and tissues adapt, so early leakage does not necessarily reflect your final recovery.
What Happens to Semen After the Prostate Is Removed?
After your prostate and seminal vesicles are removed, you will no longer ejaculate semen. You can still experience orgasm, but little or no fluid comes out of your penis, which is known as a dry orgasm.
Your testes remain in place and continue producing testosterone. The change in ejaculation is permanent because your prostate and seminal vesicles do not grow back.
Can You Still Have an Orgasm Without a Prostate?
Many men can still experience orgasm after robotic prostate surgery, even though semen is no longer ejaculated. You may notice that your orgasm feels different or takes longer to achieve as you recover.
A small amount of urine may sometimes leak during orgasm, known as climacturia. This can improve as your urinary control recovers, but your experience can vary from person to person.
Research Insight
Climacturia, meaning urine leakage during orgasm, is a recognised but often under-reported consequence of radical prostatectomy. A 2025 systematic review of 13 studies involving 5,208 patients identified climacturia in 1,417 men, giving an overall prevalence of 27.2%. Your individual experience may differ, but this shows why changes during orgasm are worth discussing as part of sexual recovery after surgery.
What Happens to Erections After the Prostate Is Removed?
After your prostate is removed, you may have difficulty getting or maintaining an erection because the nerves controlling erections run very close to the prostate. Your surgeon may preserve these nerves when it is safe, but temporary erectile problems are still common after surgery.
Erectile function may gradually improve over many months, depending on factors such as your age, erectile function before surgery and whether one or both nerve bundles could be preserved. Your doctor may also recommend treatments such as tablets, vacuum devices or injections to support your recovery.
Can You Still Father Children Naturally After Prostate Removal?
No. After radical prostatectomy, you cannot father a child naturally through sexual intercourse because your prostate and seminal vesicles are removed and the normal sperm pathway is interrupted. Your testes can still produce sperm, but you will no longer ejaculate semen.
If having biological children matters to you, discuss fertility before surgery. You may consider sperm banking beforehand, while specialist fertility treatments may offer other options in some circumstances.
UK Guidance Note
NICE advises that before radical treatment for prostate cancer, patients should be told about the potential effects on sexual function, ejaculation and fertility. NICE also recommends offering sperm storage before radical treatment. NICE also recommends access to specialist erectile dysfunction and continence services when these problems occur after treatment.
What Happens to PSA Once the Prostate Has Been Removed?
After your prostate is removed, your PSA should fall to a very low or undetectable level because the prostate gland has been removed. Your PSA is then used to monitor you for any signs of remaining or returning prostate cancer.
If your PSA stays undetectable, this is reassuring. If it remains detectable or rises later, your specialist will look at the trend alongside your pathology results to decide whether further investigation is needed.
What Happens If Lymph Nodes Are Removed Too?
If your surgeon removes nearby pelvic lymph nodes, a pathologist examines them for cancer cells. This can provide extra information about your cancer stage and help your team decide whether you may need further treatment.
Removing lymph nodes does not remove your entire lymphatic system. However, you may occasionally develop a lymphocele, which is a collection of lymphatic fluid in the pelvis.
Which Anatomical Changes After Surgery Are Permanent?
After robotic prostate surgery, your prostate and usually your seminal vesicles are permanently removed, and your bladder is permanently connected to your remaining urethra. You will also no longer ejaculate semen or be naturally fertile through intercourse.
Your PSA should usually remain very low or undetectable after radical prostatectomy and will continue to be monitored during follow-up. Urinary leakage and erectile difficulties, however, may improve over time as your muscles, tissues and nerves recover.
Myth vs Fact
| Myth | Fact |
| Removing the prostate leaves a permanent empty space inside your pelvis. | Your bladder is reconnected to your remaining urethra, and the surrounding tissues heal around the reconstructed area. You do not need an artificial prostate or replacement tissue. |
| You cannot pass urine once your prostate has been removed. | Your kidneys and bladder continue working, and urine passes through the reconstructed bladder-to-urethra pathway. Urinary control may take time to recover after surgery. |
| Your body stops producing testosterone after prostate removal. | Your testes remain in place and continue producing testosterone because the prostate is not the main source of this hormone. |
| Nerve-sparing surgery guarantees normal erections. | Preserving the erection nerves may improve the possibility of recovery, but erectile dysfunction can still occur and recovery varies between patients. |
| You can no longer have an orgasm after your prostate is removed. | Many men can still experience orgasm, but semen is no longer ejaculated after radical prostatectomy and the sensation may feel different. |
Key Takeaways
- Robotic radical prostatectomy removes the whole prostate and usually the seminal vesicles, while the bladder, penis and testes remain in place.
- Your surgeon reconnects the bladder to the remaining urethra so urine can continue to leave your body, although urinary control may take time to recover.
- Semen ejaculation and natural conception through sexual intercourse are permanently lost after radical prostatectomy, although many men can still experience orgasm.
- Erections may be affected because the erection nerves lie close to the prostate, and recovery varies depending on your individual circumstances and whether nerve-sparing surgery is possible.
