Radical prostatectomy is a surgical procedure that treats prostate cancer and involves removing the prostate gland and surrounding tissues. Those who undergo this procedure might experience certain side effects afterwards. Two of the main radical prostatectomy side effects are impotence and urinary incontinence. In addition, bowel incontinence, damage to the rectum and urethral stricture are radical prostatectomy side effects as well. In some cases, it might be possible to undergo a certain type of radical prostatectomy procedure that might spare impotence from becoming a side effect.
Impotence, or erection problems, is one of the two main radical prostatectomy side effects. The nerves responsible for erections are within close proximity to the prostate gland, and during radical prostatectomy, these nerves can become damaged or might even be removed alongside the prostate gland. While some men might be able to regain the ability to have an erection, there is always the possibility of little or no recovery. For those who regain the ability, it can take between three months and a year, depending on age, the amount of damage done to the nerves and the ability to have an erection prior to the procedure. For others, some medications, such as sildenafil, might help with impotence.
Urinary incontinence, or difficulty controlling urination, is another one of the two main radical prostatectomy side effects. The urethra connects to the bladder and is located through the center of the prostate gland. During the procedure, the surgeon cuts the urethra then reconnects it later. The better the reconnection, the lower the chances are of developing urinary incontinence. Urinary incontinence pads are one way in which to deal with this side effect, but if the problem persists for longer than a year, then affected persons might need to seek treatment.
In general, there are two different types of radical prostatectomy procedures: open surgery and laparoscopic surgery. Open procedures include radical retropubic prostatectomy and radical perineal prostatectomy, and involve making a large incision. Laparoscopic procedures involve making several smaller incisions, and are done by hand but can also be done with the aid of a robotic system. Sometimes, it is possible to perform a nerve-sparing operation in which the surgeon spares the nerves that are responsible for an erection. This procedure is actually an adapted version of radical retropubic prostatectomy and the surgeon uses the same procedure but does not remove nerves that do not appear to be cancerous.