Life After Prostate Removal: What To Expect

The prostate gland is prone to inflammation and developing cancer. 

Almost half of the men above the age of  60 have benign prostate hyperplasia (BPH) or prostate enlargement. 

However, BPH does not cause removing the prostate, but the presence of cancer or its early sign is the reason for prostate removal.

Prostate cancer has become a significant concern in recent years. Its incidence is increasing, and now its diagnosis is becoming more common even among middle-aged men. 

Prostate cancer is now among the most common cancers in older men. 

Aging indeed has lots to do with the increased prostate cancer rate, but it is not the only cause. It seems that this disproportionate increase in the annual incidence of prostate cancer also has to do with other lifestyle issues like a high-fat diet, greater prevalence of metabolic disorders, environmental toxins, hormonal changes, and more.

The prostate plays an important role in male fertility and sex life. Although men can survive without a prostate, unfortunately, for many men, prostate removal results in poor quality of life, issues like erectile dysfunction, and more. 

Some men can expect to recover well from proctectomy. However, for others the journey to recovery is prolonged and distressing. Keep reading to find out more about life after prostate removal and what you can expect.

The prostate is a small walnut-sized gland located in front of the rectum and below the bladder. Its main function is to provide semen fluid to ensure the transportation of sperms. Hence, it plays an important role in male fertility. 

What is a prostatectomy? 

A prostatectomy is prostate removal surgery. Doctors may remove part of the prostate or the entire prostate gland. 

However, in some cases, doctors may also remove the surrounding tissues. The scope of surgery depends on the severity of the condition.

Depending on the scope of the surgery, doctors may use different approaches to remove the prostate gland. For example, they may go for minimally invasive surgery or open radical prostatectomy. 

Doctors may also use different approaches for the removal of the prostate gland. Thus, they may remove it via a suprapubic incision (incision in the lower abdomen)  or go for a perineum incision through the skin between the scrotum and rectum. 

Here it is worth understanding that different clinics use many new minimally invasive methods. Like in some cases, doctors may go for transurethral resection of the prostate (TURP)

Some of the new techniques cause very less trauma. However, not all patients may qualify for minimally invasive surgery, and thus doctors may have to go for an open prostatectomy.

It means that amount of trauma may vary significantly depending on how the prostate surgery is done. In some cases, like partial removal of the prostate with the help of minimally invasive surgery, one may start walking the next day and make a complete post-surgical recovery within a few days.

However, in the case of open surgery with the removal of the complete prostate and surrounding tissues (open radical prostatectomy), the journey to full recovery may take longer. 

Here it is worth understanding that the patient’s age also plays a significant role in how fast and well one would recover after a surgery. 

Regretfully, more invasive surgery like open radical prostatectomy is more likely to be done in older adults, and thus even prolonged recovery period.

prostatectomy

Why do doctors perform prostatectomies?

Since the prostate gland is not an organ essential for survivability, doctors recommend its removal in some cases. Perhaps the number one cause of removal of the prostate gland would be early-stage prostate cancer. 

In such cases, doctors may go for complete prostate removal, or they may even go for radical proctectomy, in which they also remove the surrounding tissues.

However, prostate cancer is not the only cause. Doctors may also recommend prostatectomy to individuals with high risk or high probability of prostate cancer. Such individuals would often have some other severe symptoms like issues urinating.

Doctors may also remove the prostate gland if there are issues like acute urinary retention, recurrent urinary infections, recurrent hematuria, bladder stone, bladder outlet problems not responsive to conservative treatment, renal insufficiency due to chronic bladder obstruction, etc.

So, prostate cancer may be the leading cause of prostatectomy, but there are many other reasons why doctors may recommend it. Moreover, when people live with different non-cancerous prostate issues, they are also at an increased risk of developing prostate cancer.

Considerations when opting for surgery

Before agreeing with any surgery, knowing its benefits and risks is vital. It is even more important when the surgery is not urgent, like in the cases of proctectomy. 

Thus, one should ask a doctor about various treatment options, prostate surgery recovery, and what to expect after prostate surgery.

Sometimes prostate surgery is one of the options. Thus, it is important to ask a doctor if it would be better to have some watchful waiting

If one goes for prostate removal, one should know about the benefits, prostate surgery complications, the side effects of living without a prostate, how long prostate cancer surgery is, its impact on sex life, etc.

Additionally, one should inquire about all the surgical options available and consider the risk and benefits of each of the options. 

Quite often, doctors may also help in making the decision. Here good communication with a healthcare provider is the key.

nerve sparing prostatectomy

What are the side effects of prostate cancer surgery?

