It takes a long time to adjust to life after prostate removal.
For many men, the emotional impact can be a major burden.
Although prostate cancer surgery can be a life-saving procedure, it usually takes a heavy toll on a man’s sex life.
The treatment can make patients feel frustrated and discouraged by causing problems like erectile dysfunction and preventing ejaculation.
So, can you live without a prostate?
Absolutely. But not everyone will heal the same.
If you want a realistic outlook on the effects of having your prostate removed, alternative options, and other things to consider, then the guide below can help.
What is the prostate gland?
The prostate gland is a small muscular gland capable of producing fluid. This fluid keeps the sperm safe and helps transport it.
This gland weighs around 30 g (1 ounce). The prostate is located right above the pelvic floor muscles and below the bladder. Here is how the prostate works. (1)
It produces a fluid that, together with fluids from other glands and the sperm cells from the testicles, make up semen. The prostate muscles press the semen into the urethra so the body can expel it during ejaculation.
Is prostate surgery painful?
The surgery itself doesn’t hurt. You receive general anesthesia, which keeps you asleep.
But, this is a major operation. So you can expect some pain, swelling, and soreness after it.
In the first week of prostate surgery recovery, the scrotum and penis can swell. It should get better in 1 to 2 weeks. The soreness might subside in 1 to 2 weeks. Hospital stays usually last 6 days.
Can you live without a prostate?
A properly functioning prostate is not necessary for survival. But, it is crucial for reproduction.
In other words, your body can’t ejaculate semen after prostate removal surgery or produce semen. These are permanent and unavoidable consequences of prostate removal. (2)
Men can still experience pleasurable sensations that come with orgasm. But, there won’t be ejaculate fluid. This is known as a “dry orgasm.”
However, not all men recover the same way after radical prostatectomy (RP). Some might find that their orgasms completely change.
Studies show an impaired orgasmic sensation in 33% – 77% of patients after radical prostatectomy.
For example, men can experience a reduced orgasmic intensity and need more time to reach an orgasm. (3)
For others, their body can produce a little bit of fluid during or before an orgasm. This fluid comes from the glands in the urethra. The amount is much small than that of a typical ejaculation process.
Can you still pee if your prostate is removed?
Life without a prostate can feel uncomfortable and agitating. The physical changes after the procedure include:
- Being unable to control the urine
- Trouble keeping or getting an erection
Regardless of the type of prostate procedure you get, you will have to deal with urinary incontinence. Many patients are shocked when they realize they need to buy a whole case of padded undergarments.
The reason why incontinence problems are so present is that the prostate gland is the main organ that controls the urinary flow.
So, what happens to the urinary flow if you remove the prostate? If there is urine in the bladder, which there will be, it flows through to the outside.
Therefore, patients need a different way to control their urination. Men often use a tube (urinary catheter) that helps with urine drainage.
This tube stays in the opening of the penis until the urethra completely recovers. This can take somewhere from 6 to 9 days. The tube is attached to a leg bag, so you can hide it under pants.
After the doctor removes the tube, it can take the body a few weeks or over to fully stop the urine leaking. How long the incontinence lasts varies from person to person.
Can I pee after bladder and prostate removal?
When the entire bladder is removed, a surgeon creates a new way for your body to pee. This is known as urinary diversion.
Different types of urinary diversions exist. These include bladder reconstruction, urostomy, and continent urinary diversion.
Can you get an erection if you have your prostate removed?
About 85% of men have erection problems after prostate removal.
In the first months, men won’t have a spontaneous erection of the penis when waking up or during sleep.
Research estimates that recovery of a satisfactory sexual function takes 12 to 24 months. (4) (5)
What if prescription medicines don’t work for restoring erection after prostate removal?
If products like tadalafil, vardenafil, or sildenafil are not enough to get an erect penis, other treatments may work. These are injection medication, a vacuum (mechanical pump placed over the penis), and a penis implant.
On another note, patients also want to know about ejaculating urine after prostatectomy. During an orgasm, a man can eject urine from the urethra.
