The risk of serious complications after radical prostatectomy is low, and the procedure rarely results in patient death or severe disability.
There are important nerves that cross between the prostate and the penis, and a skilled surgeon can usually protect most of them during a radical prostatectomy. However, it is still possible to inadvertently injure the nerve during surgery, which can lead to the following complications:
Common complications
- Urinary incontinence: After radical prostatectomy, urinary function may be compromised in a small number of patients.
- Erectile dysfunction (commonly known as impotence): Erectile dysfunction is a common complication after prostatectomy. Nevertheless, most men can maintain sexual function after prostatectomy with oral medications (PDE-5 inhibitors, such as sildenafil), vacuum erection devices, or intraurethral/intracavernosal vasodilators. The younger the patient, the lower the incidence of postoperative erectile dysfunction. However, it takes time for erectile function to return.
It takes a great deal of skill on the part of the surgeon to do this without damaging the nerves during radical prostatectomy.
Other complications that may arise from radical prostatectomy include:
Early complications:
- Postoperative bleeding
- rectal, ureteral, or nerve injury
- Urinary leakage or fistula
- Thrombosis
- Urinary tract infection
- Poor incisional healing
- Cystic lymphangiectasia
Late complications:
- inguinal hernia
- Urethral stricture, dyspareunia
- Complications occur in less than 10% of patients after prostatectomy and are usually manageable and generally of short duration.