Life After Prostatectomy: Side Effects of Prostate Removal

A radical prostatectomy is a surgery used to treat prostate cancer. It removes the prostate, seminal vesicles and their connecting sperm ducts (also known as the vas deferens). If you are considering this as a treatment, you may wonder — what is life like after prostate removal? What are the side effects of prostate removal?

Here, we summarize the most important things you need to know about prostatectomy side effects and recovery. Before deciding on your treatment, you and your doctor should discuss the short-term and long-term changes that come with each treatment option.

Some short-term prostate removal side effects and changes may include:

• Post-surgical pain or swelling

Pain around your incision, abdomen or genitals may be likely to occur. Pain medication can help mitigate this while you recover. The pain or swelling will likely subside a few weeks after your surgery.

• Constipation or painful flatulence

You may face issues with passing stools, or difficulty passing gas from your body. For constipation, a stool softener, laxative or high fiber food may help your bowel movements return to normal. For issues with passing gas, walking may help ease flatulence, while a hot water bag may help relieve pain.

• Temporary drain placement at your surgical wound

After your surgery, your surgeon may decide to place a tube to help drain the wound. This device will help to drain blood and other fluids from the wound, to prevent infection and speed up wound healing. If kept after discharge, you will need to drain it regularly until its removal.

• Temporary catheter placement

After your surgery, you will likely have a catheter temporarily placed. This will allow you to urinate comfortably without interfering with your incision site. The tube will pass through your urethra, exit through your penis, and drain your urine into a bag attached to your leg.

Most likely, you will need a catheter for at least 7 to 10 days. As you recover from your surgery, you will need to take care of your catheter. It may cause sporadic pelvic pain, or more frequent urges to urinate. However, these side effects are temporary, and will subside after the removal of your catheter.

In the long-term, while there are chances of recovery, some permanent side effects of prostate removal are possible. Some possible changes include:

• No longer being able to ejaculate after prostatectomy

The prostatectomy surgery will remove organs that are critical in producing semen. In the future, be prepared to rely on assistive reproductive procedures to have a child that is biologically yours. You may wish to make use of sperm banking beforehand to ensure that you have access to your sperm in the future.

• Erectile dysfunction after prostatectomy

One of the most common prostatectomy side effects, erectile dysfunction refers to difficulty in having and maintaining an erection. Unfortunately, prostate removal may interfere with your time in the bedroom.

Your surgeon may be able to preserve some of the nerves responsible for erectile function. This procedure is known as a nerve-sparing radical prostatectomy. Approximately 60% of cases will be able to recover their erectile function back to pre-surgery levels.

However, you may still need to rely on a supportive drug to improve blood circulation to your penis. Note that even if you do not see signs of recovery early on, a late recovery is still possible.

Various strategies are available for erectile dysfunction recovery and could help you lead life as per normal. These include:

• Oral medications or injections

Some drugs can help relax the penis' blood vessels and improve blood flow, making maintaining erections easier.

• Vacuum erection devices

To help maintain erections, these devices can mechanically enhance blood flow, by sucking blood to the penis.

• Surgical implants

These are devices surgically implanted into the penis to help provide on-demand erections.

• Incontinence

Incontinence after prostatectomy may be one of the most frustrating prostatectomy side effects. Incontinence refers to the inability to control your urination effectively as the required muscles become too weak.

You may need to go to the toilet more frequently, or rely on absorbent padding to prevent urine leaks. Similar issues also include the involuntary loss of urine during orgasm or arousal.

In a recent study, up to 70% of patients no longer needed to use absorbent pads a year after surgery. Beyond that, further recovery is also still possible as time passes.

Rest assured, solutions have been studied over the years to help with incontinence recovery. Pelvic floor muscle exercises are usually the first strategy recommended to strengthen the muscles which control urination. After that, drug treatments may be considered, followed by surgical intervention as a last resort.

Following a successful prostatectomy, the possibility of recurrence would be around 1 in 5 after five years. Regular prostate-specific antigen testing can help catch cases of recurrence easily. After that, your doctor can still treat recurrence with additional chemotherapy, hormonal therapy or radiotherapy as necessary.

As you consider various treatment options, it should be noted that prostatectomy side effects include relatively higher reports of incontinence and erectile dysfunction. However, declines in urinary and sexual function are still common across all treatments.

While the procedure will bring some drastic changes to your life, it is a one-time procedure that can save you the stress of undergoing a longer series of radiotherapy or chemotherapy sessions.