Life After Prostate Removal: What To Expect
The prostate gland is prone to inflammation and developing cancer.
Almost half of the men above the age of 60 have benign prostate hyperplasia or prostate enlargement.
However, BPH does not cause removing the prostate, but the presence of cancer or its early sign is the reason for prostate removal.
Prostate cancer has become a significant concern in recent years. Its incidence is increasing, and now its diagnosis is becoming more common even among middle-aged men.
Prostate cancer is now among the most common cancers in older men.
Aging indeed has lots to do with the increased prostate cancer rate, but it is not the only cause. It seems that this disproportionate increase in the annual incidence of prostate cancer also has to do with other lifestyle issues like a high-fat diet, greater prevalence of metabolic disorders, environmental toxins, hormonal changes, and more.
The prostate plays an important role in male fertility and sex life. Although men can survive without a prostate, unfortunately, for many men, prostate removal results in poor quality of life, issues like erectile dysfunction, and more.
Some men can expect to recover well from proctectomy. However, for others the journey to recovery is prolonged and distressing. Keep reading to find out more about life after prostate removal and what you can expect.
Life After Prostate Removal
For many men with prostate cancer, prostate removal is never needed because the cancer is often slow-growing and managed with non-surgical treatments. But, if the cancer has grown beyond the prostate, the oncologist may recommend prostate removal surgery, also called a prostatectomy. If you are going to have prostate removal surgery, this information can help you in your discussion with the doctors.
Can A Man Have A Normal Sex Life After Prostate Surgery
The question is loaded what is a normal sex life anyway? Most men will experience a slowing down or drop off in their sexual activity as they get older.
That said, it is still a source of pleasure and intimacy amongst older couples, and for those for whom it is an important part of their relationship, they are keen to understand what sex after surgery will look and feel like.
The majority of men with a diagnose of localized prostate cancer will undergo a conservative approach known as active surveillance, but some of them will require surgery at some point.
The surgeons will excise the growth, or in some cases remove the entire prostate. There are also less invasive surgeries, such as the TURPs and other non-surgical therapies such as radiation therapy.
With careful intervention, most men will be able to resume a healthy sex life after the initial recovery period.
If you have had a radical prostatectomy without a nerve-sparing technique, theres a high chance you will experience a significant reduction in your sexual sensation and libido
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Who Should Get A Radical Prostatectomy
Men younger than 75 years old with limited prostate cancer and who are expected to live at least 10 more years tend to get the most benefit from radical prostatectomy.
Before doing a radical prostatectomy, doctors first try to confirm that the prostate cancer has not spread beyond the prostate. They can figure out the statistical risk of spread by looking at tables comparing the results of a biopsy and PSA levels.
Other tests to check for signs of spread, if needed, can include CT scans, bone scans, MRI scans, ultrasound, PET scans, and bone scans.
If it appears that the prostate cancer hasnât spread, your surgeon may first offer you other options besides surgery. These can include radiation therapy, hormone therapy, or simply watching the prostate cancer over time, since many prostate cancers grow slowly.
Depending on how high your risk of the cancer spreading is, your surgeon may also consider doing an operation called pelvic lymph node dissection.
After Prostate Removal The Sperm Has To Go Somewhere But Where
Men who are facing prostate removal due to cancer will surely wonder where their sperm will go after removal of the prostate gland. Its fair to wonder about this.
First of all, sperm is produced in the testicles.
People can continue to have orgasms, though, because the nerves that have to do with climax are unaffected, and are actually not related to whether or not someone ejaculates.
The sperm gets broken down and reabsorbed by the body. This is the same process as if someone were abstinent or had a vasectomy.
In short, prostate removal will not affect sperm production or quantity. It only affects what happens to the sperm once its produced.
Unfortunately, removal of the prostate may be more of an issue to a woman than to the man, if she believes she cant enjoy intimate relations without ejaculations.
Men who have partners like this should focus on all that can be done to treat their prostate cancer and prevent a recurrence.
Prostate cancer affects one out of six men as a lifetime risk, and the number it kills every year in the U.S. averages in the high 20,000s.
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When Should I See My Healthcare Provider
Talk to your healthcare provider if you have any of these symptoms after your surgery:
- Bleeding, swelling or drainage from the incisions.
- Inability to have a bowel movement.
- Inability to urinate after catheter removal.
- Increased pain around the incisions.
A note from Cleveland Clinic
Radical prostatectomy is a common surgery to remove the entire prostate gland. This prostate cancer surgery may be robotic surgery or open surgery. Robotic surgery has a shorter recovery time. Full recovery can take weeks, with some side effects lasting for months. Light exercise and medication can help you heal faster.
Last reviewed by a Cleveland Clinic medical professional on 08/03/2021.
References
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What Are The Limitations Of Prostate Ultrasound Imaging
Men who have had the tail end of their bowel removed during prior surgery are not good candidates for ultrasound of the prostate gland because this type of ultrasound typically requires placing a probe into the rectum. However, the radiologist may attempt to examine the prostate gland by placing a regular ultrasound imaging probe on the perineal skin of the patient, between the legs and behind the scrotum of the patient. Sometimes the gland can be examined by ultrasound this way, but the images may not be as detailed as with the transrectal probe. An MRI of the pelvis may be obtained as an alternative imaging test, because it may be obtained with an external receiver coil.
