The prostate is a gland located near the rectum that makes up part of the male reproductive system. Prostate cancer develops when cells within the prostate acquire genetic mutations and begin to divide rapidly, leading to the development of a tumor. Once diagnosed, prostate cancer can be treated by chemotherapy, radiotherapy, or surgery. Prostate removal surgery, called a prostatectomy, is a serious medical procedure that can lead to a range of side effects.
Erectile Dysfunction
Some types of prostate cancer surgery, especially those used to treat more aggressive forms of the disease, remove the prostate as well as surrounding tissue. Embedded in the surrounding tissue is a collection of nerves, known as cavernous nerves. This bundle of nerves functions to stimulate and maintain an erection. In an aggressive prostate cancer surgery, these nerves are severed, so the patient is unable to achieve or maintain an erection for months or years after surgery.
According to the Prostate Cancer Canada Network, erectile dysfunction is a long-term side effect resulting from surgery. Following milder surgery, where the cavernous nerves are left intact, the patient will eventually recover and re-develop the ability to achieve an erection. Patients may require up to two years to be able to achieve an erection following more severe surgeries.
Infertility
Prostate cancer surgery can lead to infertility. Normally, the prostate gland secretes a fluid that combines with secretions from the testicles to make up semen and allow ejaculation. If the prostate is removed, prostate fluid is no longer released to help form semen. As a result, male orgasm in patients who have had a prostate cancer surgery is dry-there is no ejaculation and no delivery of sperm. Infertility following prostate cancer surgery is permanent.
The Prostate Cancer Foundation reports that the best way to sidestep the effects of infertility is for patients to bank their sperm before prostate cancer surgery. Alternatively, sperm can be extracted directly from the testicles and used for in vitro fertilization.
Incontinence
During prostate cancer surgery, the surgeon may have to sever the tubes leading from the bladder to the urethra. In other cases, tissue removal leads to a decrease in the muscle function surrounding the bladder, which leads to urinary incontinence. Most men who undergo prostate cancer surgery will experience temporary urinary incontinence.
The rate of recovery for incontinence can take months or years, according to New York University. NYU reports that 80 percent of men who had prostate cancer surgery regained continence within three months, and 98 percent of men regained continence within 24 months.