- PSA should usually fall to a very low or undetectable level after prostate removal and is then monitored during follow-up.
Frequently Asked Questions
1. Is the Whole Prostate Removed During Robotic Prostate Surgery?
Yes. During robotic radical prostatectomy, your surgeon removes the entire prostate rather than only the visible cancer. Your prostate does not grow back. You can still pass urine through the reconstructed urinary tract, while your testes remain in place and continue to produce testosterone.
2. What Happens to Your Bladder After Prostate Removal?
Your bladder remains in place after robotic prostate surgery. Your surgeon reconnects your bladder directly to your remaining urethra, allowing urine to pass through the reconstructed urinary tract once the new connection has healed.
3. What Happens to the Space Where Your Prostate Was?
You are not left with a permanent hollow space after your prostate is removed. Your bladder neck is connected to your remaining urethra, while the surrounding pelvic tissues heal and settle around the reconstructed area.
4. Why Do You Need a Catheter After Robotic Prostate Surgery?
You usually need a urinary catheter while your bladder and urethra heal together. The catheter drains urine and helps protect the new connection during the early stages of recovery.
5. Can You Still Pass Urine Without a Prostate?
Yes. Your kidneys and bladder continue to function, and your surgeon reconnects your bladder to your remaining urethra. You may initially experience urinary leakage or changes in bladder control while your muscles and tissues recover.
6. What Happens to Semen After Your Prostate Is Removed?
You will no longer ejaculate semen because your prostate and seminal vesicles are removed and the normal sperm pathway is interrupted. Many men can still experience an orgasm, but it will usually be a dry orgasm.
7. Can You Still Have Erections After Your Prostate Is Removed?
You may have difficulty getting or maintaining an erection after surgery because the nerves involved in erections run close to the prostate. If these nerves can safely be preserved, your erections may gradually improve over the following months or longer.
8. Can You Still Father Children Naturally After Prostate Removal?
No. After radical prostatectomy, you cannot father a child naturally through sexual intercourse because your prostate and seminal vesicles are removed and the normal sperm pathway is interrupted.
If having biological children is important to you, discuss fertility preservation, such as sperm banking, with your specialist before surgery.
9. What Happens to Your PSA After Robotic Prostate Surgery?
Your PSA should usually fall to a very low or undetectable level after robotic prostate surgery because the main source of PSA-producing tissue has been removed. Your doctor will then use regular PSA tests to monitor you for signs of remaining or returning prostate cancer.
10. Which Anatomical Changes After Surgery Are Permanent?
Your prostate and usually your seminal vesicles are permanently removed, and your bladder remains permanently connected to your remaining urethra. You will also permanently lose normal ejaculation and natural fertility through sexual intercourse.
Final Thoughts: Understanding the Changes After Robotic Prostate Surgery
After robotic prostate surgery, your prostate and usually your seminal vesicles are permanently removed, while your bladder is reconnected to your remaining urethra. You can continue to pass urine and experience orgasm, but you will no longer produce a normal ejaculation or be naturally fertile through sexual intercourse. Your urinary control and erections may also take time to recover, while regular PSA testing helps your specialist monitor you after treatment.
If you are considering robotic prostate surgery in London and would like specialist advice, you can contact our team at Prostate Clinic London to discuss your treatment options and arrange a consultation tailored to your individual needs.
References:
- National Institute for Health and Care Excellence (NICE) (2019, updated 2021) Prostate cancer: diagnosis and management. NICE guideline NG131. Available at: https://www.nice.org.uk/guidance/ng131
- NHS (2025) Treatment for prostate cancer. Last reviewed 31 July 2025. Available at: https://www.nhs.uk/conditions/prostate-cancer/treatment
- Macmillan Cancer Support (2025) Prostatectomy for prostate cancer. Reviewed 1 October 2025. Available at: https://www.macmillan.org.uk/cancer-information-and-support/treatments-and-drugs/prostatectomy-for-prostate-cancer
- Cancer Research UK (2025) Surgery to remove prostate cancer. Last reviewed 19 June 2025. Available at: https://www.cancerresearchuk.org/about-cancer/prostate-cancer/treatment/surgery/surgery-remove-your-prostate-gland
- Guy’s and St Thomas’ NHS Foundation Trust (2025) Prostate cancer surgery follow-up. Last reviewed June 2025. Available at: https://www.guysandstthomas.nhs.uk/health-information/prostate-cancer-surgery-follow-up
- British Association of Urological Surgeons (BAUS) (2024) Robotic-assisted radical prostatectomy (RARP). Available at: https://www.baus.org.uk/patients/information_leaflets/180/roboticassisted_laparoscopic_removal_of_prostate_for_cancer_rarp
- Ferrão, J.V., Becker, A.S., Konopka, G. et al. (2025) ‘The Prevalence of Climacturia in Patients after Radical Prostatectomy: A Systematic Review’, International Brazilian Journal of Urology, 51(1), e20240406. Available at: https://pubmed.ncbi.nlm.nih.gov/39556847/