Surgeons commonly perform a prostatectomy to treat prostate cancer. It involves removing all or part of the prostate. However, prostate removal may cause bowel problems in some people.

A prostatectomy is a surgical procedure. Surgeons often perform this surgery to remove tumors from or around the prostate.

Though generally effective in treating cancer, it can cause several side effects, including sexual dysfunction, urinary incontinence, and bowel problems.

This article reviews the bowel-related side effects of a prostatectomy, including how to manage them.

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Bowel problems are a rare complication of prostatectomy.

An older 2011 study examined bowel complications following robot-assisted prostatectomy in 288 participants. Researchers found that only 1.04% experienced bowel injuries during the procedure.

Another study from 2011 found that a prostatectomy may cause irritable bowel syndrome (IBS). Researchers found that those who had an open prostatectomy experienced an increased rate of bowel symptoms, including diarrhea, abdominal pain, and changes in bowel habits.

A more recent 2020 study involving 296 participants looked at the difference in bowel function following nerve-sparing versus non-nerve-sparing robot-assisted prostatectomy. They found that those who underwent nerve-sparing procedures had less bowel impairment 6 months following the procedure compared to the other group.

A study from 2021 looked at the effects of inflammatory bowel disease (IBD) on prostatectomy outcomes. The study included over 262,000 men, with over 3,400 of them living with IBD.

Researchers found that those living with IBD had significantly higher surgery complication rates compared to others in the study — 14.1% for open surgery and 17.2% for minimally invasive surgery.

Additionally, gastrointestinal complications occurred in 3.4% of people with IBD compared to 1.7% of others. The researchers concluded that there is a link between IBD and a higher rate of bowel complications after prostatectomy.

A person may develop IBS following a prostatectomy.

IBS symptoms include abdominal pain with bowel movements.

Other possible symptoms can include:

  • diarrhea, constipation, or both
  • white mucus discharge in stool
  • bloating
  • feeling as if not all stool passed

If the procedure causes bowel perforation, a person may experience abdominal swelling and pain. A bowel perforation can result in a life threatening infection and requires immediate medical attention.

The following lifestyle changes, including changes in dietary habits, can help manage bowel dysfunction after prostatectomy:

  • eating 5 to 6 small meals each day
  • avoiding chewing gum
  • eating foods that are neither too hot nor too cold
  • eating slowly
  • drinking 8 to 10 glasses of water each day
  • taking steps to manage stress
  • avoiding or reducing alcohol consumption
  • taking a bath or using ointments to soothe the anus
  • gently cleaning the anus after each bowel movement

People may also find certain foods help improve or worsen their symptoms.

Some foods that may help someone feel better include:

  • boiled eggs
  • lean proteins, such as chicken and fish
  • white bread, rice, or cream of wheat
  • certain fruits, such as applesauce and bananas
  • well-cooked vegetables and potatoes

Foods a person may want to limit include:

  • overly spicy or hot foods
  • high fiber fruits, vegetables, and grains
  • fat or greasy foods
  • high fat milk products

A person can consider consulting a doctor if they experience any of the following symptoms:

  • fever above 100.5°F (38°C) with diarrhea
  • pain and diarrhea that does not get better
  • signs of dehydration, such as fatigue or reduced or dark-colored urine
  • bloody stools

A person may also experience bowel problems following radiation therapy for cancer.

In most cases, symptoms clear within a few weeks after ending treatment. Less commonly, they can last for months or years.

Radiation for prostate cancer can also increase a person’s risk of developing rectal cancer.

Bowel problems do not occur frequently after a prostatectomy. In some cases, prostatectomy can cause irritable bowel syndrome.

Additionally, living with inflammatory bowel disease may put a person at higher risk for bowel and other prostatectomy-related complications.

Other prostate cancer treatments, such as radiation, can also cause bowel issues. The symptoms can be similar to those of inflammatory bowel syndrome and often clear after treatment finishes.