What Happens During Prostate Surgery
Before having a prostatectomy, a surgeon will either use general anesthesia causing the patient to lose consciousness or they will use a spinal anesthesia which numbs the lower half of the patients body while they remain conscious.
There are two main types of prostate surgery. The more traditional open prostatectomy is when the surgeon will make a large incision in the skin in order to remove the prostate.
The more modern method, and more common these days, is to use minimally invasive laparoscopic surgery. This version will result in the surgeon performing the procedure through four small incisions using a tiny camera and small tools.
What Determines Erection Recovery After Surgery
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.
Recovery Of Erectile Function After Surgery
Upon removing the catheter after surgery, many of you are probably hopeful that things return to normal again but this is often far from the case. As expected, the timeline of recovery varies from man to man, although erectile function can usually be the final hurdle to overcome. This is regularly the symptom holding you back from moving on with your life.
Up to 90% of men have erectile dysfunction in the early stages following a radical prostatectomy, therefore its mostly inevitable. Many of you wont feel any hints of sustaining an erection within the first 3-6 months, which can kill off any sort of hope for a spontaneous return. However, this emphasises the need to complete an early penile rehabilitation program which often includes a daily dose of Viagra, a vacuum device, lube and a box of tissues. Encouraging erections through sufficient stimulation is important, even if you dont achieve 100% of normal, to ensure that your penis tissue qualities are preserved.
Overcoming erectile dysfunction after prostate surgery is a long and enduring path for all men. Ensuring that youre covering all bases early and consistently within your recovery and not having too high of expectations are important elements to successfully manage. Visit us at www.onlineprostate.physio and let us help you get started!
LEARN MORE ABOUT EFFECTIVE MANAGEMENT STRATEGIES FOR ERECTILE DYSFUNCTION WITH OUR ONLINE COURSES
References
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Providing Your Medical History
At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?
As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.
If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.
Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
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Treatments For Erection Problems And Penile Rehabilitation
Different treatments work for different people and they can have side effects. Talk through your options with a doctor or nurse with expertise in this area. Ask them to refer you to your local Erectile Dysfunction Clinic if they are not able to give you this specialist advice.
The aim of penile rehabilitation is to:
- provide a stimulus for erections
This can hopefully help you to adapt to changes in your sexual function and relationships.
A penile rehabilitation programme includes:
- counselling and sex therapy
- healthy living such as exercise, weight control not smoking and pelvic floor exercises
Talk About How You Feel
First off, it is essential to evaluate how you feel.
It is vital to talk about it if you want to improve.
Most men prefer not to talk about this with a professional, and they avoid the topic with their partners.
However, this position will only make things worse with your partner and cause anxiety to you.
After talking it out with a professional, you will see how easy it is.
They are trained to answer your questions and give you recommendations and a variety of options.
Sometimes men are anxious about erections after surgery because they read so much about it.
Their anxiety plays against them, turning a weaker erection function into a complete failure.
Thus, one of the first aspects to consider is your mindset, feelings, and emotions.
Therapy can help a lot if youre struggling.
It is sometimes appropriate to incorporate your partner in the talking, but it is not always required.
Prostate health issues such as benign prostatic hyperplasia and prostate cancer affect hundreds of thousands of men in the United States every year.
If youve been diagnosed with a serious prostate issue, your healthcare provider may suggest a prostatectomy a surgical procedure in which your part or all of your prostate gland is surgically removed from your body.
Prostate removal surgery is usually highly effective at treating cancer and prostate enlargement , but it can potentially lead to complications.
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Why Is There Increasing Concern At This Time Regarding Erectile Dysfunction Issues Following Radical Prostatectomy
The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas. Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return.
Sex After Prostatectomy: What To Expect
A health problem, especially something like prostate cancer or BPH, can take a huge toll on a couple and their sex life.
It leads to stress, emotional pain, anxiety, debt, and more.
If youve had a prostatectomy, you may wonder what you can expect after prostate surgery.
Can you have sex after treatment?
How will the entire prostate surgery experience impact your sex life?
