- A radical prostatectomy is a surgical procedure that involves the full removal of the prostate.
- There are many complications associated with radical prostatectomies, including changes to sexual function, urinary incontinence, and urinary tract infection.
- Erectile dysfunction (ED) is the most common complication following radical prostatectomy.
- The first line of treatment for ED after prostatectomy is prescription ED medication, like Viagra or Cialis.
Thousands of men undergo radical prostatectomies each year, for conditions like prostate cancer and benign prostate hyperplasia (BPH). Although erectile dysfunction (ED) is the most common complication of this procedure, in most cases, the ED is not permanent. Read ahead to learn more about the complications of radical prostatectomy — and the steps you can take to overcome them.
What is a Radical Prostatectomy?
Prostatectomies are one of the most common treatments for prostate cancer. A radical prostatectomy is the complete removal of the prostate gland, but it may also include removal of surrounding nerves, lymph nodes, or tissues. This procedure can also be used to treat benign prostate hyperplasia (BPH).
A prostatectomy may damage the nerves within the male reproductive organs. To reduce this risk, your doctor may perform a “nerve-sparing radical prostatectomy.” Your provider will determine the best treatment for you following a prostate biopsy.
What are the Complications of a Radical Prostatectomy?
Radical prostatectomies are common, but they are still surgical procedures. As with other forms of surgery, complications can develop. Fortunately, most of these are temporary.
Potential short-term complications include:
- Bleeding. Any bleeding is likely a short-term side effect of surgery.
- Infection. Some men experience urinary tract infections (UTIs) or infections at the surgery site after their procedure. This is short-term and can be treated with antibiotics.
- Urinary incontinence, leakage, or dribbling. You may notice urinary leaking when you cough, sneeze, or perform any extraneous activity following your surgery. This complication is typically short-term, lasting a few weeks up to a few months post-operation. You can treat this complication with pelvic floor therapy and Kegel exercises.
Long-term complications can include:
- Changes to anatomy. Some men may experience narrowing of their urethra or shortening of their penis length.
- Dry orgasms. Men who undergo prostatectomy can still orgasm, but may experience “dry orgasms.” This means that they do not expel semen upon climax. You may wish to see a fertility specialist or other specialty provider if you are worried about fertility after your procedure.
- Erectile dysfunction (ED). ED is the most common complication of radical prostatectomy. Many men recover their ability to achieve and maintain an erection within one to two years after surgery. Some men will struggle with ED long-term after surgery. The severity of your ED will depend on your health, the type of prostatectomy performed, and the extent of any nerve damage done during your surgery.
- Lymphedema. This condition involves fluid accumulation in the tissues. It’s rare but more common if the lymph nodes were removed during surgery. Lymphedema can result in pain and swelling, particularly in the genital region and in the legs. It can be managed with physical therapy.
You should always speak with your medical provider or care team to discuss your concerns regarding complications prior to surgery. You should also promptly seek medical care if you experience any sudden or unexpected complications.
Is ED Permanent After Radical Prostatectomy?
All men who undergo radical prostatectomy will experience ED for at least several weeks following the procedure. You are more likely to regain erectile function within one to two years if your nerves remain intact after surgery. However, even if you had a nerve-sparing radical prostatectomy, you are not guaranteed full erectile recovery.
If you undergo a nerve-sparing prostatectomy, you are 40 to 50 percent likely to regain your pre-treatment erectile function, and it may take up to two years. You may need additional treatment, penile rehabilitation to help regain your erectile function.
If you haven’t recovered your erectile function within two years of your procedure, you may require more intensive therapies to overcome ED. Additionally, if you are also living with a chronic condition, such as diabetes or heart disease, you are more likely to have ED long-term after your prostatectomy.
How is ED Treated After Radical Prostatectomy?
Fortunately, there are many treatment options for ED following radical prostatectomy. These treatments can range from non-invasive and simple to intensive and invasive. Your treatment will depend on your overall health and the extent of your condition.
Treatment options include:
- ED medications, like Viagra, Cialis, Levitra, and others
- Lifestyle changes, such as a new diet or exercise regimen
- Pelvic floor therapy
- Penile implants
- Penile injections
- Therapy or sex therapy
Prescription ED medications, such as Viagra or its generic sildenafil, are typically the first line of treatment for ED. Research shows that regular doses of sildenafil 100 milligrams consistently demonstrates improved sexual function after nerve-sparing radical prostatectomy. If you cannot take prescription ED medications, you may need to explore more intensive treatment options, such as penile injections or implants.
eDrugstore Can Help
You may be left with many questions following prostate surgery. We have the resources needed to help you navigate sex and intimacy after radical prostatectomy. Browse our medication guide or take advantage of our free online consultation by calling 1-800-467-5146. Virtual health visits and shipping are always free.
Shelby is a public health professional with research and field experience in sexual and reproductive health. She holds a Master of Public Health (MPH) and is a Certified Health Education Specialist (CHES).