These are among the most common, and potentially most serious, complications of radical prostatectomy. Blood clots that form in the legs’ deep veins (this is called deep venous thrombosis) can be, at best, painful. At worst they can be fatal. The leg veins are, as one doctor describes it, “a straight shot to the lungs”; the worst-case scenario here is for a chunk of a blood clot in the leg to break free and shoot up to the lungs.

Blood clots in the legs can occur in as many as 12 percent of men after radical prostatectomy, and pulmonary embolisms, or blood clots in the lungs, occur in an estimated 2 percent to 5 percent of these men. (In one Johns Hopkins study of 1,300 radical prostatectomy patients, fewer than 2 percent had a blood clot, and two men died of a blood clot.)

Clearly, the best way to deal with this problem is to prevent it from ever happening. Some doctors do this by administering blood-thinning medications such as mini-dose heparin before surgery. Some doctors also give their patients compression devices—various forms of heavy-duty support hose—for the legs. One of these looks like a pair of “long Johns,” and is designed to force all blood into the deep veins, and keep the flow powerful and continuous. (Sluggish blood flow leads to clot formation.) Other hose have special compression chambers that control blood flow, and are designed to “milk” blood up the leg.

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