Side effects of a radical prostatectomy

Possible side effects of a radical prostatectomy include erectile dysfunction, infertility and bladder problems. You may be able to have nerve-sparing surgery, which reduces your risk of developing some of these side effects.

Erectile dysfunction (ED) is when you have problems getting or keeping an erection. This can be caused by damage to the nerves during your operation. You can ask your surgeon to give you an idea of your likely risk of ED before your surgery. Some men find that their ability to have an erection gradually returns.

Infertility happens because removing the prostate gland makes it impossible for men to ejaculate. This means your sperm can’t get out of your body. If you want to have children after your surgery you may be able to store your sperm before the operation.

A problem controlling your bladder (urinary incontinence) is a less common side effect. Most men have some incontinence straight after their operation but this usually goes away with time. Talk to your doctor or nurse if you have ongoing incontinence as they can give you advice.

Side effects of radical prostatectomy

Problems getting an erection

Surgery to the prostate can cause problems getting or keeping an erection (erectile dysfunction – ED). This is caused by damage to the nerves. Nerve-sparing techniques have reduced the risk of these problems, but often the need to remove all of the cancer cells makes it impossible to avoid nerve damage.

Lots of studies have looked at how many men might have problems getting an erection following a nerve-sparing radical prostatectomy. The numbers tend to vary as it depends on different factors, such as:

  • whether or not you had erection problems before treatment
  • your age
  • whether the surgeon was able to spare some or all of the nerves.

You can ask your surgeon to give you an idea of your likely risk of ED.

Some men who have surgery on its own may find that their ability to have an erection gradually returns. It may take as long as a year or two for this to happen. It’s less likely to return in men who have treatment after surgery, such as hormonal therapy or radiotherapy. There are various ways to cope with erection problems.

Coping with sexual difficulties

Brian talks about the impact of prostate cancer and impotence on his sex life. He explains how his relationship with Elizabeth remained strong.

About our cancer information videos

Coping with sexual difficulties

Brian talks about the impact of prostate cancer and impotence on his sex life. He explains how his relationship with Elizabeth remained strong.

About our cancer information videos


Infertility

The prostate gland produces semen, which is normally mixed with sperm from the testicles. Removing the prostate gland makes it impossible for men to ejaculate. Although there is still sperm, it can’t get out of the body. This causes infertility. If you want children after your treatment, it may be possible to store sperm before your surgery.

It’s still possible for men who have had their prostate gland removed to have an orgasm, but there will be no ejaculation. This is known as a dry ejaculation. A dry ejaculation may cause some discomfort at first but this usually improves with time.


Problems controlling your bladder (urinary incontinence)

This is a less common side effect. Most men have some incontinence when their catheter is first removed. This usually improves with time and pelvic floor exercises. A small number of men may have some ongoing incontinence which may be worse on bending, coughing, sneezing or during exercise. It’s very rare to be completely incontinent.

Talk to your doctor or nurse if you have ongoing incontinence. They can refer you to a continence team who can give you advice about coping with this problem.

Another less common effect of surgery is scarring of the bladder or urethra. The urethra is the tube that runs from the bladder to the tip of the penis. It takes urine away from the bladder. Scar tissue can make passing urine difficult. It can be treated with minor surgery.

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TURP surgery

A transurethral resection of the prostate (TURP) is an operation to remove part of the prostate gland and make passing urine easier.