Prostate Cancer: Radical Prostatectomy
Risks of Radical Prostatectomy
Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.
Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:
- Urinary incontinence: More than 95% of men younger than 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
- Erectile dysfunction (ED): Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED (such as Viagra or Cialis), an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.
Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.
Other complications of radical prostatectomy include:
- Bleeding after the operation
- Urinary leaks
- Blood clots
- Poor wound healing
- Groin hernia
- Narrowing of the urethra, blocking urine flow
Less than 10% of men experience complications after prostatectomy, and these are usually treatable or short-term.
Success of Radical Prostatectomy
The goal of radical prostatectomy is to cure prostate cancer. However, prostate cancer cure is only possible from prostatectomy if prostate cancer is limited to the prostate.
During radical prostatectomy, the removed prostate is examined under a microscope to see if prostate cancer has reached the edge of the prostate. If so, the prostate cancer has probably spread. In these cases, further treatments may be needed.
Men with no evidence of prostate cancer spread have an 85% chance of surviving 10 years after radical prostatectomy.
What to Expect After Radical Prostatectomy
Most men stay in the hospital for one to three days after radical prostatectomy. A urinary catheter is inserted during the surgery, and some men may need to wear the catheter home for a few days to a few weeks. Another catheter inserted through the skin also may need to stay in place for a few days after returning home.
Pain after radical prostatectomy can generally be controlled with prescription pain medicines. It can take weeks or months for urinary and sexual function to return to their maximum levels.
After radical prostatectomy, regular follow-up is essential to make sure prostate cancer does not return.