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Prostate Surgery

Prostate surgery may be used to remove tumors or provide symptom relief. The potential side effects of prostate surgery include impotence and urinary incontinence. These are worrisome possibilities for men. And like any form of surgery, bleeding or infection is always a risk. The potential complications of surgery must be weighed against the possible gains.

Radical Prostatectomy

If cancer is caught in its early stages, a partial or radical prostatectomy may be performed. A partial procedure removes the diseased portion of the gland. A radical prostatectomy removes the entire gland and, hopefully, all cancerous cells.

Complete removal of the gland is usually only considered if the cancer is confined to the prostate. If the cancer has metastasized to the lymph nodes or other organs, surgical removal will not improve either symptoms or prognosis. If so, hormone therapy and other treatments are considered.

Damage to nerves and blood vessels during surgery cause some degree of erectile dysfunction in up to fifty percent of men under age sixty. A new form of surgery called nerve-sparing prostatectomy offers less risk of nerve damage. Nerve-sparing techniques cannot be used on large tumors or tumors too close to nerve clusters.

The prostate provides a large portion of the semen necessary to transport sperm. Once the gland is removed, generally together with the seminal vesicles, this ability is lost, and men have what are known as dry ejaculations. Men who want to father children following surgery should consider banking sperm before the operation.

Preserving Erection Ability Following Prostatectomy

New information presented at the Annual Meeting of the American Urological Association in April 2003 reveals that men may be able to preserve their ability to achieve and maintain an erection following radical prostatectomy by taking Viagra® (sildenafil) nightly for nine months following the surgery. The researchers reported that 27 percent of the men in the test group regained full erection ability, compared to only four percent of the men who received a placebo. All of the men who participated in the study had normal erectile function prior to prostatectomy. The research was funded by Pfizer Inc., makers of Viagra.

Transurethral Resection of the Prostate

A transurethral resection of the prostate (TURP) does not attempt to remove tumors. Instead, TURP surgery offers symptomatic relief. A small surgical tool is attached to a cystoscopy tube and inserted into the urethra. Excess tissue that blocks the urethra is removed, allowing urine to flow with greater ease.

Possible side effects of TURP include erectile problems, and possible scarring of the urethra, which can cause further urinary difficulties. Also common is a condition known as retrograde ejaculation: semen is shot backwards into the bladder instead of forwards. Retrograde ejaculation in no way hinders a man's ability to reach orgasm, but does often cause infertility.

Orchiectomy

Orchiectomy is the surgical removal of the testicles. Orchiectomy is actually a form of hormone therapy: testosterone production is halted by the surgery. Because orchiectomy stops testosterone production, it slows the progression of cancer.

Side effects of an orchiectomy may include impotence and a loss of libido. About fifty percent of all patients experience hot flashes. And, of course, the psychological effects of the operation must be carefully weighed.

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