Although your hospital stay may be short, prostate cancer surgery is major surgery.
The result of your surgery depends on your age and overall health and whether the cancer can be completely removed by the surgery.
Surgery for prostate cancer is normally a good option if you’re medically fit, you expect to live for 10 years or more, you haven’t already received radiotherapy, and if the cancer is likely to progress and threaten your health.
If all the cancer can be removed, it can give you immediate peace of mind.
As with any medical procedure, there are possible side effects associated with prostate cancer surgery. The chance of side effects and complications depends on a number of things, including your general health.
Common conditions that may affect your outcome include diabetes and obesity. Smokers are also at a higher risk of complications following surgery. You won’t be able to smoke during your hospital stay so this could be a good opportunity to quit.
There’s a risk of erectile dysfunction caused by injury to the nerves during surgery. If this happens, your surgeon will tell you. In some cases, if your prostate cancer is advanced, the nerves cannot be preserved, as the surgeon will want to ensure all the cancer is removed. After the surgery, your surgeon may prescribe medications to improve your sexual functioning. Vacuum devices and implants are also available to help with erection problems. Some studies show that 70% of men with no erection problems before surgery, who have nerve-sparing surgery without other therapy, can get back adequate sexual function.
This is when you don’t produce semen after surgery for prostate cancer.
Your prostate is located close to your urethral sphincter and some or all of it may be removed during the procedure, which can lead to urinary incontinence. A short period of incontinence is normal after the surgery, but it’s permanent in 7% to 17% of men. It can take 6 to 12 months for your normal bladder control to return.
You’ll have a urinary catheter for the first 7 to 14 days after surgery. You may go home from hospital with the catheter still in place with a plan to have it removed in a week or 2.
Narrowing of your bladder neck
This can happen some time after surgery if scar tissue forms around the neck of your bladder causing urgency, dribbling and urinary retention. Narrowing of the bladder neck occurs in 1% to 10% of men after radical prostate surgery but is much less likely after a robotic procedure.
The risk of infection is very low and your surgeon will give you antibiotics during and after your surgery. Infection of your wound, urinary tract infection or pneumonia can occur.
Blood loss and transfusions
Some blood loss during your surgery is expected and it’s possible you may need a blood transfusion.
You may experience constipation after surgery. This can be due to the effect of the surgery on your bowel, the side effects of opioid painkillers, a change in your usual diet or a reduction in your usual activity levels.
Deep vein thrombosis/pulmonary embolism
After surgery, blood clots may develop in the veins of your calf. These clots can travel to your lungs and cause a pulmonary embolism, which may be fatal in rare cases. In order to prevent this, your surgeon may prescribe some injections after the surgery. You may be given compression stockings and/or a machine that compresses your calves. If you smoke or are obese, the risk of blood clots is increased.
Decrease in penis size
This can affect both the length and thickness of your penis and is noticeable when your penis is both soft and hard. One in 5 men notice a reduction in penis size following removal of his prostate.
If your lymph nodes are removed, collections of fluid can form in the pelvis and abdomen. This may need to be drained.
With removal of the lymph nodes comes a risk of lymphoedema, which is swelling of a leg or legs.
There’s a risk of injury to your bowel during surgery because it’s close to your prostate. If this happens it is usually corrected during the surgery.
This is a type of hernia that can occur following open surgery. It may require further surgery.