Prostate cancer

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Potential side effects of surgery for prostate cancer

Side effects can occur with any type of treatment for prostate cancer, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on the:

  • type of surgery
  • man's overall health

Side effects can happen any time during surgery. Some may happen during, immediately after or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.

It is important to report side effects to the healthcare team.


Pain often occurs after surgery because of trauma to the tissue during surgery. Pain-relieving medications are used to control pain. It may take time for pain to decrease after surgery, depending on the procedure, how the person heals and how they tolerate pain. If pain persists or pain medications are not relieving the pain, check with the doctor.

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Nausea and vomiting

Nausea and vomiting can occur because of the effects of general anesthesia used during surgery. Medications are often given to prevent and control nausea and vomiting. Nausea and vomiting are usually temporary side effects and often go away a few days after surgery.

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Paralytic ileus

Paralytic ileus is paralysis of the bowel. It is a common side effect of abdominal surgery. The length of time that the bowel is paralyzed is variable and may depend on the difficulty of the surgery, blood loss and length of time under general anesthesia. It may last for 2–4 days.

  • Most surgeons will order a clear liquid diet after surgery and a regular diet when the man starts to pass flatus (gas).

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Bleeding or hemorrhage can occur if a blood vessel is not sealed off during surgery or if the person has a problem with blood clotting. Nursing staff monitor vital signs such as pulse and blood pressure and frequently check bandages and drains for excessive bleeding right after surgery. If bleeding occurs and is severe enough, the surgeon may have to take the person back to the operating room, to find where bleeding is coming from and to stop it.

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Some people may develop a infection after surgery. This is not a common side effect, but it can potentially occur after any type of surgery. Antibiotics may be used to help prevent or treat an infection. Infections are a temporary side effect of surgery.

Report signs of infection to the healthcare team, such as pain, pus, foul-smelling drainage, and fever.

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Blood clots

A blood clot in the leg is called a deep vein thrombosis (DVT). A DVT can occur right after surgery because the person is not walking or moving around much. Other factors can increase the risk of a DVT. In the most serious cases, a blood clot can break off and travel to the lung. This is called a pulmonary embolus. This causes shortness of breath and affects the ability of the lungs to get oxygen into the blood. Blood clots in the lungs can potentially cause heart failure.

Taking blood thinners (anticoagulants) and applying compression stockings during and after surgery helps to prevent DVT.

Report any redness, swelling, pain or cramps in the calf of the leg or shortness of breath to the healthcare team.

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Urinary incontinence

Urinary incontinence is an involuntary loss of urine or the inability to control urination. Many men will experience incontinence after a radical prostatectomy, but the problem will gradually get better as the body recovers. Six months after surgery, most men will only lose a few drops of urine during lifting, sneezing, coughing or sudden position changes (called stress incontinence). Modern surgical techniques have greatly reduced this complication by carefully avoiding damage to the bladder sphincter (valve) during surgery.

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Erectile dysfunction

Erectile dysfunction (ED), or impotence, is the inability of a man to get and keep an erection firm enough to have sex. Radical prostatectomy can damage the nerves needed for erection. Newer surgical techniques attempt to spare the nerves and decrease the occurrence of erectile dysfunction.

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Retrograde ejaculation

In TURP, the bladder neck is removed with the prostate, so it becomes unable to close during ejaculation. This means that the semen goes into the bladder rather than outside the body when a man has an orgasm. This results in infertility. The semen exits the bladder with the urine when the man urinates.

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Dry orgasm

Usually when a man has an orgasm, semen will be ejaculated. The fluid portion of the semen comes from the prostate, seminal vesicles and vasa deferentia (the tubes that join the testes to the prostate). All these connections are disrupted when the prostate is removed. The man may still experience an orgasm, but there will be no ejaculation. This is called a dry orgasm and results in infertility.

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Urethral stricture

This can occur when an injury to the lining of the urethra forms a scar. This scar tissue causes narrowing or blockage of the urethraurethraThe tube that carries urine from the bladder to the outside of the body.. It is treated with dilation (widening) of the stricture.

Surgery may be required if the problem is severe and cannot be relieved with dilation.

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Lymphedema of the legs

When large numbers of lymph nodes are removed by surgery, the normal flow and drainage of lymph fluid may be blocked. This leads to a buildup of lymph fluid in the soft tissues and is called lymphedema. Rarely, swelling of the legs may occur due to removal of the pelvic lymph nodes. The goal of treatment is to prevent further fluid buildup and reduce swelling as much as possible.

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Dr Shawn Li I’m extremely grateful to the Canadian Cancer Society for funding my research with an Innovation Grant.

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