While there are several options for treatment when it comes to prostate cancer, surgery is unfortunately necessary in some cases.
Prostate cancer surgery, which typically involves removing the prostate and any areas around the prostate found to contain cancer, is a major surgery that will require about six weeks for you to feel back to normal.
Some incontinence is normal for a period of time after surgical treatment for prostate cancer. After surgery, you’ll have a catheter in for about one or two weeks. This will need to be removed by your doctor at the right time. You may experience incontinence of a few weeks or months, but you should expect to gradually gain control of your bladder again. Talk with your doctor about things you can do to help control the incontinence, such as Kegel exercises, which help strengthen the muscles that control your bladder. It’s important to give your body time to heal after your surgery, so don’t be too put off by the incontinence factor. Stress or urge incontinence after prostate cancer surgery is normal for a period of time, so expect this after your surgery.
Like incontinence, some erectile dysfunction is to be expected after prostate cancer surgery, depending on several factors. There are nerves around your prostate that control erections. Unless the prostate cancer is located very close to these nerves, your surgeon will do his or her best to leave them alone. If, however, your cancer has spread near these areas, these nerves may need to be removed entirely. If this happens, you will not be able to achieve erections on your own anymore. If some nerves are left intact, it’s expected that you’ll be able to regain some control of your erections. For some men it could take a few months up to a couple years to get full functionality back. Your ability to have an erection after surgical treatment for prostate cancer will depend on your age, the status of the nerves around your prostate, and how well you were able to achieve erections before the surgery. Unfortunately, medications that help with erections will not work if all nerves are gone; however, there are other options that can enable you to have sexual intercourse, and you can discuss these with your doctor.
Other Changes in Sexual Health
After surgical treatment for prostate cancer, you will no longer be able to father a child naturally. Since many men who need to receive surgery for prostate cancer are older, this is not a common issue, but talk with your doctor if you have concerns about your loss of fertility before the surgery. In addition to this, you may also experience some changes in your orgasms. They may be less intense, harder to achieve, or go away completely. This will again depend on the state of the bundles of nerves around your prostate that help control erections and your ability to achieve orgasm before the surgery. Surgery for prostate cancer may also affect the length of your penis, as typically a small section of the urethra will need to be removed along with the prostate (the urethra goes through the prostate). These are all things you should discuss with your doctor before the surgery and will depend on the severity of your cancer and what your doctor finds during the surgery.
Continuation in Monitoring
There will always be a risk for your prostate cancer to come back, even after surgical treatment. This means you’ll need to continue to monitor the health of your prostate by visiting your doctor. Regular visits are important as the cancer can come back even years after your prostate cancer surgery. You and your doctor will discuss a follow-up treatment plan for after your surgery. The monitoring will likely involve the same tests it did before your prostate cancer—a PSA blood test, perhaps a digital rectal exam (DRE), questions your doctor will ask about your health and any symptoms you’re experiencing, and imaging tests to see the prostate. Continuing to monitor the health of your prostate is very important after surgery to ensure the cancer doesn’t return, and if it does, to seek treatment as soon as possible.
Surgical treatment for prostate cancer is life-changing. This is why prevention is all the more important, but if you do need prostate cancer surgery, these are some things you can expect. It’s important to discuss all concerns with your doctor before the surgery so that you’ll feel the best you can about the treatment.