If you want to learn more about sex after prostatectomy, you are in the right place. Here, we will answer all your queries.
Note: The goal of this post isnt to encourage readers to get a prostatectomy. This guideline is for educational purposes only. If anyone struggles with prostate complications, its best to contact a specialist.
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Tips For Talking With Your Partner
Feeling less of a desire to have sex or having trouble getting an erection may affect your relationship. Try to be as open with your partner as you can. Here are some tips:
- Bring your partner with you to doctors visits. Being part of the conversation may help them understand what youre experiencing.
- Listen to your partners concerns, too. Remember that this issue affects both of you.
- See a therapist or a sex therapist to help you work out any issues that are affecting your sex life.
- If sex is a problem right now, its possible to fulfill each other sexually in other ways. Cuddling, kissing, and caressing can also be pleasurable.
What Are The Current Expectations With Regard To Outcomes After Radical Prostatectomy
Following a series of anatomical discoveries of the prostate and its surrounding structures about 2 decades ago, changes in the surgical approach permitted the procedure to be performed with significantly improved outcomes. Now after the surgery, expectations are that physical capacity is fully recovered in most patients within several weeks, return of urinary continence is achieved by more than 95% of patients within a few months, and erection recovery with ability to engage in sexual intercourse is regained by most patients with or without oral phosphodiesterase 5 inhibitors within 2 years.
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How To Cope With Ed After Prostate Surgery
Even when you know that erectile problems are temporary after surgery, it is not easy to experience such a change.
It can turn into a significant burden for your relationship and yourself.
Thus, knowing how to cope with erectile dysfunction is useful, even if you dont experience a complete lack of erections.
Why Does Erectile Dysfunction Happen With Prostate Cancer Treatment
To help you understand why prostate cancer treatment may cause you to have erectile dysfunction, it is good for you to learn how your body may be changed by your treatment. Usually when a man is sexually aroused :
Radical Prostatectomy
Radiation Therapy
Radiation therapy may damage the nerves near your prostate gland that help you have erections. Over time, you may notice that you are not having as many erections as you used to. Some men start having erectile dysfunction six months or more after their radiation therapy. If this happens, the erectile dysfunction usually does not improve.
Hormone Therapy
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The Basics: How An Erection Occurs
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Image: Hank Grebe/Getty Images |
Its usually difficult for a man to get another erection right away. The length of the interval between erections varies, depending on a mans age, his health, and whether he is sexually active on a regular basis. A young, sexually active man in good health may be able to get an erection after just a few minutes, whereas a man in his 50s or older may have to wait 24 hours. One reason may be that nerve function slows with age.
Why Erectile Dysfunction May Result From Prostate Disease
In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. While these factors can cause erectile dysfunction, doctors now think that 70% of the time the problem can be traced to a physical condition that restricts blood flow, hampers nerve functioning, or both. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.
However, some types of prostate disease and treatments may also be responsible.
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Options After Initial Pde
The options for nonresponders to PDE-5 inhibitors include injection therapy, intraurethral prostaglandin, vacuum erection devices, and penile implants. The concomitant use of the PDE-5 inhibitors is discouraged in the regulatory documents for all 3 PDE-5 inhibitors. Nonetheless, there is a rationale for combination therapy. Corpus cavernosum smooth muscle relaxation, and hence penile erection, is regulated in part by increases in smooth muscle synthesis of the second messengers cyclic adenosine monophosphate and cyclic guanosine monophosphate . Intraurethral or intracorporeal prostaglandin E1 increases both second messengers. Therefore, in men with failure of PDE-5 inhibition or prostaglandin therapy, a synergistic effect might occur with combination therapy.
Along those lines, in my practice, I also combine sildenafil with intracorporeal injections in men after radical prostatectomy who are experiencing failure of intracorporeal injection therapy. The combined use of sildenafil with injection or MUSE therapy, though logistically cumbersome, has allowed some patients to avoid implant therapy.25
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Questions To Ask Your Doctor Or Nurse
- How could my prostate cancer treatment affect my sex life?
