Prostate Cancer Surgery Risks

The most frequently chosen treatment option for prostate cancer is surgery, officially termed a radical prostatectomy. The cure rate for surgery is excellent, and the negative side effects are usually temporary. It is best to be fully educated and informed, however, about the less common but more severe prostate surgery risks.

Bleeding

• While blood loss has declined dramatically with the use of modern equipment, there is still a 2 to 3 percent chance of bleeding during prostate surgery. Although this is rare, some men may require a transfusion, so it is advised that a patient bank two pints of their own blood prior to the operation.

  Blood platelets typically take about 10 days to turn over, so it is important not to take aspirin or vitamin E. They cause the blood to take longer to coagulate and can lead to serious bleeding during and after surgery.

Urethral Stricture

• The urethra is cut and reconnected during prostate surgery to remove the prostate gland. Scar tissue may build up at the reconnection site causing urinary flow to decrease. This is referred to as an urethral stricture. Usually developing four to six weeks after the operation, a stricture may cause straining and incomplete voiding of the bladder, which can lead to incontinence.

  According to Peter T. Scardino, M.D., chairman of the department of urology at Memorial Sloan-Kettering Cancer Center, 10 to 20 percent of patients will experience a stricture. Most often, treatment involves the insertion of a metal catheter in the urethra to stretch the affected area. If scarring is especially thick, a scope or cutting the stricture may be necessary.

Ureteral Obstruction

• A ureteral obstruction occurs in two out of every 1,000 surgical patients. In rare cases, one of the thin tubes leading from the kidney to the bladder, called ureters, may get nicked or get caught in a suture during the operation. Patients may feel some pain or may also be free from symptoms. The condition, however, can cause kidney damage---thus, surgery is required to relieve the obstruction.

Urinary Fistula

• Another rare risk of prostate surgery is a urinary fistula. This occurs when the surgeon does not rejoin the bladder and the urethra properly, and urine leaks out. This can lead to scarring and risk of incontinence.

Death

• According to the Center of Excellence, the risk of death for men under age 65 from undergoing a radical prostatectomy is one in 1,000. That compares with one in 3,000 for all surgical procedures nationwide. Of course, this risk is increased for older men and for men with additional serious medical conditions.

Other Risks

• Although unlikely, there are risks of serious complications arising within the first 30 days after surgery. They include: pulmonary embolism, inflammation of a vein, urinary tract infections, abnormal heart rhythm and heart attack. In addition, pneumonia is a risk after general anesthesia, and wound infections occur in about 1 to 2 percent of patients.

  While nerve-sparing surgery is a surgeon's first choice, sometimes it is not possible, and permanent impotency may result.