A person can potentially survive without a prostate gland.
Prostatectomy, a surgery to remove the prostate, plays a significant role in managing various prostate-related conditions, including prostate cancer. However, this procedure comes with potential side effects that can impact sexual health, fertility, and urinary function.
Sexual Health
Erectile dysfunction (ED) is a common side effect following prostatectomy, particularly when the cancer is close to the nerves controlling erection. While some men may recover erectile function over time, many experience persistent difficulties.
Another consequence is the loss of ejaculation due to the removal or tying off of the seminal vesicles and vas deferens, which prevents semen production during orgasm. Orgasm may also sometimes be painful or absent, and some men may notice slight penile shortening if the portion of the urethra within the prostate is removed.
Despite these issues, studies suggest that long-term overall health-related quality of life, including sexual function, may not differ dramatically after surgery, although postoperative cancer upgrading can affect quality of life outcomes.
Fertility
Men become infertile after prostatectomy due to the removal of seminal vesicles and the cutting of the vas deferens, preventing semen release. In cases of azoospermia (no sperm in ejaculate), options such as sperm retrieval directly from the testes for assisted reproduction are available, but natural fertility is lost.
Urinary and Bladder Function
Urinary incontinence, especially stress incontinence, is common post-surgery but generally improves within 3 to 6 months. Some men may take 1–2 years to regain full control. A small proportion may require additional treatment for persistent issues.
Overall Life Expectancy
Prostatectomy aims to remove cancer and improve survival. Although postoperative upgrading to higher-risk cancer affects oncologic outcomes and may require additional salvage therapy, it has a low impact on long-term health-related quality of life. Surgery itself does not generally reduce life expectancy; instead, it is curative or life-prolonging in localized prostate cancer.
Additional Notes
Recovery time after surgery includes a hospital stay with catheter use and restricted physical activity for weeks. Potential general surgical risks include infection, bleeding, and blood clots, but these are not specific to sexual or fertility functions.
In summary, radical prostatectomy often results in erectile dysfunction and loss of natural fertility due to anatomical removal, with variable urinary incontinence. While these side effects can affect quality of life, they rarely reduce overall life expectancy if the cancer is effectively treated. Assisted reproductive options exist for men desiring fertility after surgery. Long-term quality of life depends on individual factors, surgical technique, and cancer status.
