Results vs risks of surgery

The effectiveness of your surgery depends on your age and overall health.

Results

If you have benign prostatic hyperplasia, surgery can relieve urination problems and other symptoms as well as reduce the risk of acute urinary retention.

Risks 

As with any medical procedure there are some potential risks. While rare, there are major possible side effects associated with prostate surgery. The chance of side effects and complications depends on the exact type of procedure you’re having and other factors, including your general health.

Common conditions that may affect your outcome include diabetes and obesity. Smokers are also at a higher risk of complications following surgery. You won’t be able to smoke during your hospital stay so this could be a good time to quit.

Infection

The risk of infection in your urinary tract is low. Your surgeon will give you antibiotics during your surgery to reduce your risk. Rarely, infection can occur in the lungs (pneumonia). After open surgery, you can get an infection in your wound.

Blood loss and transfusions

Some blood loss during your surgery is expected and occasionally a blood transfusion is needed. Two per cent of men experience persistent bleeding.

Dry orgasm (retrograde ejaculation)

After prostate surgery (with the exception of Urolift® surgery) semen will go up into your bladder rather than out of your penis with ejaculation. It’s not harmful and it’ll come back out when you urinate. However, it can affect your fertility.

Difficulty urinating

This can occur for a few days after surgery. You’ll have a urinary catheter for the first few days after surgery which will make it easier. You may go home with the catheter still in place.

Constipation

You may experience constipation after surgery. This can be due to the effect of the surgery on your bowel, the side effects of opioid painkillers, a change in your usual diet or a reduction in your usual activity levels.

Urethral narrowing or bladder neck contracture

This can happen sometime after surgery. Scar tissue can form in your urethra or around the neck of your bladder causing symptoms similar to your pre-operative ones, such as slow stream, urgency, dribbling and urinary retention. Four per cent of men who have TURP are affected.

Transurethral resection syndrome

This is a rare but very serious complication. If your body absorbs too much of the water used to irrigate your bladder during the surgery, you can experience sleepiness, tiredness and confusion after you wake up. Left untreated, the problem can escalate to cause serious problems with your heart and brain.

Bladder perforation

In transurethral resection of the prostate, with or without laser, perforation of your bladder wall can occur because of the heat generated by the instrument.

Recurrence of enlarged prostate

Unlike surgery for prostate cancer, your entire prostate isn’t removed when you have surgery for enlarged prostate. After your doctor removes part of your prostate, it may become enlarged again requiring another surgery some years down the track. Ten per cent of men who have a TURP need to have it done again within 10 years.

Erectile dysfunction

It’s uncommon, but some men suffer erectile dysfunction after surgery for an enlarged prostate. Up to 10% of men who have TURP are affected, although it may just be a temporary problem. If it happens to you, your surgeon may prescribe medications to improve your sexual functioning.

Incontinence

Your prostate is located close to your urethral sphincter and injury to it can lead to urinary incontinence. If your prostate has been blocking your urethra for a long time, the sphincter may be very weak and you’ll need to strengthen it by doing pelvic floor exercises.

Deep vein thrombosis/pulmonary embolism

After surgery, blood clots can develop in the veins of your calf. These clots can travel to the lungs causing a pulmonary embolism, which may be fatal in rare cases. To prevent this, you may be given blood-thinning medication after the surgery. You may be given compression stockings and/or a machine that compresses your calves. If you smoke or are obese, your risk of blood clots is increased.