Prostate health awareness has increased in recent years, and for a good reason. Prostate cancer is the number one cancer diagnosis for men and a leading cause of cancer death in men worldwide. When cancer develops in the tissue of this small gland found only in males, one of the possible treatment options is the surgical removal of the prostate via a procedure known as a prostatectomy. However, if you are diagnosed with prostate cancer, it is essential to weigh your treatment options carefully. Read on to learn about the side effects of removing the prostate.
Why Would I Need My Prostate Removed?
The prostate produces seminal fluid, and its removal can cause fertility issues. In addition, as the gland surrounds the urethra, it helps control urination. While the side effects can be daunting, prostate removal is strongly recommended in some cases.
There are two common reasons to remove a prostate gland. The first is to treat prostate cancer. Around 10 to 15 cases of prostate cancer are aggressive and can spread to other parts of the body if not treated quickly. You may opt to remove the cancerous tissue to reduce its chances of spreading, while others want to avoid radiation; both can be reasons for surgery.
Another reason to remove the prostate is if you develop benign growths on the prostate, called benign prostatic hyperplasia. These can cause the prostate to swell and make urination difficult. However, surgery is only required in the most severe cases when minimally invasive procedures have failed.
What Is a Prostatectomy?
A prostatectomy refers to the medical procedure in which all or part of the prostate gland is removed. Depending on your need for surgery, the gland may be removed entirely or reduced in size.
A radical prostatectomy refers to removing the entire gland, attached seminal vesicles, and sometimes surrounding lymph nodes. This is often performed if you have local, aggressive prostate cancer. The surgeon may remove pieces of the prostate or obstructions in other cases. This type of surgery is a simple prostatectomy often offered to people with an enlarged prostate.
There are different procedures for removing all or part of the gland, including laparoscopy, robotic surgery, or open surgery via an incision.
Side Effects of Removing the Prostate
While it is great to be cancer-free, a prostatectomy is not without risks or side effects. The prostate gland surrounds the urethra and sits close to the muscles responsible for starting and stopping urination. Nerves in the area that control erections are also susceptible to damage.
The most common side effects of removing the prostate are:
- Urinary incontinence
- Sexual dysfunction
- Fertility issues
- Altered bowel function
Urinary Incontinence
The prostate surrounds the urethra. When the surgeon removes the prostate, they reconnect the urethra to the bladder. A sphincter or opening at the base of the bladder can be prone to damage during surgery. As a result, you may experience leaking and difficulty urinating post-surgery. Fortunately, with time and muscle training, this can improve.
You are required to use a catheter for about one week after surgery, which your doctor will remove. You can restart normal activities can about one month after surgery. However, urinary incontinence may persist beyond this time.
Sexual Dysfunction
Erectile dysfunction (ED) is the most common post-procedural side effect; about 4 in 10 people experience ED after a prostatectomy. The delicate nerves and blood vessels that control the physical aspects of an erection can lose functionality with even the slightest trauma. However, a skilled surgeon and healing period can allow people without nerve damage to return to normal function within one to two years.
Fertility Issues
Fertility issues are another significant side effect of a prostatectomy. As the seminal vesicles are removed along with the prostate, the semen that carries the sperm can no longer leave the body. Without ejaculation, conception cannot occur naturally.
Altered Bowel Function
Bowel incontinence and reduced bowel function are not common side effects of removing the prostate. Only about 1% of people report this symptom following surgery.
Life After Prostate Removal
Research has found that a prostatectomy results in life expectancy often exceeding ten years for those with cancer. Such a favorable outcome can significantly motivate people with cancer to have their prostate removed.
However, life after a prostatectomy may be different from how it was before. For at least the first six months post-surgery, most people face urinary incontinence and may choose to wear a thin pad. In addition, although nerve damage is dependent on many factors, erectile dysfunction is also common. Several treatments are available for these conditions, including strengthening exercises for the bladder and pelvic muscles and oral medications or injections for ED.
Nevertheless, the emotional stress of a prostatectomy can take its toll. People may experience a lowered libido and depressed mood. This is especially the case if hormone therapy has preceded surgery. The gravity of a cancer diagnosis alone can be traumatic.
Consider Your Options
Whether you’re worried about the emotional impact or the physical side effects of prostate removal, it is essential to weigh your options carefully. Your urologist can help you consider the advantages and disadvantages and detail your treatment options. While there are treatments available to combat some of the side effects of a prostatectomy, consider the impact this procedure will have on your quality of life and the alternatives to surgery.
Resource Links:
- “Prostatectomy: What to Expect During Surgery and Recovery” via Johns Hopkins Medicine
- “Benign Prostatic Hyperplasia (BPH)” via Johns Hopkins Medicine
- “Prostate Cancer” via – StatPearls
- “Life After Prostate Cancer Treatment” via Urology Care Foundation
- “The prostate cancer predicament” via Harvard TH Chan School of Public Health
- “Surgery for Prostate Cancer” via American Cancer Society
- “Surgery Side Effects” via Prostate Cancer Foundation
- “Survival after radical prostatectomy and radiotherapy for prostate cancer: a population-based study” via Canadian Urological Association Journal
- “What Is A Radical Prostatectomy (Surgery)?” via Prostate Cancer Foundation
