The main side effects of radical prostatectomy (RP) are incontinence and ED (see above).
Normal bladder control usually returns within several weeks or months after surgery. Passing a small amount of urine when coughing, laughing, sneezing, or exercising may last a long time in up to 35% of men. Some patients (between 1% and 5%) have more serious stress incontinence, which may be permanent.
During the first 3 to 18 months after a radical prostatectomy, most men will have erectile dysfunction and will need to use medicines or other treatments if they want to have an erection. The effect of this operation on a man's ability to achieve an erection is related to the patient's age, his ability to get an erection before the operation, and whether nerve-sparing surgery was done.
Nearly all men who have an RP should expect some permanent decrease in their ability to have an erection, but younger men may expect to retain more of their ability. If the surgeon does not remove the nerves on either side of the prostate during prostatectomy, the impotence rate is between 25% and 30% for men under 60. But it occurs in 70% to 80% of men over 70, even if nerves on both sides are not removed.
Incontinence and ED are reported less often among men treated at major cancer centers, such as Roswell Park, where this type of surgery is performed on a more routine basis.
