In the United States, the most common treatment chosen for localized prostate cancer is surgery called a radical prostatectomy.

The operation completely removes the the entire prostate gland, along with both seminal vesicles, both ampullae (the enlarged lower sections of the vas deferens), and other surrounding tissues. The section of urethra that runs through the prostate is cut away (and with it some of the sphincter muscle that controls the flow of urine).

In a retropubic prostatectomy, the prostate is reached through an incision in the lower abdomen; in a perineal prostatectomy, the pproach is through the perineum, the space between the scrotum and the anus.

Either way, a radical prostatectomy is a complicated operation that typically requires general anesthesia and takes 2 to 4 hours. Patients stay in the hospital for about 3 days, and need to wear a tube to drain urine (catheter) for 10 days to 3 weeks.

Among the long-term problems often associated with a prostatectomy are urinary incontinence, stool incontinence, and sexual impotence.