FAQs Laparadoscopic surgery for prostate



What are the risks and possible complications?

Since minimally invasive laparoscopic methods are used, the risks and probability of post-intervention complications are very small. However, among the complications that may occur are:

Blood in the urine (hematuria).

Infections, especially urinary tract (UTI).

Post-surgical pain, what e is treated with pain relievers.

Hematomas at the sites near the laparoscopy holes.

According to the European Association of Urology, it is estimated that almost 9 percent of men who undergo this procedure develop urinary incontinence because some nerve bundles that control the bladder sphincter muscle are likely to be cut during the removal of the prostate. , which relaxes during urination. It is difficult to predict how likely you are to cause urinary incontinence before surgery.

How long is it possible to have a completely normal urinary function?

Men who undergo laparoscopic prostatectomies again enjoy a completely normal and voluntary urinary function, without discomfort or signs of obstruction, about three months after surgery.

It must be taken into account the significant percentage of patients who, due to prostate disorders (such as benign prostatic hyperplasia or malignant gland tumors) lost the ability to urinate calmly, so three months is longer than positive to regain this function.

What other self-care can be taken at home after surgery?

After the surgery, the doctor will give specific instructions on the care of the operation site to speed up the healing and recovery process. More specifically, of the incisions that were made in the skin and, for this, the care is as follows:

• Place sterile adhesive, especially for these cases, on the incision site for about 10 days to two weeks after the intervention. This will help each incision stay as dry, clean, and protected as possible from clothing rubbing.

• Avoid taking aspirin to treat pain, in that case, it is possible to take over-the-counter pain relievers such as acetaminophen.

• It is normal for the skin near the incision sites to change color and become a little bluish or dark. This is completely normal and will go away on its own after a couple of days.

• When to drive a car again is a frequent question among men undergoing this surgery and the truth is that there is no set time, but in most patients they can do it again in about 10 to 14 days. All this depends on the doctor's instructions.

Could erectile dysfunction develop from such a surgery?

Erectile dysfunction (ED) represents the most important and most prevalent risk that is run when performing a radical prostatectomy, regardless of its surgical modality. Obviously, doctors are very careful when removing the prostate and leaving the bundle of nerves that supply the penis and genital structures intact. However, the anatomy indicates that there is a close relationship between the gland and these nerves, so when removing it, it also takes some nerves with it, reducing the sensitivity of the area and the erectile response of the corpora cavernosa. However, all is not lost. If male sexual impotence, erectile dysfunction or weak erections occur, other therapeutic methods can be used to maintain the active sexual life of patients.

These therapeutic methods include:

Phosphodiesterase 5 inhibitor drugs, better known as retardants of the sildenafil, taladafil or vardenafil type. Generally orally, in tablets.

Intracavernous injections of vasodilator drugs, with excellent results in the short and medium term.

Suction or vacuum pumps.

Penile implants.

The European Association of Urology speaks of a 40.9 percent risk of developing ED after a radical prostatectomy intervention.

Can I have problems with fertile function after undergoing surgery?

No, because the prostate that will eventually be removed does not have the function of producing sperm (this occurs in the testicles, inside the scrotum).

After surgery, ejaculations will be slightly less abundant (because the prostate produces some semen) but the ability to fertilize remains intact unless there are problems with the testicles.

In which cases should I call the doctor?

If you are in the recovery period and notice the following symptoms, it is important to call your doctor or go for a consultation:

Fever over 40 ° C.

If the pain is very strong or does not go away with the indicated painkillers.

Difficulty urinating or blood in the urine.

Dizziness and vertigo.

Is it necessary to use a urinary catheter to urinate after the intervention? How long should it be in place?

Yes, it is necessary to use a catheter or bladder catheter for some time after (a couple of days) laparoscopic radical prostatectomy surgery because it is necessary to give the urethral tissues an opportunity to reconnect and heal.

Which patient is a candidate for to have laparoscopic prostate surgery?

Any male patient diagnosed with localized prostate cancer without metastasis may be a candidate for laparoscopic radical prostatectomy.

However, each case must be treated and evaluated individually since in rare cases, a tumor not so well located within the prostate glandular tissue can be approached by laparoscopic methods.

Can you have sex after laparoscopic prostate surgery?

Doctors recommend absolute sexual abstinence for one month after such an intervention. This withdrawal includes penetrative sex, masturbation, and ejaculation (ejaculation may be painful or bloody).

If I develop erectile dysfunction from laparoscopic prostatectomy, what can I do?

Developing minor erectile problems after a potentially life-threatening organ has been removed is somewhat minor. In fact, it is rare with this technique and men continue to enjoy active and fulfilling sex lives.

In many other cases, erectile dysfunction was already an underlying problem. That is, it was already present before surgery (especially in obese, diabetic, hypertensive or very old patients).

Among the alternatives to treat erectile dysfunction are:

• Phosphodiesterase 5 inhibitor drugs such as sildenafil, taladafil or vardenafil that favor the relaxation of the blood vessels that go to the penis and therefore, the erection mechanisms are enhanced.

• Intracavernous injections of alprostadil, a drug with a vasodilator effect that infiltrates the base of the corpora cavernosa of the penis and has a long-lasting effect.

• Vacuum pumps, suction devices into which the penis is inserted in a flaccid state to induce an erection.

• Penile implant surgery, a definitive and surgical solution to the problem.


Dr. Natalio Cruz

Natalio Cruz MD, with 25 years of medical experience, has been until 2016 Head of the Andrology Unit in the Urology Service of the Virgen del Rocío Hospital in Seville, National Coordinator of Andrology in the Spanish Association of Urology (AEU) and General Secretary in the ESSM, positions that he has narrowed to focus squarely on this exciting project of offering a high-level private medical consultation in Marbella, Seville, Madrid and Tenerife.


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