If you have prostate cancer or an enlarged prostate, you might undergo prostate surgery — also called a prostatectomy. Like all surgeries, this one comes with potential risks. The Prostate Cancer Foundation reports that erectile dysfunction is the most common side effect of a prostatectomy. Fortunately, there are ways to restore sexual function during prostate surgery recovery.
But first, learn about why you might need a prostatectomy, what happens during the surgery, and what to expect during the recovery process.
Reasons to Have a Prostatectomy
A common reason for having a prostatectomy is to treat prostate cancer. According to the American Cancer Society, prostate cancer is the most common cancer, after skin cancer, among men in America. More than 174,000 new cases are reported in the United States each year. If the cancer hasn’t spread outside the prostate gland, surgery is a good treatment option.
You might also choose to have prostate surgery to treat an enlarged prostate. As the prostate grows, it can block the flow of urine and cause bladder, urinary tract, and/or kidney problems. Removing part of the prostate can solve these issues.
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What Happens During Prostate Surgery
Before a prostatectomy, a surgeon will use either general anesthesia which makes you lose consciousness, or spinal anesthesia which numbs the lower half of your body while you remain conscious.
There are two main types of this prostate surgery. In the traditional open prostatectomy, the surgeon makes one large incision in the skin to remove the prostate. A more common method used today is minimally invasive laparoscopic surgery, during which the surgeon performs the procedure through four small incisions using a tiny camera and small tools. Many surgeons now use robotic assistance to perform this type of surgery.
Prostate Surgery Recovery
During surgery, your doctor will insert a catheter into your penis. This thin, flexible tube helps drain urine until you’re healed enough to urinate on your own. It’s typical to have the catheter in place for one to two weeks.
You can usually leave the hospital in a day or two, but the incision site will likely feel sore for a few days. You won’t be able to drive for at least a week, and usually can return to normal activities within a couple of weeks.
During recovery, you might experience side effects including:
- Urinary tract infection
- Temporary loss of bladder control
- Erectile dysfunction (ED)
- Ejaculatory dysfunction
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Restoring Sexual Function After Surgery
Erections are controlled by nerves and blood vessels that run along both sides of the prostate. Because they’re very delicate, any trauma to these nerves or blood vessels can affect erectile function, says the Prostate Cancer Foundation. And if cancer is growing near the nerves, the surgeon might need to remove them.
Even if you don’t have ED before surgery, you may experience it afterward. While ED usually lasts at least two to three months after surgery, it can last for up to two years.
To restore sexual function, your doctor may suggest:
- Oral medicine, such as Viagra® or Cialis® (assuming surgery didn’t cause nerve damage)
- Penile injections that you use before having sex
- A vacuum device that draws blood into the penis to create an erection
- A penile implant, inserted via surgery
To learn more about prostatectomies, visit the UPMC Men’s Health Center or call 1-877-647-4MEN (4636) to make an appointment.
The UPMC Department of Urology treats all manners of conditions involving the urinary tract and male reproductive organs. We treat those disorders both in children and adults. We have a multifaceted team of physicians and researchers working together to provide the best care. We provide cutting-edge treatments, and we continue to lead research into even better methods for diagnosis and treatment. U.S. News & World Report ranks UPMC Presbyterian Shadyside as among the best hospitals in the country for urological care.