Surgery on the prostate gland can be done for a variety of different reasons. They can range from benign prostatic hyperplasia (BPH) to prostate cancer. A variety of techniques and approaches can be used depending on the individual condition being treated, but all surgical interventions carry their own risk of side effects that must be weighed by the patient before undergoing therapy.
Infection
This is a side effect of all surgery, and prostate surgery is no exception. This can range from a superficial infection at the incision site to a much more serious infection of the deeper tissues.
Bleeding
Bleeding can also occur with any surgery and historically was a major concern (see Reference 1) that has now been addressed for the most part with modern surgical technique. However, bleeding can still occur, and most surgeons keep a few units of blood available during surgery in case it is called upon.
Sexual Dysfunction
This can occur and is more common in men that have more advanced age (see Reference 1). In addition, 80 to 90 percent of men can suffer from retrograde ejaculation following prostate surgery (see Reference 1), according to the "Campbell-Walsh Urology" textbook. Usually the surgeon tries to avoid these complications by preserving the bladder neck during surgery; damage to this is often a cause of these sexual side effects.
Contracture of Bladder Neck
The bladder neck can develop a contracture, or shortening, after prostate surgery. This can happen in 2 to 5 percent of patients and usually occurs between 6 to 12 weeks after prostate surgery (see Reference 1). The surgeon can treat this side effect with dilation to increase the diameter of the bladder neck.
Urinary Tract Infection
This is also a side effect of prostate surgery that can usually be prevented with the patient voiding the bladder completely each time he urinates.
Urinary Incontinence
This can also result immediately after surgery and is usually a self-resolving condition. While it is occurring, catheterization of the bladder is recommended to allow the bladder to drain normally.
Transurethral Resection Syndrome
This is characterized by confusion, nausea and vomiting, increased blood pressure, decreased heart rate and visual disruptions. This is thought to be due to the absorption of fluid (See Reference 3) during the TURP procedure, which is a minimally invasive form of prostate surgery. The increased fluid absorption can result in low levels of body sodium due to dilution, and this results in the symptoms seen, according to the "Campbell-Walsh Urology" textbook.
References
- "Campbell-Walsh Urology, 9th Edition"; Wein; 2007
- "Urology"; Long-Term Results of Open Transvesical Prostatectomy from a Contemporary Series of Patients; Varkarakis, I et al. Volume 64, 2004.
- "Journal of Urology"; Transurethral Prostatectomy: Immediate and Postoperative Complications. A Cooperative Study of Thirteen Participating Institutions Evaluating 3,885 Patients; Mebust, WK et al. Volume 141, 1989.
