Pain after prostate removal surgery is common and typical. However, a small fraction of people experience chronic pelvic pain.

Some pain after prostatectomy, which is also known as prostate removal surgery, is typical. However, it may also indicate an underlying problem, such as nerve damage after surgery.

Sometimes, when pain persists for many weeks following surgery, it may signal an infection or an injury to another structure, such as the rectum. Lymphedema, which can occur if there is an injury to a lymph node, is another cause of postsurgery pain.

Because pain can be a sign of a treatable injury, consulting a doctor about any symptoms that persist longer than a few weeks is important.

Read on to learn more about long-term pain after prostatectomy.

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In most cases, pain improves after a few weeks. However, it can sometimes last longer and even become chronic. When this occurs, it may signal an underlying condition, such as an injury from surgery.

Estimates of how common pain is following surgery vary and depend on the type of pain. For example, a 2021 review points to research estimating that 9.5% to 14% of men experience painful orgasms following radical prostatectomy.

Some of the causes of pain after this type of surgery include:

  • Fistula: Surgical injuries can cause a fistula, which is an atypical growth of tissue between two areas in the body. The fistula itself may cause pain. In some cases, it may also cause other issues, such as infection.
  • Infection: Severe pain may signal a surgical or wound infection, especially if a person also has a fever. Sometimes complications of surgery, such as fistula, increase the risk of infection.
  • Other treatments: People who undergo prostatectomy may also undergo other treatments, such as radiation therapy to kill cancer, which may lead to radiation-induced cystitis. Cystitis can cause pelvic pain along with frequent urination or incontinence.
  • Nerve injuries: Surgery on or around the prostate may injure surrounding nerves. This can cause nerve pain and unusual sensations that may radiate to other areas of the body, such as the legs or rectum.
  • Lymphedema: Surgical damage to the lymph nodes around the prostate and radiation treatment may cause lymphedema. Depending on the location of the damage, painful swelling may occur in the groin area or in the lower limbs.

It is typical for a person to experience some degree of pain after surgery. They may need to stay in the hospital for a few days following surgery and may need pain medication for several days to weeks.

It is not typical for pain to be severe, get steadily worse, or persist for several months. Pain that radiates elsewhere in the body, numbness, and pain during an orgasm could also suggest an underlying issue.

If a person develops a fever, unusual discharge, or pain elsewhere in the body, this may be a sign of a complication, such as infection.

To diagnose the cause of pain after prostate surgery, a doctor will ask about the specific symptoms a person has and when they have them.

They may also examine the genital area and order internal imaging scans to look for damage that may not be visible from the outside.

Treatment for pain after a prostatectomy depends on the cause of the pain and how severe it is.

Physical therapy may help with unexplained pain, nerve pain, injuries from surgery, or post-surgical lymphedema. Compression therapy may also help with lymphedema.

A person may also benefit from pain medication if the pain is severe. In some cases, they may need additional medication, such as antibiotics, for an underlying infection.

In severe cases, a person may need follow-up surgery, especially if they have a fistula, an infection in the pubic bone, or damage to surrounding structures.

A person needs to contact a doctor if they:

  • have pain that lasts longer than a doctor says it should
  • have pain that gets steadily worse
  • develop symptoms such as painful orgasms or urination
  • experience pain different from what their doctor told them to anticipate, such as radiating pain
  • develop swelling in the groin
  • have a fever or other signs of infection

Prostatectomy can save a person’s life and lower their risk of severe complications from cancer and other diseases. While pain is common after any surgery, it may also be the body’s way of signaling that there is a health issue.

Chronic pain is not an inevitable outcome of a prostatectomy and is not something a person has to learn to live with.

People who experience pain following a prostatectomy need to speak with a doctor. They may need additional treatment or follow-up surgery.