Complications and Treatment of Prostate Surgery

Acute (short-term) complications of prostatectomy and their management

These typically appear in the days or weeks after the operation.

Most common acute complications

• Bleeding and hemorrhagic complications – Significant blood loss can occur during or after surgery, which may even necessitate blood transfusion.
• Infections – A urinary tract infection or wound infection may develop.
• Urinary retention – Due to postoperative swelling, the patient may be unable to urinate properly.
• Blood clot formation (deep vein thrombosis, pulmonary embolism) – The risk of clot formation is increased during and after surgery, and clots can travel to the lungs.
• Suture failure – The suture between the bladder and the urethra may not heal properly, which can lead to urine leakage.
• Pain and swelling – Postoperative pain and pelvic swelling can persist for weeks.

Management of acute complications

• Pain relief – Non-steroidal anti-inflammatory drugs (NSAIDs), and opioids if necessary.
• Antibiotics – For prevention or treatment of infections.
• Anticoagulants – To reduce the risk of clot formation.
• Catheter use – Urethral catheterization may be required to ensure proper urine drainage during recovery.
• Wound care – Proper care to avoid wound infections.

Long-term complications of prostate surgery

These are complications that can appear immediately after surgery or months to years later; their effects are often persistent and their treatment can be prolonged.

Most common long-term complications

• Urinary incontinence – Reduced ability to hold urine due to damage to the muscles and motor nerves that control the bladder and urethra.
• Erectile dysfunction – Permanent erection problems may occur due to damage to the nerves that control erection.
• Urethral stricture – Pathological scarring at the surgical site can narrow the urethra, causing difficulty urinating.
• Pelvic pain – Some patients report persistent pelvic pain after surgery.
• Bowel dysfunction – Rarely, dysfunction of the nearby rectum can occur, resulting in defecation problems.
• Infertility – Removal of the prostate and seminal vesicles results in loss of the ability to ejaculate.

Treatment options for long-term complications

Treatment of urinary incontinence

Problems with urine control are very common after prostatectomy, but several treatment methods are available:

Pelvic floor strengthening exercises (Kegel exercises) – Strengthening the pelvic floor muscles helps with urine retention. Muscle strengthening is only possible with regular, persistent training. For Kegel exercises to have a meaningful effect, practice several times daily for at least 10–15 minutes each session. Even then, results may take 5–6 months or longer to appear.

Functional muscle stimulation – a modern treatment method. The effect of Kegel exercises can be enhanced and the time to improvement shortened with electrical muscle stimulation.

For the period until continence returns, a simple device, the Prosecca belt can help discreetly prevent involuntary urine leakage.

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One of the most effective and fastest ways to treat incontinence can be muscle stimulation. Its application is not complicated. The article demonstrates the practical implementation of stimulation.

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Treatment of erectile dysfunction

Erectile dysfunction is one of the most common long-term consequences of prostate surgery. The treatment offers several options.

Vacuum erection device – a mechanical device that creates a vacuum around the penis. As a result, blood flows into the penis, which helps produce an erection. Retention of the erection is then ensured by a rubber ring placed at the base of the penis. The method is safe, non-invasive, and can help virtually everyone.

The Rehabi PVT device is intended for penis training after prostate surgery. It was specifically developed for penile training following prostate surgery.

Prostatectomy can be a life-saving operation, but it may be associated with significant short- and long-term complications. Urinary incontinence and erectile dysfunction are the most common long-term problems, and there are multiple treatment options available for them.

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