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What Is The Most Common Approach
A technique called transurethral resection of the prostate is considered to be the standard surgical approach. This procedure involves inserting a thin tube called a resectoscope into the urethra and guiding it through to the prostate. The resectoscope is equipped with a tiny camera and an electrical loop that is used to mechanically remove prostate tissue. The loop produces heat at the same time, which quickly seals off the blood vessels. The resectoscope also has valves that regulate the release of fluid to flush the removed tissue out. TURP takes about 90 minutes and is done under local or general anesthetic. Men who have had this procedure usually need to have a urinary for a few days after, and generally stay in the hospital for two to seven days. They then have to rest and take it easy for a few weeks.
Some variations of TURP are also considered to be standard treatments and have similar outcomes and consequences to conventional TURP. These include transurethral electrovaporization , transurethral vaporesection and plasmakinetic enucleation of the prostate .
What Is A Radical Prostatectomy
Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.
The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.
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What Is Prostate Cancer
Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.
Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.
Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.
Ask your doctor to use this picture to show you where your cancer is.
The prostate
The prostate is a gland found only in men, so only men can get prostate cancer.
The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.
There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.
Prostate Cancer Surgery Checklist
Before you have any operation, you may feel overwhelmed. To lessen this feeling, make a checklist of things to remember before the day of your surgery. Some things to remember include:
Personal items. Your comfort is important before, during, and after surgery. Make sure you bring any care items that will help you stay at ease. This might include glasses or contact lenses , false teeth, or a phone charger. Set these things aside in a bag before the day of surgery.
Medications. Bring a bag with all the medications you currently take. Make sure that you bring the labeled containers so that your doctor knows the amount youâre on.
Comfortable clothes. Wear a loose-fitting outfit. Something comfortable, like sweatpants, is always a good option to wear to surgery. Donât wear jewelry or any other metal objects. For your comfort, itâs a good idea to bring a pair of underwear thatâs one to two sizes bigger than what you normally wear. This will give you extra room after surgery.
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What Are The Side Effects
The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .
Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.
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How May Erectile Dysfunction Affect My Sex Life
Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship. You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.
If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.
This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.
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What Does The Prostate Do
As men get older their prostate often enlarges.
Benign prostate enlargement causes men to urinate more frequently and is a common medical condition in men over 50.
BPE does not make a patient more likely to develop prostate cancer, however.
The causes of prostate cancer are largely unknown, although research suggests that it’s linked to obesity and family history.
The Facts On A Psa Test
A PSA or prostate-specific antigen test is a screening test our team uses to check males for prostate cancer. The PSA test is a relatively noninvasive blood test. It checks the levels of PSA in your blood.
The tissues in your prostate gland make PSA. Its made from healthy and cancerous tissues, making it hard to find with this test alone. However, if your examination reveals exceptionally high levels of PSA, youre more likely to have prostate cancer.
Our team often performs a digital rectal exam with your PSA test. Although our team uses this test to find cancer, elevated PSA levels indicate other non-life-threatening issues with your prostate gland.
Because a high PSA result can be a sign of cancer or other problems, our team recommends a prostate biopsy if your results come back elevated. A biopsy is a better way to find cancer if your results arent conclusive from your PSA test.
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What Can I As A Partner Expect
One of the effects of prostate cancer treatment is erectile dysfunction or impotence. This means that your partner may not be able to have erections that are hard enough for him to have sex with you or that he may not be interested in sex because of the medicine he is taking to treat his prostate cancer. This affects not only the man, but you, too, as his intimate partner. If you are the partner of a man with erectile dysfunction, it can be difficult to cope with changes in your sexual relationship. Sometimes men struggle to come to terms with changes in their body image or their ability to perform sexually. This can sometimes result in him staying away from intimate situations where he may feel under pressure to make love. As a partner you may feel rejected by what seems like a lack of sexual interest or intimacy. This may not have anything to do with his feelings for you, but is a result of his cancer treatment. Erectile dysfunction can be difficult for both of you. You may want to reassure your partner that:
- Sex is not as important as long as he is healthy and that he is no less of a man to you
- You will work through it with him
- You understand his feelings
- He is important to you
It may help if you explain to your partner how important nonsexual touching and intimacy such as kissing and cuddling is to you.
Types Of Prostate Surgery
There are several ways of removing the prostate keyhole surgery either by hand or robot-assisted, and open surgery.
Although robot-assisted keyhole surgery is the newest technique, the most recent research suggests all three techniques are as good as each other for treating prostate cancer, as long as the surgeon is experienced. They also have similar rates of side effects.
The advantages of keyhole surgery, both by hand and robot-assisted, are that you are likely to lose less blood, have less pain, spend less time in hospital, and heal more quickly than with open surgery.
Keyhole surgery
Keyhole surgery .
- Robot-assisted keyhole surgery Your surgeon makes five or six small cuts in your lower abdomen and a slightly bigger cut near your belly button, and removes the prostate using special surgical tools. These include a thin, lighted tube with a small camera on the tip. The image will appear on a screen so the surgeon can see what theyre doing. Your surgeon controls the tools from a console in the operating room via four or five robotic arms. Although its called robot-assisted, its still a surgeon who does the operation. You may hear the equipment called the da Vinci® Robot.
- Keyhole surgery by hand As with robot-assisted keyhole surgery, the surgeon will make four or five small cuts in your abdomen. But they will hold the surgical tools in their hands, rather than using robotic arms.
Open surgery
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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