Potential Risks and Complications
Although both the open and robotic radical prostatectomy have been proven to be very safe, all surgical procedures have risks and potential complications. The complication rates between the open and robotic approach are similar, and include:
- Bleeding: Blood loss has been demonstrated to be reduced during robotic prostatectomy, and very rarely is a transfusion necessary. The risk of requiring a transfusion after open surgery is slightly higher. If you are interested in donating your own blood prior to surgery and having it available to be transfused back to you after surgery, contact your surgeon at least 2 weeks prior to surgery.
- Blood clots: Patients undergoing prostatectmy are at risk for blood clot formation; such clots are referred to as deep vein thromboses (DVT). When these clots form, they can break free and travel in the blood stream, ultimately getting lodged in the lungs; this is known as a pulmonary embolism (PE) and can be a life-threatening complication. Precautions are taken to avoid DVT and PE during prostatectomy.
- Infection: All patients are treated with broad-spectrum intravenous antibiotics prior to starting the surgery to decrease the chance of infection from occurring after surgery. If you develop any signs or symptoms of infection after the surgery (fever, drainage from the incision, urinary frequency/discomfort or pain) or anything else that you may be concerned about, please contact us at once.
- Hernia: a hernia is when one of the incisions used for surgery weakens and bulges outward. Hernias after radical prostatectomy are uncommon, but can occur.
- Tissue / Organ Injury: Although uncommon, during any surgery there is risk of injury to surrounding tissue and organs including but not limited to the intestines, rectum, blood vessels, nerves, muscles, bladder, and ureters, which could require further surgery. In addition, injuries to nerves and/or muscles can occur from being immobile on the operating room table for extended periods.
- Incontinence: Prostate cancer surgery can effect urinary control and result in urine leakage. Fortunately, with modern surgical techniques. Most men (>90%) are dry after radical prostatectomy in contemporary experience. Leakage of urine is common, however, after catheter removal and can last weeks to months until control is re-established.
- Erectile function/Potency: Prostate cancer surgery can damage the cavernous nerves, also referred to as the neurovascular bundles, that lead to erections. Erectile function after radical prostatectomy depends on many factors, including patient age, preoperative potency, degree of nerve-sparing during surgery, etc. Speak with your surgeon to learn more about potency and prostate cancer treatments.
- Conversion to Open Surgery: Rarely, a surgeon performing a robotic radical prostatectomy may require conversion to the standard open operation if difficulty is encountered during the robotic procedure. This could result in a larger standard open incision and possibly a longer recuperation period. This occurs in less than 1% of patients undergoing a robotic prostatectomy.