Life After Prostatectomy: Side Effects of Prostate Removal

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

Here, we summarize the most important things you need to know when it comes to prostatectomy recovery. Before deciding on your treatment, you and your doctor should be able to discuss the short-term and long-term changes that come with each possible option.

After prostate removal, besides post-surgery pain, some short-term changes may include:

• Temporary drain placement at your surgical wound

Used depending on your surgeon’s preference, this device will help to drain blood and other fluids from your wound after your surgery to help prevent infection and speed up wound healing. If kept after discharge, you will need to drain it regularly until its removal.

• Temporary catheter placement

The catheter will aid your urination post surgery, and will need to be well cared for. It will likely be left for 7 to 10 days as you recover from your surgery. The tube will pass through your urethra, exit through your penis, and drain your urine into a bag attached to your leg.

In the long-term, some possible important changes after prostate removal include:

• No longer being able to ejaculate

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

• Erectile dysfunction

Referring to difficulty in having and maintaining an erection, erectile dysfunction after prostatectomy is one of the most common prostatectomy side effects. Unfortunately, this may interfere with your time in the bedroom.

Notably, your surgeon may be able to preserve the nerves responsible for erectile function (also 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. Reassuringly, even if you do not see signs of recovery early on, a late recovery is still possible.

Various strategies are available to mitigate this issue and could help you lead life as per normal. This includes oral medications or injection into the penis of drugs which relax the penis' blood vessels to improve blood flow, vacuum erection devices which suck more blood to the penis and implants which help to provide on-demand erections.

Learn more: Sex after Prostate Cancer

• 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. Recently, it was found that a year after surgery, up to 70% of patients no longer needed to rely on an absorbent pad day-to-day. Beyond that, further recovery is also still possible as time passes.

Rest assured, solutions have been developed over the years to help address this issue. Pelvic floor muscle exercises are usually the first strategy recommended to strengthen the muscles which control urination, followed by drug treatments and surgical intervention, as a last resort.

Following a successful prostatectomy, the possibility of recurrence would be around 1 in 5 after five years. If recurrence does occur, it can be spotted by regular prostate-specific antigen testing, and then treated with additional chemotherapy, hormonal therapy or radiotherapy as necessary.

As you consider various treatment options, it should be noted that prostatectomy is associated with 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.