Side effects of prostate cancer surgery

You can expect to return to your usual activities within about six weeks after surgery for prostate cancer. Usually you can start driving again in a couple of weeks, but heavy lifting should be avoided for six weeks. You may experience some or all of the following side effects:

Nerve damage

The nerves needed for erections and the muscle that controls the flow of urine (sphincter) are both close to the prostate. It may be very difficult to avoid these during surgery, and any damage can cause problems with erections and bladder control.

Loss of bladder control

You may have some light dribbling or trouble controlling your bladder after a radical prostatectomy. This is known as urinary incontinence or urinary leakage. You may need to use a pad to manage urinary leakage for some days or weeks after the operation. Bladder control usually improves in a few weeks but it can take up to a year after the surgery. For about 5% of people, incontinence is ongoing and may need an operation to fix. In rare cases, incontinence may be permanent.

For help managing these problems, see Urinary problems.

Changes in erections (impotence)

Problems getting and keeping erections after prostate surgery are common. Erections may improve over months to a few years. It’s more likely you won’t get strong erections again if erections were already difficult before the operation. Learn ways to manage problems with erections.

Changes in ejaculation

During a prostatectomy, the tubes from the testicles (vas deferens) are sealed and the prostate and seminal vesicles are removed, so semen is no longer ejaculated during orgasm. This is known as a dry orgasm.

Infertility

Surgery can cause infertility. If you wish to have children, talk to your doctor before treatment about sperm banking or other options.

Changes in penis size

You may notice that your penis gradually becomes a little shorter after surgery. Regularly using a vacuum erection device can help maintain penis size. Changes to the size of your penis can be difficult to deal with.

This information was last reviewed in April 2020. View who reviewed this content.

Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.

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