Why Does It Take So Long To Recover Erections After The Very Best Surgery
A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.
Mechanisms Of Ed After Turp
There are two mechanisms for ED after TURP: as men age, the rate of ED increases so for some men its incidental that they have TURP and their ED flares up the heat generated during TURP, especially if the resection is thorough or the prostate is small can damage the nerve fibers that run alongside the prostate gland and innervate the penis. This can lead to ED. The risk of ED attributable to TURP as distinct to aging is somewhere in the range of 15% based on data from randomized controlled studies.
Randomized studies show that after TURP, some men experience worsening erectile function, and some experience improvement.
Did you know?Dr. Shteynshlyuger has performed over 1,000 surgeries and procedures for enlarged prostate, including Rezum, Urolift, prostate enucleation, laser ablation of the prostate, and TURP. He performs over 100 prostate procedures a year.
Cost of Enlarged Prostate Treatment without Insurance
At New York Urology Specialists, we offer affordable treatment for men. Our prices are low for patients without insurance and for those who have high insurance copays, high deductibles, or insurance plans that do not cover treatment costs.
At New York Urology Specialists, we offer a flat-fee all-cost-included Urolift procedure. The procedure is performed in our office under local anesthesia. Men from other states can save thousands of dollars over local hospital fees by coming to New York Urology Specialists for treatment.
Cialis For Treatment Of Urinary Symptoms Caused By Enlarged Prostate
Cialis 5 mg, when taken daily, can help men with both problems, erection problems, and urinary problems. Cialis works best for men with mild to moderate symptoms of an enlarged prostate. If you are taking Cialis daily and still have to wake up at night to urinate, have frequent urination or slow urine stream, other treatment options for enlarged prostate should be considered. These include medications such as Flomax, Detrol, finasteride and procedures such as the Urolift system for BPH and laser enucleation of the prostate.
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How Can You Prevent Bph
The following lifestyle changes can prevent BPH:
- Patel ND, Parsons JK. Epidemiology and aetiology of benign prostatic hyperplasia and bladder outlet obstruction. Indian J Urol. 2014 Apr 30:170-6. do: 10.4103/0970-1591.126900. PubMed PMID: 24744516 PubMed Central PMCID: PMC3989819.
What Is Prostate Enlargement
Enlargement of the prostate occurs when the prostate gland cells begin to multiply and cause the prostate gland to swell. This swelling tends to compress the urethra, limiting urine flow and causing symptoms known as lower urinary tract symptoms . BPH is a condition that many men encounter with aging.
Most of the symptoms of BPH are associated with urinary function. They are:
- Frequent need to urinate
- Urinary retention inability to empty the bladder
- An intense urge to urinate, even shortly after urinating
- A weak urine stream or an interrupted urine stream
- Difficulty starting or stopping urination
While BPH itself is not a directly linked cause of sexual problems, most men that suffer from it do indeed find it affects sexual performance. Some common sexual side effects of BPH are:
- Inability to maintain an erection
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Assessing Your Cardiovascular Health
Your GP may assess your cardiovascular health. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease .
Your GP may:
- reducing stress
As well as helping to improve your erectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease .
Read more about preventing cardiovascular disease
Natural Ways To Overcome Erectile Dysfunction
Can you run as fast as you did when you were 20 years old? Hit a baseball as far as you once could? Bash a tennis ball with the same speed and spin?
But even as we age, there are still plenty of ways to stay in the game and enjoy it. Thats as true of sex as it is of sports.
Erectile dysfunction can occur for many reasons. Sometimes it is as simple as the side effect of a particular medication. But for roughly 75% of men, the cause is more complex. ED may result from vascular disease, neurological disease, diabetes, or prostate-related treatments or surgeries.
Whether you currently suffer from ED or are hoping to sidestep this condition, try these tips to overcome ED for better health and a better sex life.
For more on diagnosing, treating, and learning how to overcome ED, read What to do about Erectile Dysfunction, a Special Health Report from Harvard Medical School.
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Can You Take Erectile Dysfunction Medications If You Are Taking Prostate Problems Medications
Actually, yes. Taking medication for erectile dysfunction may also be useful in treating the symptoms of something like benign prostatic hyperplasia .
In fact, there is a medication that’s used to treat both problems with an erection as well as issues that have occurred from an enlarged prostate.
Let’s take tadalafil for example. This medication can treat both issues, and it can also treat pulmonary hypertension. This medication is more well-known as Cialis or at Adcirca.
