Is prostate surgery painful?

During the procedure you will feel nothing thanks to anaesthesia. Afterwards, burning when urinating and bladder urgency are normal for some time — actual wound pain is minimal with the procedure through the urethra.

How long will I need a bladder catheter?

Usually only one to three days, until the urine is clear. The catheter is removed while you are still in hospital, and you will only go home once urination is functioning again.

Does the surgery have consequences for sexuality?

Erectile function is usually preserved with the common procedures. Very often, however, ejaculation afterwards enters the bladder rather than being expelled — this is harmless, but important to know if you wish to have children. Discuss this topic openly before the procedure.

Will I become incontinent after the surgery?

Persistent incontinence is rare with surgery for benign enlargement. Temporary strong urinary urgency in the first few weeks, on the other hand, is normal and will subside; targeted pelvic floor training can additionally support control.

Does the surgery protect against prostate cancer?

No. What is removed is the inner, benignly enlarged part of the gland; the outer portions remain. The usual screening considerations with your doctor therefore continue to apply — but the removed tissue is always examined in the laboratory as well.

When will I be fit for work again?

For office work, often after one to two weeks; for physical work, after three to four weeks. You should avoid heavy lifting and cycling for four to six weeks — your urologist will adapt the recommendation to your progress.

Prostate Surgery — Procedure, Preparation & Cost

When a benign enlarged prostate obstructs urinary flow so severely that medication is no longer sufficient, surgery can clear the way again: excess prostate tissue is removed — usually through the urethra, without an external incision. This is distinct from surgery for prostate cancer, which follows a different approach; here we are discussing the common procedure for benign enlargement.

Typical Areas of Use

Weakened urinary stream and sensation of incomplete emptying
Frequent urge to urinate, especially at night
Recurrent bladder infections or bladder stones due to residual urine
Urinary retention — the bladder can no longer be emptied
Symptoms despite exhausted medical treatment

How It Works

1Beforehand, your urologist will use urinary flow measurement, ultrasound and blood tests to clarify whether and which surgery makes sense; alternatives and newer procedures will also be discussed.
2The classic procedure is performed under spinal or general anaesthesia through the urethra: using a fine optical instrument, the constricting tissue is removed from the inside — depending on the clinic, with an electric loop or laser.
3For very large prostates, a different access route may be chosen; which method is suitable depends on size, comorbidities and your priorities.
4After the procedure, a bladder catheter flushes the bladder for one to three days until the urine is clear.
5You will usually stay in hospital for two to four nights; the removed tissue is examined in the laboratory.

How to Prepare

Discuss blood-thinning medication in good time with your urologist and GP — it often needs to be paused.
A urinary tract infection will be treated before surgery; report burning or fever before the appointment.
Arrive fasting according to the instructions from the anaesthesia team.
Plan for two to four nights' hospital stay and a quieter period afterwards.

Side Effects & Risks

Blood in the urine and frequent, burning urge to urinate in the first days to weeks — this is part of normal healing.
With most procedures, ejaculation permanently enters the bladder afterwards (dry orgasm) — usually without consequences for sensation, but important if you wish to have children.
Rarely urinary tract infections, post-operative bleeding or temporary renewed need for a catheter.
Rarely persistent incontinence; erectile function is usually preserved with the common procedures.
Over the years, tissue can regrow and rarely a repeat procedure may be necessary.

Afterwards — and When to Seek Help

Drink plenty of fluids in the first few weeks so that the bladder is well flushed, and avoid heavy lifting, cycling, straining during bowel movements and longer journeys for about four to six weeks. Slightly bloody urine, occasional burning and frequent urges are normal during the healing phase and will improve steadily. Contact your doctor promptly if the urine becomes heavily bloody or contains clots, if fever or chills occur, or if urination suddenly becomes impossible — the latter is an emergency. At the follow-up appointment, your urologist will also discuss the laboratory results of the removed tissue with you.

Cost & Insurance

Surgery for benign prostate enlargement is, when medically indicated, covered by basic insurance, including hospital stay in the general ward; the deductible and co-payment apply as usual. Referral is made by your GP to the urologist. For certain newer procedures, it is worth enquiring in advance with your insurance company about coverage — without guarantee.

Frequently Asked Questions

Is prostate surgery painful?: During the procedure you will feel nothing thanks to anaesthesia. Afterwards, burning when urinating and bladder urgency are normal for some time — actual wound pain is minimal with the procedure through the urethra.
How long will I need a bladder catheter?: Usually only one to three days, until the urine is clear. The catheter is removed while you are still in hospital, and you will only go home once urination is functioning again.
Does the surgery have consequences for sexuality?: Erectile function is usually preserved with the common procedures. Very often, however, ejaculation afterwards enters the bladder rather than being expelled — this is harmless, but important to know if you wish to have children. Discuss this topic openly before the procedure.
Will I become incontinent after the surgery?: Persistent incontinence is rare with surgery for benign enlargement. Temporary strong urinary urgency in the first few weeks, on the other hand, is normal and will subside; targeted pelvic floor training can additionally support control.
Does the surgery protect against prostate cancer?: No. What is removed is the inner, benignly enlarged part of the gland; the outer portions remain. The usual screening considerations with your doctor therefore continue to apply — but the removed tissue is always examined in the laboratory as well.
When will I be fit for work again?: For office work, often after one to two weeks; for physical work, after three to four weeks. You should avoid heavy lifting and cycling for four to six weeks — your urologist will adapt the recommendation to your progress.