Complication of Radical Prostatectomy



Traditionally, this has been a greatly feared operation because of the complications and consequences associated; however, thanks to research in recent years, it has been posible to describe the anatomical details and exact location of the blood vessels and nerves that are responsable for both urinary continence and for the erection. Now that the anatomy of the region is known perfectly, the technique has evolved and surgery can be performed while respecting each of these important structures and minimizing the associated risks. These risks are inherent in the general condition of the patient and the surgical procedure itself. They can be classified into general and specific risks.

These are the same complications as for any other surgery, and include the following:

  • Allergic reactions
  • Infecion
  • Pumonary problems
  • Hemorrhage
  • Cardiovascular problems

These are the complications related to the specific surgery used in the treatment of prostate cancer.

  • Intestinal injury: this is the most dangerous of all; it consists of fecal material leaking into the abdominal cavity due to the opening of the colon or rectum during surgery. This complication is very rare.
  • Rectovesical fistula: this is a communication between the rectum and the location where the bladder was joined to the urethra.
  • Urinary incontinence: This is the involuntary loss of urine, requiring the use of diapers. Usually it is transient. The patient progressively notes his recovery. Generally, one year after surgery, 96% of the patients have restored urinary continence.
  • Erectile dysfunction: the difficulty to achieve and maintain erections, due to the loss of the blood vessels and nerves responsible for erection. The way the patient is affected depends on age and the condition of the erections before surgery, in addition to general health conditions and risk factors such as smoking, diabetes, and others having to do with the microcirculation in the penis.
  • Urethral stricture: narrowing of the urethra due to scaring. This can occur anywhere along the urethra, from the tip of the penis to the site where the urethra joins the bladder.

Extract from Prostate Cancer: A Patient’s Guide.