12 Questions to Ask Your Urologist Before Prostate Surgery

Most men leave their pre-surgical consultation with a good understanding of the cancer and a poor understanding of what happens to the rest of their life afterward. That’s not a criticism of urologists — the appointment is short, the priority is correctly the cancer, and most men are too overwhelmed to think of questions in the room.

I had that appointment myself. I asked almost none of these. This is the list I wish someone had handed me.

Print it, or put it in your phone, and take it with you.

About the cancer and the procedure

1. What is my Gleason score and stage, and what does that mean for my treatment options?

You should leave knowing your numbers and what they indicate. Ask for them in writing.

2. Is surgery clearly the best option for me, or is it one of several reasonable choices?

For some men, radiation, active surveillance, or other approaches are genuinely comparable. For others, surgery is clearly indicated. Knowing which situation you’re in changes how you think about everything else.

3. How many of these procedures do you perform each year?

Surgical volume correlates with outcomes across many procedures. This is a fair question and a good surgeon will not be offended by it.

4. Am I a candidate for nerve-sparing surgery, and on one side or both?

The neurovascular bundles that control erections run within millimeters of the prostate. Whether they can be spared — and how completely — is among the strongest predictors of erectile recovery. Ask directly, and ask what would cause you to change that plan during the operation.

About erectile function

5. Based on my situation specifically, what is a realistic expectation for erectile recovery?

Not the general statistic. Yours, given your age, your current function, and your nerve-sparing plan. Push gently for a real answer.

6. What is your recommended plan for erectile rehabilitation after surgery?

This is the question that most changes what happens to you afterward.

More than 80% of men experience erectile dysfunction after prostate cancer treatment, and a great many of them are never given a structured plan for it. Some urologists have detailed protocols. Others prescribe a medication and leave it there. Some will refer you to a specialist. You want to know which kind of practice you’re in before surgery, not four months after.

7. Should I start anything before surgery?

Beginning rehabilitation before the operation — prehabilitation — means going into surgery with well-conditioned tissue, and learning to use any device while you feel well rather than during catheter recovery. Ask what your surgeon thinks. Even if they don’t have a formal program, most are supportive once asked.

8. Will this affect penile length or size?

Many men experience some change in length and girth after prostatectomy, and most are not warned about it. It is far easier to hear this before it happens. Ask what causes it and whether anything can be done to reduce it.

9. Is a vacuum erection device something you recommend, and when would I start?

Vacuum devices were a first-line therapy after prostate surgery before oral medications became common, and they remain recommended. A 2025 review summarizing the 5th International Consultation on Sexual Medicine advises clinicians to offer vacuum devices alone or combined with other therapies, including in difficult cases. Ask about timing relative to catheter removal.

About everything else

10. What should I expect regarding urinary control, and for how long?

Incontinence after prostatectomy is common early on and improves for most men over months. Ask about pelvic floor exercises and whether you should start before surgery.

11. What does the recovery timeline actually look like week by week?

Catheter duration, time off work, driving, lifting restrictions, exercise. Men consistently underestimate this.

12. Who do I call when I have a question at week six?

Possibly the most practical question on this list. Find out now whether you’ll have access to a person or to a voicemail system, and get a direct number if one exists.

Two things worth doing before the appointment

Bring someone. You will not remember everything said in that room. A second set of ears catches what you miss, and it’s easier for a partner to ask an awkward question than for you to.

Write your questions down. Not because you’ll forget them — because having a written list gives you permission to work through them rather than nodding along and leaving.

The question behind the questions

If I could get every man to ask only one thing, it would be number six.

Cancer treatment has a plan. There’s a surgery date, a pathology report, follow-up appointments, PSA monitoring. Everyone knows what happens next.

Erectile recovery usually has no plan. It has a prescription and a hope. Men leave the hospital assuming that function will return on its own with time, and for many men it doesn’t work that way — because recovery depends on tissue staying healthy during the months when the body has lost its own means of maintaining it.

Knowing that before surgery, rather than discovering it a year later, is the difference this list is trying to make.

Where CBH fits

Some urologists have a rehabilitation protocol and a team to support it. Many don’t, and refer patients elsewhere — including to us. Physicians at MD Anderson and UT Physicians refer their patients to me for penile rehabilitation support, and so do practices around the country.

If your urologist doesn’t have a structured plan, that isn’t a failure on their part. Prostate surgery is their specialty; at-home rehabilitation over the following year is a different job.

CBH provides the device, the routine built for your situation, video tutorials, and one-on-one coaching for the months afterward. I built it after my own prostate cancer treatment, because it’s what I needed and couldn’t find.

If you have a surgery date coming up, call or text me at 947.224.7342. Talking through what to expect costs nothing.

Frequently Asked Questions

What is the most important question to ask before prostate surgery? Ask what the plan is for erectile rehabilitation after surgery. Cancer treatment comes with a structured plan; erectile recovery frequently does not, and knowing that in advance lets you arrange support before you need it.

Should I start penile rehabilitation before surgery? Many men do. Beginning beforehand means entering surgery with well-conditioned tissue and knowing how to use the device already. Discuss timing with your urologist.

Will nerve-sparing surgery preserve my erections? Nerve-sparing improves the odds but does not guarantee recovery, since the neurovascular bundles sit within millimeters of the prostate and are affected even when spared.

How long does erectile recovery take after prostatectomy? It varies widely. The first four to eight months after surgery are generally considered the most important window for maintaining tissue health during recovery.

Should I bring my partner to the consultation? Yes. A second person remembers more of what was said, and questions about sexual function are often easier to raise with support in the room.