When ‘elective’ doesn’t mean optional: Lloyd Austin’s cancer surgery

A prostatectomy, the surgery Austin underwent last month, can be serious and is required for some patients, even if not urgently, said Dr. Quoc-Dien Trinh, co-director of the Dana-Farber/Brigham and Women’s Prostate Cancer Center. The procedure removes some or all of the prostate to remove the cancer.

There are minimally invasive versions of the surgery, which are done with robots — Austin’s doctors described his procedure as “minimally invasive” — as well as a more traditional open version.

Austin’s symptoms after surgery — severe abdominal, hip and leg pain and nausea — were not among those considered typical by the Mayo Clinic, which says serious complications are rare.

The Pentagon said Austin’s complications were the result of a urinary tract infection and that collections of abdominal fluid had impaired his small intestines.

Yerram and Trinh, emphasizing that they did not have all the details, said Austin’s complications indicated he had a urinary leak. After the prostate is removed, surgeons must reconnect the bladder to the urethra, which can sometimes be the site of a leak.

“It’s a known complication of surgery — it’s not very common, but it’s known,” Yerram said. “They have an excellent prognosis of recovery if diagnosed promptly and treated promptly.”

Yerram said he believed a leak likely caused Austin’s bowels to stop working. Drainage is the most common way to treat the condition, and the Pentagon said that Austin’s doctors had inserted a tube through his nose to drain his stomach.

Patients often fully recover in a matter of days or weeks and the Pentagon said that Austin’s infection had cleared and that his doctors anticipated a full recovery.

Patients usually recover from the surgery in four to six weeks, according to the Mayo Clinic.