It is possible to leak urine as well, especially when sexually aroused. Those who had a prostate removal recovery claim that such effects can be frustrating for them and their partner.
How long can you live after prostate removal?
Data shows that the life expectancy of men treated with radical prostatectomy should exceed 10 years.
But, can you live longer than that? 2012 studies indicate that with long-term follow-up, RP can offer beneficial outcomes even at 20 years. (7) (8)
Why would the prostate be removed?
Prostatectomy is used to treat localized prostate cancer. Prostate gland surgery aims to take out cancer before it spreads to other sections of the body. It could be used alone or alongside hormone therapy, chemo, and radiation.
In some patients, a doctor may recommend prostate surgery to manage a highly enlarged prostate gland or severe urinary symptoms. Prostate enlargement is also known as benign prostatic hyperplasia. (9)
What are the side effects of prostatectomy?
Urination problems, poor bladder control, and erectile dysfunction are at the forefront of prostate surgery side effects.
But, there are other radical prostatectomy side effects that not many patients know about. These include: (10)
- orgasm-associated pain
- penile shortening
- urinary incontinence with sexual stimulation
- orgasm-associated incontinence
- penile deformity
Other prostatectomy side effects include poor bowel function. Less than 1% of men have problems with bowel movements.
This can happen in patients whose advanced prostate cancer invaded their rectum. The surgical procedure could cause some rectal damage.
Quality of life after prostate removal
Recovering from radical prostatectomy is no easy feat. Both the effects of prostate cancer and its treatment can affect the quality of life. They interfere with sexual, urinary, and bowel functions. (11)
But, it can also affect your general vitality, energy, and performance in social and physical roles. Being diagnosed with cancer can bring about a drastic change in your quality of life. And can put a strain on any sexual relationship.
And given the high rate of prostate removal side effects, it is normal to feel overwhelmed. Here are some prostatectomy recovery tips that might help.
- Don’t be shy to talk to your doctor about any intimacy issues. They can suggest treatments that may work.
- Manual, oral, or self-stimulation can help you achieve an orgasm. Even without an erection.
- Placing a vibrator at the head of the penis can offer good stimulation. The body sends these signals directly to the brain.
- Don’t rely too much on antidepressants. Using the SSRI class of medications can suppress orgasm. Talk to a doctor if you need a dose readjustment or other types of medication.
- Be open with your partner. Dealing with pain after prostate surgery can make it downright taxing to think about sex or want sex. Communicate with your partner about any of the prostate removal consequences you are feeling.
- Make sure to be extra careful around the surgery site. Don’t expect it to heal overnight. Give your body time to recover.
Alternatives to prostate removal surgery
Some men can avoid prostate cancer surgery that removes their prostate. The treatment options can vary from person to person. This is to help them avoid potential prostate surgery complications.
A doctor can recommend the best form of treatment. Some of these alternatives include:
Hormone treatment is often a go-to choice when prostate carcinoma has spread. The aim is to slow tumor growth and shrink cancer.
The possible side effects of hormone therapy include lowered libido, erectile dysfunction, loss of bone density, physical strength, muscle mass, etc.
This treatment involves using high-energy rays to reduce or destroy cancer cells. It, too, can come with side effects and long-term problems, such as impotence and incontinence.
This therapy relies on drugs to attack and identify cancer cells. The goal is to do as little damage to normal cells as possible. Side effects include fatigue, diarrhea, constipation, etc.
If cancer doesn’t respond to hormone treatment, doctors might recommend chemo. The side effects of chemo are usually easier to spot. They can lead to hair loss, diarrhea, fatigue, mouth sores, and more.
Doctors are constantly looking to find better prostate carcinoma treatments. Patients can find different ongoing clinical trials, such as those involving cryotherapy, photodynamic treatment, or other options that might help.
Prostate removal recovery can be an intense process. The erectile dysfunction, poor urine control, and pain when healing can affect your mental and physical health.
Many patients report having a reduced quality of life after prostate removal surgery. Talk to a specialist to find the right treatment to help improve your side effects.