The surgical risks associated with all radical prostatectomy techniques (RP and RALP) are similar to those of any major surgery. The level of risk depends in large part on the patient's overall health and age. Rare risks include cardiac or pulmonary events, blood clots or injuries to structures surrounding the prostate. The primary side effects unique to a radical prostatectomy are incontinence and impotence.
Urinary Control: Following surgery, significant bladder control often returns within 12 weeks and continues to improve over 12 to 24 months. Return of function is often dependent on pre-operative urine control and patient weight. For example, men with larger abdomens (that press down on bladder) may have more problems with return of continence. Approximately 1 to 2 percent of patients will have persistent, severe post¬operative incontinence. This group of patients will wear pads, take medication or undergo further procedures to treat this side effect. Mild stress incontinence, which is passing a small amount of urine when coughing, laughing or sneezing, does occur following surgery. Some men may choose to wear pads to protect themselves from unexpected leakage. However, the majority of men do not consider this to be a major issue.
Of patients who undergo a prostatectomy, over 90 percent have excellent urinary control and require no pads or other means of protection.
Sexual Function: Sexual dysfunction is a common problem in both men and women. Sexual problems become progressively more common with aging, heart disease, high cholesterol and diabetes. Prostate cancer and the treatment of prostate cancer can have a significant impact on sexual function. At diagnosis, we assess baseline sexual function. We provide counseling to the patient and his partner about anticipated changes in sexual function and try to predict the likelihood of preserving and recovering sexual function after prostate cancer treatment.