It might also be beneficial to know that some men who have an enlarged prostate and erectile dysfunction often experience alleviation of their symptoms after erectile dysfunction medications.
Does Enlarged Prostate Cause Ed
Of the many symptoms caused by BPH, one of the most common complaints men have when visiting a urologist is Erectile Dysfunction or ED. This is defined as the inability of a man to attain or maintain an erection sufficient for vaginal penetration and satisfactory sexual performance.
BPH does not directly cause ED, but many men with BPH seek medical attention to relieve ED.
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Why Choose New York Urology Specialists For Treatment Of Erectile Dysfunction
- All treatment is performed by a board-certified urologist experienced in treating men with symptoms of ED, premature ejaculation, and other sexual problems using medical therapy, minimally invasive therapies, lasers, and surgery.
- We are one of the few practices in the region to offer a full range of options for the treatment of sexual, and erection problems in men.
- We offer diagnostic testing in our office which avoids hospital costs.
- Extensive Experience: Thousands of men have treated successfully using medical therapy, shockwave therapy for ED, penile injections with Trimix, and penile implant surgery.
- Confidential and Understanding Care. We understand that most of our patients desire privacy. We see patients with a variety of urological problems. Your reason for visiting us is entirely confidential.
- We are one of the few practices in the region to offer a full range of options for the treatment of sexual and erection problems in men.
- We are conveniently located within 30-60 minute commute to men who are seeking ED treatment in Manhattan, Brooklyn, Queens, Staten Island, Westchester, Long Island, Bronx, and New Jersey.
The Link Between Bph And Ed Is Probably More Complex Than We Appreciate
It has been noted that men who have enlarged prostate and BPH are more likely to have ED. The question is why?
BPH is a significant health issue for men. It has a greater impact on health than is generally appreciated. The direct effect of BPH is to cause urinary symptoms, slow urinary stream, and frequent urination. It causes numerous quality of life issues such as poor sleep, social restrictions on travel because of the constant need to void. It can lead to urinary incontinence and depression.
It appears that the relationship is due to a common risk factor, age as well as the effect of BPH on sleep and hormonal milieu. Aging is associated with increased risk for ED as are hypertension, obesity, and diabetes. These conditions tend to have onset around the age when BPH becomes symptomatic close to age 50-60.
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Treatment Options With Minimal Side Effects
Another new and exciting FDA-approved treatment for BPH is Urolift. The Urolift procedure an effective treatment option for BPH, which involves an office-based insertion of a urethral trans-prostatic implant. Analysis of a randomized control trial revealed that there are no ejaculatory side effects and no erectile side effects many men actually experienced a slight improvement in sexual function.
Other good treatment options for men who are concerned about sexual dysfunction from the treatment of BPH are minimally-invasive treatments that include the Rezum procedure. Rezum therapy has a very small risk of retrograde ejaculation of < 5% the risk is much lower with Rezum than with TURP.
Erectile Dysfunction And Lower Urinary Tract Symptom Severity
The severity of ED was directly related to LUTS severity, and majority of patients with high severity score had ED. This finding was similar to the study carried out by Darab et al. using IPSS and IIEF questionnaires to assess LUTS caused by BPE and ED, respectively, and showed that sexual function can be severely affected by LUTS severity.
The point prevalence of ED in this study was 32.5% for mild ED, 29.9% for mild to moderate ED, 12.8% for moderate ED and 1.7% for severe ED. This is dissimilar and higher to the values obtained by Ngai et al. among Chinese men. The difference in the findings may be due to environmental factors and genetic make-up which differs between Africans and Orientals. The point prevalence of mild, moderate and severe LUTS in this study was 20.5%, 53.8% and 25.6%, respectively. Schiff et al. found that for every decade, the percentage of men with moderate or severe LUTS increased and for each IPSS grouping there was increased prevalence of ED. This was similar to the observation made in this study, and the severity of ED was associated with higher IPSS and a mean IPSS of 18 and 23 was noted in patients with moderate and severe ED, respectively . This may be due to the voiding symptoms from the bulk of the adenoma as reported by Ikuerowo et al. .
