Prostate Removal Surgery: Recovery Time and Consequences

In cases of prostate cancer, treatment often involves the complete removal of the prostatic gland, a procedure known as radical prostatectomy. Although life without a prostatic gland requires some adjustments, it is entirely manageable. Removal of the prostate does not affect the vital functions of the male body, but certain side effects may occur, which can vary from person to person.

Are There Major Risks?

Removal of the prostate does not impact a patient’s life expectancy. The key factor remains the effectiveness of the cancer treatment. Therefore, regular medical follow-up is essential to detect or prevent any recurrence.

Regarding hormonal balance, removal of the prostate does not cause significant changes, because it does not produce sex hormones such as testosterone. Instead, it contributes to the production of seminal fluid. As a result, hormonal levels remain stable after surgery.

As with any surgical procedure, there are potential risks such as infections, bleeding, or other post-operative complications. These are generally manageable and common in the context of major surgery. For this reason, close monitoring and regular follow-ups are crucial after operation.

How Is the Procedure Performed?

Today, in most cases, radical prostatectomy is performed using the Da Vinci robotic system, a high-precision surgical method. This minimally invasive technique allows for faster recovery and a lower risk of complications. Moreover, it helps preserve the nerve pathways responsible for erection, which run alongside the prostatic gland.

However, each case is unique. Even with advanced surgical methods, patients must be informed about the possible consequences of the procedure.

Possible Consequences of Prostatic Gland Removal

1. Impact on Sexual Function

If the surgery is successful and the tumor is not extensive, erectile function may be preserved. Nevertheless, temporary or, in some cases, permanent erectile difficulties may occur, depending on how much the surrounding nerves are affected.

One lesser-known consequence is that men who have undergone prostate removal experience dry orgasms - that is, orgasms without ejaculation. This is because the seminal vesicles and ends of the vas deferens, which are responsible for producing and transporting semen, are also removed during operation. As a result, the patient becomes infertile, although libido and the ability to achieve orgasm can often remain intact.

2. Urinary Incontinence

Immediately after surgery, most men experience difficulty controlling urination. This symptom, known as urinary incontinence, is usually temporary and improves over the first few months after surgery.

However, 5–10% of patients may experience persistent incontinence, which can significantly affect quality of life and may require specific treatment.

3. Urinary Incontinence During Sexual Activity

A less common but documented issue is climacturia, which refers to the involuntary leakage of urine during orgasm. Although this condition affects only a small percentage of patients, it may have emotional or relational implications.

Over time, the frequency and severity of climacturia often decrease. Helpful measures include:

• Emptying the bladder before sexual activity;
• Using a condom to better manage any leakage.

4. Pain and Recovery

As with any surgery, post-operative pain and fatigue are common in the days or weeks that follow. Full recovery varies from patient to patient and often involves a rehabilitation program to restore urinary and sexual function.

Recovery Time

The typical recovery time after radical prostatectomy is between 4 and 6 weeks, although returning to full function - especially regarding continence and sexual health - may take longer. Each individual’s experience is unique, and ongoing support can make a meaningful difference in the healing process.

It is important for patients to have realistic expectations and follow medical advice regarding pelvic floor exercises, physical therapy, and, when needed, psychological support.

Conclusion

Prostate removal surgery is a major but manageable condition that can be life-saving in the context of prostate cancer. While side effects related to urinary or sexual function may occur, most are temporary or treatable. With modern surgical methods like the Da Vinci technique and careful medical supervision, many patients are able to return to a satisfying quality of life.

Open discussions with a urologist, proper information, and support from the medical team play a vital role in recovery and long-term adjustment.