Talking about the prostate is not easy. Much less talk about what happens when it stops being there. For many men, prostatectomy —the surgery to remove the prostate— represents a mixture of relief and fear: relief because cancer he left, afraid because no one clearly explained how life changes afterwards.
This is not a text to scare, but to tell the complete truth, without filters or taboos. Because an informed man is not defenseless: he is prepared.
Why is the prostate removed?
There are two main reasons:
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Prostate cancer located, when the disease has not yet spread outside the gland.
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Severe prostate enlargement, so extreme that it blocks urine and does not respond to other treatments.
In both cases, surgery can be life-saving. But it also profoundly changes the functioning of the body.
What really happens during surgery
The prostate is located in an extremely delicate area of the body. She is neither alone nor isolated:
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It is connected to the bladder
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The urethra it passes through its interior
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Around it are the nerves responsible for erection
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They are also removed seminal vesicles
This means that even if the surgery is technically successful, neighboring structures suffer. From there arise the main consequences.
1. Urine loss: the silent battle
After surgery, between the 60% and 80% of men they present some degree of urinary incontinence when the catheter is removed.
It's not weakness. It is not lack of hygiene.
It is a biological consequence.
Most regain control, but it may take time months or even years.
Which really helps
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Pelvic floor exercises (Kegel) well done
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Daily record (several times a day)
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Start even before from surgery, if possible
If after a year the problem persists, there are medical and surgical solutions. No one should resign themselves to living in shame.
2. Erections: the topic that almost no one talks about
After surgery, 100% of men temporarily loses the ability to have erections. In the long term, between the 50% and 90% you will have persistent difficulties, depending on:
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Age
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Previous sexual function
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Preservation of nerves during surgery
Nerves can “turn off” for months. The big mistake is wait without doing anything.
Early rehabilitation: absolute key
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Early rehabilitation: absolute key
If there are no erections for a long time, the penis atrophies. That is why it is essential:
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Oral medication (not as a luxury, but as a treatment)
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Vacuum pump exercises
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Intracavernous injections when necessary
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Prostheses in selected cases
Recover sexuality it's possible- but it requires action, not silence.
3. Orgasm without ejaculation: a definitive change
After a radical prostatectomy:
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There is no ejaculation, in no case
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The orgasm still exists
Surgery -
Pleasure may change, but it does not disappear
This change impacts many men psychologically, because culturally ejaculation is associated with masculinity and power.
If the desire to be a father still exists, it is essential freeze semen before surgery.
The emotional impact: the grief that no one explains
The depression after this surgery is real. It's not weakness. It's grief.
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Grief for a part of the body
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Fear of cancer
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Shame about incontinence
Anatomy -
Sexual frustration
Asking for help does not take away your value. It restores balance.
Talking to professionals, your partner, and other men who have been through the same thing can change everything.
What if the PSA rises again?
In some cases, years later, the PSA may rise again. It does not mean an immediate sentence.
Today there are advanced tools to:
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Detect microscopic recurrences
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Apply rescue radiotherapy
Health problems -
Control the disease for many years
Constant medical follow-up is key.
Practical tips and recommendations
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Find out before surgery, not after
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Start pelvic floor exercises as soon as possible
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Don't wait to treat erectile dysfunction
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Talk openly with your partner
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Don't normalize deep sadness
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Strictly comply with medical checks
Reproductive health -
Seek second opinions if something doesn't convince you
Living without a prostate is not the end of life, but yes, it is the beginning of a different stage. The body changes, intimacy changes, identity is rearranged. Still, life goes on, and it can be fulfilling.
Many men, over time, look back and understand that the price was high, but the life they earned was worth it. With information, support and patience, this new chapter can be written with dignity, strength and hope.
