A study published in the journal Research and Reports in Urology found that the rate of prostatectomy-related regret increases over time, with up to 47 percent of men reporting regret five years after surgery.  You can read the original article here: “How to Avoid Buyer’s Remorse After Your Prostatectomy”  According to the National Cancer Institute, nearly half of all men diagnosed with prostate cancer in the U.S. choose surgery.

One author’s mind-set nearly 2 years following his surgery is “I want my prostate back.”  The possible side effects that weren’t stressed to him, or just not mentioned prior to his treatment have led to major “buyer’s remorse.”  There are multiple reasons why patients experience buyer’s remorse following their robotic surgery for prostate cancer.

The first source of buyer’s remorse comes from believing exaggerated and unsubstantiated claims.  A 2011 Johns Hopkins School of Medicine study found that 164 hospital robot-surgery websites surveyed “overestimate benefits, largely ignore risks and are strongly influenced by the manufacturer.”

A second source of buyer’s remorse comes from miscommunication/misunderstanding between the surgeon and the patient about regaining urinary control.  What one surgeon defines as urinary control- “using one pad a day,” can be different from another- “living without a pad is urinary control.”  Another urinary side effect that can have devastating effects is urine leakage.  Yes, urinary leakage can occur when the bladder is full and a patient coughs, sneezes, or lifts a heavy object, but it can also be in the form of climacturia.  Climacturia is when there is urine leakage before or during orgasm.  According to the International Society of Sexual Medicine, “an estimated 22% to 43% of men experience climacturia after prostatectomy.”  For many patients it can be a distressing situation for both men and their partners, putting a strain on the relationship and/or marriage.

The third source of buyer’s remorse occurs during the discussion about the return of erectile functioning.  Many men believe that a return of sexual functioning means a return to their pre-surgery ability and sex life, but for many that is not what it means.  Post-surgery changes can include loss of ejaculation, temporary impotence, medical interventions such as a vacuum pump, ED medication, or penile injections, changes in intensity of orgasm, penile shrinkage, climacturia, and changes in desire for sex, and potency.

Whether you choose surgery or one of the other treatment modalities, it is imperative for the patient to understand all of the quality of life issues and changes they’ll experience with each treatment option.

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