BHP TREATMENT. OPEN PROSTATECTOMY: COMPLICATIONS
Like any surgical procedure, open prostatectomy is not without risks, the chief one being blood loss that requires a transfusion. All surgery involving anesthesia carries the risk of death, but this is extremely rare. The serious surgical complications that sometimes befall patients in the over-50 age group, such as a heart attack, pneumonia, or a blood clot in the lung, are also extremely rare. To help prevent such aftereffects, however, it’s crucial to get moving again as soon as possible after surgery—so be sure to walk, move your legs in bed, and do breathing exercises.
Other complications include epididymitis, if a precautionary vasectomy wasn’t performed during surgery; and bladder spasms (painful, uncontrollable contractions of the bladder, forcing urine out in spurts around the catheter)— which may be largely attributable to the presence of a catheter, and which should improve once the catheter is removed.
After the catheter is removed, some men may have trouble with stress incontinence—when urine leaks during certain physical activities, like running or playing golf. This may be temporary, and may resolve itself during the first few months after surgery. In rare cases, however, it is permanent, either as a result of damage to the urinary sphincter during the operation, or as the inevitable consequence of years of bladder damage, persistent bladder instability and urgency incontinence—when urine leaks as a man who urgendy has to go to the bathroom is trying to get there.
The most common aftereffect of open prostatectomy is retrograde, or “dry,” ejaculation. Impotence (difficulty achieving or maintaining an erection) may affect as many as 15 to 20 percent of men. (This is an unverifiable statistic; it’s tough to try to quantify impotence, because so many factors are involved. For more on impotence, see Chapter 8.)
Also seen, but rarely (in 2 percent of men), is a constriction of the bladder neck, called a bladder neck contracture, which is caused by scar tissue from the surgery. This can be reopened in outpatient surgery by a urologist. (Using a cystoscope, the urologist makes a few tiny cuts to relax the tight scar tissue.)
In rare cases, men may also develop a urethral stricture (scar tissue in the urethra). Most urethral strictures respond well to dilation—stretching the urethra, in one or two sessions. Stubborn strictures can also be treated with tiny incisions, like those done to ease bladder neck contractures.
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Tags: Erectile Dysfunction, Men’s Health