Prostate cancer, one of the most common cancers in men, occurs in the prostate, a gland located under the bladder that wraps around the urethra. Prostate cancer is the third leading cause of cancer deaths in men of any age and the most common cause in those over age 75, MedlinePlus reports. Prostate cancer treatment consists of chemotherapy, radiation or surgery. Surgery carries significant risk of long term disability. Several types of surgery to remove the prostate, called radical prostatectomy, can be done, but all have similar side effects.
Urinary Complications
Incontinence, the inability to control urine, occurs as a complication in as many as 5 to 10 percent of prostates surgeries. Incontinence is classified in one of several ways: stress incontinence, the most common type, where urine leaks when coughing, sneezing or laughing; overflow incontinence, the inability to completely empty the bladder and a weak urine stream; urge incontinence, a strong sudden need to urinate; and continuous incontinence, the complete inability to control urine flow. In men without long-term incontinence, bladder control can take weeks to months to regain and often occurs in stages.
Other urinary complications, including bladder neck contracture or urinary stricture, occur in 7 to 20 percent of men after surgery.
Impotence
Impotence affects between 30 and 100 percent of men who undergo radical prostatectomy, depending on the patient's age and sexual function before surgery. The nerves that control the ability to have an erection may be damaged or cut during surgery. Recovery of sexual function may occur slowly over a two-year period after surgery. Nerve-sparing surgeries may decrease the rate of impotence to less than 10 percent in men under 50. Around 15 percent of men also have a decrease in penile length, the American Cancer Society states.
Lymphedema
Rarely, men who have had prostate surgery with removal of lymph nodes around the prostate develop lymphedema, a condition where lymph fluid accumulates since it can no longer drain through removed lymph nodes. Fluid may accumulate in the legs and genital area, resulting in pain and swelling.
Sterility
Even if the ability to have an erection continues, the ejaculation will be "dry"---no semen is ejaculated, so patients are unable to father children. Medications can increase the ability to maintain an erection. Mechanical aids such as vacuum pumps or penile implants also aid in maintaining erections. Men who want to preserve the option of fathering children in the future can "bank" sperm by saving semen at a fertility laboratory before the surgery.
Rectal Complications
Rectal complications from prostate cancer surgery include damage to the bowel and bowel incontinence, the inability to control bowel movements. Because the prostate sits just above the rectum, its removal leaves the rectum more susceptible to injury, especially in the three months immediately after surgery. To minimize the risk of injury to the rectum, doctors may prescribe stool softeners or laxatives.