People often ask what happens if the prostate is removed? What to expect after prostate surgery? And can you have your prostate removed at all? The answer is yes it is possible to have the prostate removed. 

Life without a prostate can be close to normal for some, though not free from the after effects of prostate removal.

There are few prostate surgery complications. Some are acute, and others chronic. Among acute side effects could be a reaction to anesthesia, bleeding issues, blood clots in legs, damage to nearby organs, and infection at the surgery site.

However, in most cases, people are interested in life after prostate removal, the pain after prostate surgery, and the long-term after effects of a prostatectomy.

There are two main side effects of prostate surgery. These are urinary incontinence and erectile dysfunction. 

Urinary incontinence

Urinary incontinence may be a severe and embarrassing issue in many cases. It is among the common complications of prostate removal surgery. 

In this condition, the person cannot control the leakage of urine. It may also result in significant emotional issues.

In some cases of prostate surgery, nerves that tighten the urinary valve and prevent its leakage may become damaged. 

Weakened nerves mean poor control and thus greater chances of urinary leakage during periods of stress like coughing, laughing, sneezing, and exercise.

However, some may have just the opposite problem: emptying their bladder. This happens due to the formation of scar tissues in the region that narrow the bladder outlet.

There are other causes of urinary inconsistency, such as the bladder becoming too sensitive after the surgery. 

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Erectile dysfunction

An even greater concern for many men is erectile dysfunction or impotence, as sex life is quite important for young adults. 

Indeed, the prostate does not play any role in male erection, and it has more to do with fertility or sperm transportation. However, the problem is that nerves that cause erection in males are two very minute nerves running on both sides of a prostate gland. It means that there is a high risk of these nerves getting damaged during any prostate surgery.

Generally, surgeons would opt for nerve-sparing surgery to try their best not to damage these nerves. However, in the case of prostate cancer requiring radical proctectomy, requiring the removal of most of the tissues surrounding the prostate gland, damage to these nerves is highly likely.

If these nerves are damaged, then erectile dysfunction may be severe in most cases.

RELATED: How to Speed Up Your Nerve Regeneration After Prostate Surgery.

How can a prostatectomy impact your quality of life?

Prostatectomy is not life-threatening, but prostate removal significantly affects the quality of life, and it may cause problems like urinary symptoms, bladder issues, erectile dysfunction, and more. T

These issues may last for several months and even years, something patients should be ready for if they decide to have the surgery.

However, a lot depends on the patient’s age and the kind of surgery done. Studies show that about 60% of patients would make an almost complete recovery within 3 months with no long-term complications. By 12-months, almost 90% of patients can expect to feel much better and nearly normal. 

Unfortunately, improvement is slow for some people, and they need 2-3 years to revive their sexual function and get rid of urinary issues. Regretfully, these issues may continue to haunt some for a while.

Here it is vital to understand that the above data is for radical proctectomy (complete prostate removal and adjoining tissues). The outlook is better after partial proctectomy. 

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What are the long-term effects of having your prostate removed?

As per the American Cancer Society, there are two common long-term effects when the prostate is removed; urinary inconsistency and erectile dysfuction.

Both these issues are quite common and will last at least three months in all the cases. Most will see improvement in about 12 months. 

Nevertheless, some urinary issues and erectile dysfunction may be chronic and last for a few years, requiring continuous care and treatment.

Can you still have an erection if your prostate is removed? 

Yes, it is possible as the prostate gland does not play any direct role in erectile function or testosterone production. Erectile dysfunction (ED) after prostatectomy is mainly due to local inflammation and nerve injury.

How severe one would have prostate surgery-related issues would depend on the kind of surgery one had. 

For example, if one had a minimally invasive surgery for partial prostate removal, the chances are slim that nerves involved in erection might be damaged. 

Nevertheless, these nerves may not function well for a few months due to local inflammation. However, most men can expect to reach their prior erection quality in 3 months in such cases.

There are greater chances of nerve damage when it comes to radical prostatectomy because of localized prostate cancer than there are greater chances of nerve damage. 60% of men can expect their erectile function to reach the prior-to-surgery level within 3 months.

Regretfully, the road to recovery for the rest of 40% is prolonged. They might need months and even years of treatment. Some may need regular treatment for erectile dysfunction for the rest of their life after prostate removal.

doctor

Making an informed decision

There are many things to consider when agreeing to proctectomy. Thus, one should ask healthcare providers various questions, from the cost of prostate cancer surgery to prostate cancer surgery after side effects.

During appointments or doctor visits, take more interest in prostate cancer treatment medications, supplements, how the process is done, whether the doctor would consider hormone therapy, other treatment options, sex life after prostatectomy, diet after surgery, rehabilitation, and more.

