The two most feared side effects of total prostate removal (radical prostatectomy) are permanent impotency (loss of erections) and permanent urinary incontinence. These side effects can occur but, in fact, seldom do with an experienced surgeon. But, they can also occur, regardless of the surgeon. Other more common side effects are as follows: Sometimes, the bladder capacity is smaller after prostate removal and, therefore, urination is more frequent. Some patients have urgent urination if they try to hold it too long. Other possible problems are scar tissue formation (stricture) between the bladder and urethra that causes blockage of the urinary stream. Sometimes it is detected years after the operation. Also, after total removal of the prostate, there is little, if any, ejaculate, although there is the sensation of climax and orgasm. In many patients, there is retraction of the penis that gives the appearance of shortening; however, with return of erections, this retraction diminishes.