Sexual and Urinary Function after Prostate Surgery – What To Expect

There’s a Rolling Stones’ song with lyrics reminding us that we can’t always get what we want, and that sentiment may be relevant to men who have unrealistic expectations about their sexual and urinary function after prostate surgery (prostatectomy). A new study finds that nearly 50 percent of men who had a prostatectomy expected better sexual function and urinary continence one year postsurgery than what they got, even though they had extensive preoperative counseling about the side effects of the procedure.

A total of 152 men scheduled to undergo prostatectomy received comprehensive preoperative counseling before surgery. After counseling, they completed a questionnaire which asked them about their expectations regarding side effects such as sexual function, urinary incontinence, bowel incontinence, urinary irritable symptoms, and hormone function.

One year postsurgery, the same men were again asked to complete a questionnaire about their side effects and expectations. How well did the men’s presurgery expectations match their one-year postsurgery reality check?

When it came to the men’s expectations regarding bowel and hormonal function, the before and after thoughts were fairly close. However, their expectations about urinary incontinence and sexual function did not fare as well. Thirty-six percent of men expected their urinary incontinence to be the same one year after surgery as before surgery, while 40 percent of men expected their sexual function not to change at all.

In addition, 47 percent of men had worse than expected outcomes in urinary incontinence and 44 percent had worse than expected outcomes in sexual function at one year postsurgery. A surprisingly significant percentage of men even expected their urinary incontinence and sexual function to get better after surgery than it was before going under the knife: 12 percent and 17 percent, respectively.

According to Daniela Wittmann, MSW, sexual health coordinator at the University of Michigan prostate cancer survivorship program, preoperative counseling “alerts men to urinary and sexual problems after surgery,” but that “we can only inform men in terms of overall statistics. We can’t predict for the individual. This may mean that, if in doubt, people tend toward being hopeful and optimistic, perhaps overly optimistic.”

Remember the Rolling Stones’ song also mentioning that we get what we need? The University of Michigan researchers suggested that it is important that men about to undergo prostatectomy be provided with preoperative education as well as tools for urinary and sexual function recovery postsurgery. “We also need to help men and their partners with the recovery process after surgery in order to help them regain their intimate lives,” noted Wittmann.

Read more in our Prostate Cancer Health Center.

References

University of Michigan Health System

Wittmann D et al. Patient preoperative expectations of urinary, bowel, hormonal and sexual functioning do not match actual outcomes 1 year after radical prostatectomy.  Journal of Urology 2011 Aug; 186(2): 494-99