Can the Prostate Regrow After Surgery?
The prostate does not regrow after radical prostatectomy because the entire gland is removed, but residual prostatic tissue can persist and cause symptoms after transurethral resection of the prostate (TURP) or simple prostatectomy, sometimes requiring repeat procedures. 1
After Radical Prostatectomy
The prostate cannot regrow following radical prostatectomy because the procedure involves complete removal of the entire prostate gland along with the attached seminal vesicles. 1 This is fundamentally different from partial removal procedures.
- Radical prostatectomy removes all prostatic tissue, making regrowth anatomically impossible 1
- After the prostate is removed, the bladder is directly reconnected to the urethra 1
- Any PSA elevation after radical prostatectomy indicates either residual microscopic disease, local recurrence at the surgical site, or distant metastases—not prostate regrowth 2
Important Clinical Distinction
- Biochemical recurrence (rising PSA) after radical prostatectomy can occur from cancer cells left behind at the surgical margins or from metastatic disease, but this is not the prostate "growing back" 1, 2
- Approximately one-third of patients experience PSA recurrence within a decade, which represents cancer recurrence rather than benign prostatic regrowth 1
After TURP or Simple Prostatectomy
While the evidence provided focuses primarily on radical prostatectomy, the clinical reality is that after partial removal procedures like TURP or simple prostatectomy, residual prostatic tissue remains and can continue to grow, potentially causing recurrent obstructive symptoms.
- TURP removes only the obstructing central portion of the prostate, leaving the peripheral zone intact 3
- Prior TURP increases technical complexity and morbidity if subsequent radical prostatectomy becomes necessary for cancer 3
- Patients who undergo radical prostatectomy after previous TURP have longer operative times and moderately increased postoperative complications 3
Functional Outcomes After Repeat Surgery
Men requiring radical prostatectomy after previous prostate surgery for benign disease experience worse functional outcomes than those undergoing primary radical prostatectomy. 3
- Complete urinary continence at 12 months occurs in only 86% of patients after radical prostatectomy following prior TURP, compared to 84-88% after primary surgery 3
- Adequate erectile function is reported by only 12% of men after radical prostatectomy following previous prostate surgery 3
- Prior TURP increases the risk of urinary incontinence after subsequent radical prostatectomy 4
Key Clinical Pitfall
Do not confuse PSA recurrence after radical prostatectomy with prostatic regrowth—rising PSA indicates cancer recurrence, not benign tissue regeneration. 2 This distinction is critical for appropriate management, as these patients require oncologic evaluation and treatment (salvage radiotherapy, hormone therapy) rather than repeat resection for benign disease. 1