Urinary Complications After Prostate Cancer Treatment

Prostate cancer treatment may include radiation, high intensity focused ultrasound (HIFU) or radical prostatectomy.

These therapies can cause urinary complications such as:

  • Urinary incontinence: This typically occurs with minimal leakage and only with heavy activity. More severe urinary incontinence involves leakage throughout the day (requiring a heavy pad). An artificial sphincter can be effective in treating moderate to severe male stress incontinence.
  • Rectourethral fistulas: Also known as a urinary rectal fistula, a rectourethral fistula is a small hole that forms between the urethra and the rectum.
  • Urethral fistulas: An abnormal opening within the urinary tract
  • Urethral stricture: An obstructed or blocked urethra, which can make it difficult to urinate. When the connection narrows due to scarring, it is called a bladder neck contracture (can occur after radiation). Symptoms include straining to urinate, a feeling of incomplete bladder emptying, and reduced flow rate.
  • Erectile dysfunction: A common complication that can occur after radical prostatectomy, a procedure that treats prostate cancer by surgically removing the prostate, parts of the vas deferens, seminal vesicles, and nearby tissue. In the process, nerves that are crucial for erectile function are severed. Despite the use of advanced, nerve-sparing techniques, achieving erectile function naturally can take up to two years. 

Dr. Jill Buckley investigates current approaches to anastomotic stricture and rectourethral fistula following radical prostatectomy. Read the publication on Pub Med Health

Our reconstructive urologists have expertise in treating urinary complications that arise after prostate cancer surgery and radiation. We are skilled in procedures that can help restore erectile function after radical prostatectomy, including:

  • Penile implants (prosthesis)
  • Vacuum constrictive devices
  • Vascular surgery

Prosthesis surgery is not usually recommended unless spontaneous recovery of erectile function seems unlikely. Mike Hsieh, MD, urologist and male fertility expert, is currently exploring outcomes of penile prosthetic surgery. Learn about male fertility and sexual health at UC San Diego Health.

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Meet Our Specialist

Dr. Jill Buckley, a leading expert in male reconstructive urology, has co-authored numerous research studies and several surgical textbooks on urethral reconstruction, acute urinary trauma management and genitourinary reconstruction. She is nationally recognized for her work in complex urinary reconstruction.