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Radical Prostatectomy

Risks

Erection problems

Erection problems are one of the serious side effects of radical prostatectomy. The nerves that control a man's ability to have an erection lie next to the prostate gland. They often are damaged or removed during surgery. Sometimes these nerves can be spared during surgery to preserve erections.

About half of men are able to regain some of their ability to have erections.^{Reference 3} But this takes time. It can take as little as 3 months. But for most men, it will be 6 months to a year.^{Reference 4}

Recovery depends on:

Whether the man was able to have an erection before surgery.
How the surgery affected the nerves that control erections.
How old the man was at the time of surgery.

Medicines such as sildenafil (Viagra), tadalafil (Cialis), or vardenafil (Levitra) and mechanical aids may help men who are impotent because of treatment. Using medicines soon after surgery may help men regain sexual function. Talk with your doctor about your concerns.

Urinary incontinence

Up to half of all men who have a radical prostatectomy develop Reference urinary incontinence Opens New Window, ranging from a need to wear urinary incontinence pads to occasional dribbling.

The urethra—the tube that carries urine from your bladder—runs through the middle of the doughnut-shaped prostate gland. To remove the prostate, the surgeon must cut the urethra and later reconnect it to the bladder. Evidence shows that the greater the surgeon's experience and skill in making this reconnection, the lower the rate of incontinence.^{Reference 5}

If urinary leakage continues longer than 1 year, you may need treatment for incontinence after prostatectomy.

Complications

Radical prostatectomy is major surgery. So it carries the same general risks as other major operations, including heart problems, blood clots, allergic reaction to anesthesia, blood loss, and infection of the wound.

Also, these complications can be caused by radical prostatectomy:

Erection problems
Urinary incontinence
Damage to the Reference urethra Opens New Window
Damage to the rectum

By:	Reference Healthwise Staff	Last Revised: September 12, 2012
Medical Review:	Reference E. Gregory Thompson, MD - Internal Medicine Reference Christopher G. Wood, MD, FACS - Urology, Oncology