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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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Impact Of Erectile Dysfunction On Qol
Preservation of sexual function should be considered in the management of patients with symptomatic BPE. With increase in elderly population, it is expected that more men will experience ED and symptomatic BPE. There was positive correlation between the severity of ED and prostate size in this study, and patients with severe ED had higher mean prostate size of 122.94 g. This further supports the need to screen patients with symptomatic BPE for ED. Sexual and urinary functions have a direct impact on QoL. This present study shows that QoL has a weak negative correlation with ED and a weak positive correlation with prostate size . This is because patients impression on quality of life varies. While a patient with a huge prostate and severe ED may be satisfied with the symptoms, another patient with milder form may feel terrible with his symptoms .
Is Surgery The Only Option For Enlarged Prostate
Key points to remember. Surgery can help if your enlarged prostate is causing serious problemssuch as kidney problems or repeated urinary tract infectionsor if medicines havent helped. The most important thing in deciding whether to have surgery is how much the symptoms bother you. Surgery works well for most men.
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How Is A Varicocele Treated
Once diagnosed, a surgical procedure can be done to correct the problem. The procedure may be needed because of the decreased size of the testicle, infertility, or because of the size and discomfort related to the varicocele. If the varicocele is the cause of infertility, in many cases fertility will improve in a few months.
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Swollen Prostate Treatments That May Lead To Erectile Dysfunction
Managing a swollen prostate may require medication, or sometimes surgery to get it under control.
These treatments can be effective in getting the prostate to an acceptable state, but may sometimes do so at the expense of causing serious side-effects, notable of which is erectile dysfunction.
Drugs to manage benign prostatic hyperplasia like alpha blockers such as tamsulosin and terazosin, and 5-alpha-reductase inhibitors such as finasteride and dutasteride have side effects that include erectile dysfunction.
In treating prostate cancer, procedures like a radical prostatectomy may lead to injuries of the cavernous nerve and blood cells.
This can cause ED. Hormonal therapy in the form of androgen-deprivation is also known to cause erectile dysfunction and decreased sexual desire.
Radiation therapy to treat cancer can also lead to nerve damage, which may lead to ED. There are however some promising approaches to reduce the risks of erectile dysfunction following this treatment.
In instances where ED occurs following treatment for a swollen gland, measures like the use of PDE5 inhibitors, intracavernosal injections, and combination therapy may be able to treat sexual dysfunction.
As always, it is important to talk to your healthcare provider to ensure you get the best and safest advice on what approaches to consider for your specific condition.
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What Is Prostatitis
Prostatitis is an inflammation of the prostate which can often be as painful as it sounds. You may not hear about it a lot, but this condition is the most common urinary tract problem for men younger than fifty. It is also the third most common urinary tract condition for men above fifty.
There are four types of prostatitis:
Acute bacterial prostatitis: a bacterial infection of the prostate which lasts a short time.
Chronic bacterial prostatitis: a recurrent infection of the prostate that goes on for a long time.
Chronic pelvic pain syndrome/chronic prostatitis: pain in the lower back and pelvic area that may be caused by an infection, though not from bacteria. It may also be due to inflammation from other causes.
Asymptomatic inflammatory prostatitis: inflamed prostate with no symptoms.
Does Turp Cause Ed
Traditionally, it was noted that TURP was associated with sexual side effects, including retrograde ejaculation as well as ED. In fact, its one of the risk factors that is often discussed. However, it should be noted that men with BPH are at increased risk for ED. Many men undergoing TURP have significant problems with ED to start with.
During the surgery , we remove the obstructive tissue, which is confluent with the muscle fibers that propel semen forward during ejaculation. As a result, around 70% of men experience retrograde ejaculation after TURP or similar procedures . For procedures such as TURP and lasers of the prostate, retrograde ejaculation is an unavoidable side effect.
A procedure called transurethral incision of the prostate is an option for men with smaller prostate it has lower retrograde ejaculation risk. Other minimally invasive procedures such as Urolift procedure and Rezum are associated with fewer sexual side effects .
TURP is also associated with ED. Whether TURP causes ED is not clear as some randomized controlled studies actually show improvement in erectile function after TURP and others show slightly worsened function .
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Increased Adrenergic Response May Cause Ed And Luts/bph
Both urinary function and erection can be affected by changes in the smooth muscle tonus caused by increased adrenergic response. Unilateral sympathectomy in rats led to homolateral increase in prostate . Transgenic rats that are spontaneously hypertensive due to greater adrenergic tonus presented urodynamic characteristics similar to those of males with LUTS . Furthermore, the rats presented a deficient erectile response to electrical stimulus of the cavernous nerve .