Side Effects of Prostate Cancer Surgery

If you have prostate cancer and surgery is an option, several factors may help you decide if it is right for you. On the plus side, if cancer is limited to the prostate gland, chances are high (more than 90 percent) that the cancer will be cured with surgery.

Any type of surgery involves risks, such as blood loss, infection or problems with anesthesia. But prostate cancer surgery may cause some other unwelcome side effects.

Check your surgical options
You may be able to choose between several types of surgery, depending on the extent and location of your prostate cancer. It's important to discuss these factors with your doctor, as they can have an impact on your decision.

Surgery is often an option if the cancer has not spread outside of the prostate. The surgeon removes the prostate gland and the tissue around it.

• Radical prostatectomy. In this procedure, doctors remove the prostate gland and surrounding tissue as well as the seminal vesicles (glands that help in the production of sperm). This surgery can be done through an incision in the lower abdomen or one between the scrotum and anus. A nerve-sparing technique may be used with either approach to help preserve the nerves involved in erections. This is easier to do with the abdominal incision. Nerve sparing techniques can only be tried if the cancer has not spread to those nerves. Even with this technique, impotence may still occur.
• Laparoscopic prostatectomy. This is a newer surgical technique that is less invasive. Only small cuts are made in the abdomen. Through these smaller cuts, a lighted telescope, called a laparoscope and small surgical tools including a camera are inserted. The surgeon views the inside of the abdomen and performs the surgery, sometimes with the aid of a robotic system. This type of surgery can also be nerve sparing, but is relatively new and requires a specially trained surgeon.

Possible side effects of prostate cancer surgery
You may have already heard about the two main side effects that are possible from prostate cancer surgery: impotence and incontinence. It may make you feel uneasy about having surgery. But before you make any decisions, get all the facts. You may be reassured by what you find out.

• Impotence (also known as erectile dysfunction or ED) is the inability to achieve an erection. The two nerves that help to make an erection run alongside the prostate gland. During surgery, there is a risk that these nerves may be damaged or removed. This can cause impotence.

If impotence does occur after prostate surgery, it may only be temporary. Nerves take some time to recover. If at least one of the nerves remains intact, it may be possible to have erections again. This may take anywhere from four months to several years. Also, the erections may not be as strong or long-lasting as they were before surgery.

The younger you are when you have surgery, the better your chances for regaining full erectile function. But if you had problems with erections before surgery, you will most likely still have them after surgery.

Even if surgery results in impotence, you will still have feeling in your penis and the ability to have an orgasm. (But, it will likely be a dry orgasm with little or no semen coming out.) There are many devices and medications available today that can help to restore erectile function in many men.

• Urinary incontinence is loss of bladder control that may lead to:
• Involuntarily leaking urine (stress incontinence)
• Having trouble with urination, such as getting flow to start, and dribbling (overflow incontinence), or
• Having a sudden need to urinate (urge incontinence)

Incontinence is common after prostate surgery, but most often it's only temporary. It should last a few weeks or months. Yet, about a third of men may continue to have some stress incontinence, leaking a small amount of urine when they cough, sneeze, laugh or exercise.

There are various methods to help correct incontinence problems. These include surgery, medication and exercises (called Kegel exercises) to strengthen the bladder muscles.

Let the members of your medical team know any concerns you have about side effects from prostate cancer surgery. Ask what you can do to avoid them and what your options may be to relieve any side effects.

Related Articles Prostate Cancer Treatments Impotence Incontinence

External Sources American Urological Association. Surgical management of prostate cancer. Accessed October 18, 2007. Kutikov A, Guzzo TJ, Malkowicz SB. Clinical approach to the prostate: an update. Radiology Clinics of North America. 2006;44:649-663 National Cancer Institute. Prostate cancer treatment. Accessed October 18, 2007. National Comprehensive Cancer Network. Types or treatments for prostate cancer. Accessed October 25, 2007.

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