- Which treatments for erection problems would be best for me? Can I get them on the NHS?
- Is there anything I can do to prepare myself before I start my prostate cancer treatment?
- What happens if the treatment doesnât work? Are there others I could try?
- What other support is available to me?
- Can my partner also get support?
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Q: Does Prostate Removal Surgery Cause Erectile Dysfunction
A:Yes. Erectile dysfunction can and often does occur after a radical prostatectomy the complete removal of the prostate gland. Thats because the operation can sometimes injure tiny nerves, muscles and blood vessels involved in getting an erection.
If you develop ED after undergoing surgery, the problem isnt necessarily permanent. Many men regain full sexual function over time, usually within a year, though for some it can take a few years.
If problems continue, medicines and devices can help. Your doctor may also prescribe medicines and devices during recovery to help bring back erection.
You are more likely to develop ED following surgery for prostate cancer if:
- You are 60 or older
- You had some evidence of erectile dysfunction before surgery
- You are in poor health
Its important to also point out that there are different types of treatments for prostate cancer and many men who are diagnosed dont need to be treated right away. If you have slow-growing cancer, your doctor may recommend observation as the first phase of treatment. Watchful waiting involves monitoring changes in your symptoms and tumors.
Each treatment option for prostate cancer has different benefits and risks. Talk to your doctor about what option is best for you.
For more information about Mount Sinai South Nassaus Center for Prostate Health, .
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What Happens If I Still Cant Have Adequate Erections After My Recovery With Oral Medications
There are several options available in this case. Most of the time it depends on you and your partners goals. Some men manage to have adequate erections with vacuum erection devices, penile injections, and occasionally, urethral suppositories. However, many men prefer the convenience and rigidity that can be achieved with a penile implant. Our clinic can help you choose the ideal option.
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Why Does Prostate Surgery Cause Erectile Dysfunction
Erectile dysfunction refers to a condition that occurs when a man cant achieve an erection or maintain an erection for sexual intercourse. Many factors can contribute to erectile dysfunction including problems with the nervous system, blood vessels and hormones.
There are two small clusters of nerves which control erections that are located on both sides of the prostate. These nerves may become injured during the operation. Your surgeon may also purposefully remove these nerves if there’s a chance that the cancer has invaded them. If these set of nerves are removed, then you wont be able to become erect without being assisted by medical devices.
There is also a type of prostate surgery called nerve sparing prostatectomy, where both bundle of nerves around the prostate are avoided. However, not everyone is suitable for this surgery, and eligibility also depends on the size and location of the cancer.
The Success Rate Of Prostate Surgery
Survival rates can tell you how many people with the same type and stage of cancer are still alive 5 years after being diagnosed. For example, if you have stage 3 colon cancer, there is a 66% chance that 5 years later, you will be alive. But the rates cannot tell you how long you will live. However, they may help give you an idea of how likely your treatment will be successful.
Survival rates are estimates. They are based on data from many people who have had cancer before. These numbers might be confusing because they dont tell you what will happen, but they can help doctors decide treatments. Talk with your doctor to see if these statistics apply to you because they know about your situation.
A relative survival rate tells how likely a person is to survive a particular type of cancer. I.e., if the 5-year close survival rate for prostate cancer is 90%, it means that men who have this type of cancer are about 90% as likely as other men to live a minimum of 5 years after being diagnosed with the disease.
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What Do We Know About Potency After A Robitic Prostatectomy
The return of potency is dependent on several factors:
- Previous sexual function before surgery. Unfortunately, robotic prostatectomy will at best return you to your level of sexual function pre-surgery. It will not improve upon what you already had before surgery.
- Age. Theyounger you are, the better your chances. Men under 65 have abetter chance of regaining potency, or erectile function than those over 65.
- How many nerves are spared. As discussed previously, ideally both nerves can be spared and thiswill give you the highest chance of regain erections. However,even men with no nerve sparing can regain erectile function.
Can You Have Sex After Prostate Removal
The good news is that sex after prostate removal is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.
Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.
Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.
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