When agreeing to proctectomy, one should consider the risk and benefits and explore all non-surgical options. Once the prostate gland is removed, one will have to live with specific issues for a long.

Alternative treatment options

Although surgical prostate removal remains the most well-tested option, doctors are testing other methods for managing prostate cancer, which may work for some. For example, brachytherapy involves planting radioactive capsules near the prostate. 

Some medical centers may also offer cryotherapy, which kills the prostate cancer cells with the help of cold therapy. In cryotherapy, doctors use needles to introduce cold gasses to the lesion and make no incision; thus, the procedure is more minimally invasive.

Talk to your doctor about watchful waiting and active surveillance to see if these are options for you too.

If doctors want to remove the prostate for other reasons than cancer, there might be many options. Like prostate artery embolization (PAE) may help with an enlarged prostate and urinary retention.

Prostate care

All men above the age of 45 should engage in prostate care even if they have no prostate issues. Prostate care is even more important for those with a family history of prostate cancer. 

When it comes to prostate care, one should aim to prevent benign prostatic hyperplasia (prostate enlargement) and prostate cancer development. It means that one can intermittently use supplements that help prevent prostate enlargement and reduce the risk of prostate cancer.

prostate health supplements

Supplements

An ideal supplement is safe for prolonged use and beneficial for prostate enlargement and prostate cancer. Moreover, it must have other health benefits like reduced risk of metabolic disorders.

Thus, ideally, one must consider a prostate supplement rich in vitamins and antioxidants. Vitamins like C, D, and E can help reduce the risk of prostate issues. 

In addition, minerals like chromium, selenium, and molybdenum may also help boost immunity and fight prostate cancers.

For prostate hypertrophy, natural extracts like saw palmetto are quite popular. Saw palmetto is the most commonly recommended natural remedy for prostate enlargement.

Thus, along with vitamins, one should look for natural compounds that can help reduce prostate cancer risk. 

Therefore, for example, Beta-sitosterols are pretty good for reducing benign prostatic hyperplasia and may also help reduce the risk of prostate cancer.

Similarly, quercetin is a potent antioxidant that can help prevent metabolic disorders and boost cardiovascular health, and new studies show that it can also help reduce the risk of prostate cancer.

Likewise, ellagic acid present in many tropical fruits is known to affect prostate cancer cells directly. In addition, studies show that it can significantly reduce the growth of cancer cells in a dose-dependent manner.

Similarly, one may also consider natural remedies for improving erection quality like horny goat weed, Tribulus Terrestris, vitamins, and more.

These are just examples of some of the natural remedies. Their regular use may help considerably reduce the risk of prostate cancer and help prevent prostatectomy. 

Conclusion

Prostate removal surgery is most commonly performed for prostate cancer. However, there could be other reasons for prostatectomy, too. Some of the side effects of prostate removal include urinary inconsistency and erectile dysfunction.

Explore More

effects of prostatectomy

How a Prostatectomy Can Affect Your Relationship.

Sources

  1. Lim KB. Epidemiology of clinical benign prostatic hyperplasia. Asian J Urol. 2017;4(3):148-151. https://pubmed.ncbi.nlm.nih.gov/29264223/ 
  2. Litwin MS, Melmed GY, Nakazon T. Life after radical prostatectomy: a longitudinal study. J Urol. 2001;166(2):587-592. https://pubmed.ncbi.nlm.nih.gov/11458073/ 
  3. Bratu O, Oprea I, Marcu D, et al. Erectile dysfunction post-radical prostatectomy – a challenge for both patient and physician. J Med Life. 2017;10(1):13-18. https://pubmed.ncbi.nlm.nih.gov/28255370/ 
  4. Wilt T, Ishani A, MacDonald R, Stark G, Mulrow C, Lau J. Beta-sitosterols for benign prostatic hyperplasia. Cochrane Database Syst Rev. 2000;(2):CD001043. https://pubmed.ncbi.nlm.nih.gov/10796740/ 
  5. Ghafouri-Fard S, Shabestari FA, Vaezi S, et al. Emerging impact of quercetin in the treatment of prostate cancer. Biomedicine & Pharmacotherapy. 2021;138:111548. https://www.sciencedirect.com/science/article/pii/S0753332221003334
  6. Malik A, Afaq S, Shahid M, Akhtar K, Assiri A. Influence of ellagic acid on prostate cancer cell proliferation: a caspase-dependent pathway. Asian Pac J Trop Med. 2011;4(7):550-555. https://pubmed.ncbi.nlm.nih.gov/21803307/

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1 Comment

  1. George

    Nicely written article. Informative and well-balanced. Thank you.

 
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