Is Another Treatment Option Better For Preservation Of Erectile Function
The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.
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.
Ejaculation will no longer occur in any patient. This is because the seminal vesicles and the vas deferens , are removed and cut during the surgery. This means that you will no longer be able to father children
Should You Worry About An Elevated Psa After Prostate Removal
PSA stands for prostate-specific antigen and is often a very good indicator of how effective treatment has been, in case of prostate removal or other prostate surgeries.
After prostate surgery, the PSA level gets very low, but this result isnt always reliable. Thats why the patient should discuss the expected PSA levels after prostatectomy with their doctor.
A lower PSA level following the removal of the prostate gland is only a part of the overall picture. There are many factors to monitor closely after prostate surgery.
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When Should I Call My Primary Provider
- Experience a sudden loss of vision in one or both of your eyes
- Experience a sudden decrease or loss hearing
- Take too much CIALIS® or generic CIALIS®
- Have an allergic reaction to CIALIS® or generic CIALIS®
- Symptoms of an allergic reaction may include:
- Swelling of the lips, tongue, or throat
- Difficulty breathing or swallowing
If you are experiencing a medical emergency, call 911 or seek immediate medical attention.
Known Side Effects Of A Radical Prostatectomy
So, what happens to a man when he has his prostate removed? There is a multitude of effects that occur to men after they have had prostate removal surgery.
The procedure is major pelvic surgery, and, as such, it carries along with it many potential risks. In addition to the immediate effects of the surgery, the removal of the prostate causes long-term side effects that are generally permanent.
Until recently, these side effects about what happens to a man when he has his prostate removed have not been relatively well-classified.
Most side effects are those reported by urologists that are performing the surgery. This reporting has been, in past years, rather poorly detailed and sparse due to the surgeons not anxious to publicize the failures of a procedure, they have attached a gold standard label.
The most reported side effects are erectile dysfunction and urinary incontinence.
Unfortunately, even though doctors have filed reports, the bias of the doctors filing them is questionable.
For example, one report details one of the significant side effects, postoperative erectile dysfunction, occurs between 14 and 90 percent of patients. This is a relatively wide range.
Based on my many years of practice, it is a very optimistic estimate. And it is likely provided by urologists who either do not want to admit their procedure causes such harm or deny the side effects and results.
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What Happens During Prostate Surgery
Before a prostatectomy, a surgeon will use either general anesthesia which makes you lose consciousness, or spinal anesthesia which numbs the lower half of your body while you remain conscious.
There are two main types of this prostate surgery. In the traditional open prostatectomy, the surgeon makes one large incision in the skin to remove the prostate. A more common method used today is minimally invasive laparoscopic surgery, during which the surgeon performs the procedure through four small incisions using a tiny camera and small tools. Many surgeons now use robotic assistance to perform this type of surgery.
Does Penile Rehabilitation Work
Studies on penile rehabilitation are mixed. Some research shows this type of therapy helps regain sexual function and penis length after radical prostatectomy, especially for men who use it in the weeks after surgery. But, itâs not clear which treatment â or combination of treatments â is best. For example, you may find that using a penis pump along with an ED medication works best for you.
Researchers will need to carry out more reviews to figure out how well these work in treating ED after surgery for prostate cancer.
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What Is The Importance Of Preserved Erectile Function
In considering the impact of the various treatment approaches for prostate cancer on their quality of life, many patients place paramount importance on the possibility of retaining natural erectile function. This matter is frequently important to young men who by age status are more likely to have intact erectile function than older men however, for all men having normal preoperative erectile function irrespective of age, preservation of this function is understandably important postoperatively.
Ed Incontinence After Prostate Surgery: What Can A Partner Do
January 10, 2019 | Kevin Hunt
This is the first of a two-part series on the effects of prostate cancer on relationships.
Ask any prostate cancer survivor and hell tell you theres no price he wouldnt pay to be cancer-free. Lets start with the surest way to cure prostate cancer when the disease hasnt spread: Removal of the walnut-size gland and surrounding tissue in a procedure called a radical prostatectomy.
The price many often pay, at least initially, is dealing with the surgerys side effects, including erectile dysfunction and uncontrollable dripping or leaking of urine.
Heres how a wife or partner can help a man after prostate surgery:
Erectile Dysfunction
Things do get better, but it takes time.
Having realistic expectations about sexual functioning after surgery is critical, says Dr. Ila Sabino, a Tallwood Mens Health clinical health psychologist.
This can have a psychological impact on men, says Dr. Sabino, who feel that ejaculating is very important and the absence of fluid means they arent a real man.’
A decrease in libido is a common byproduct of erectile dysfunction, says Dr. Sabino, which only amplifies the erectile dysfunction.
Also encourage him to keep an open mind about other treatments, such as penile injections.
They do work, says Dr. Sabino. A recent study showed that men are more likely to use this treatment if their partner was interested in maintaining a sexual relationship.
Bladder Control
Dr. Sabinos recommendations:
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Natural Treatments For Bph Induced Erectile Dysfunction
As mentioned above, many doctors consider that BPH does not directly cause ED. However, most studies also show that men with serious BPH also suffer from ED.
Both maladies are often a result of lifestyle and nutritional deficiencies. For example, many men, when tested, show a deficiency in the mineral Zinc. The prostate is an organ that requires zinc in order to function normally. Thus a zinc deficiency may result in prostate issues that span multiple symptoms, BPH and ED, among them.
Many BPH symptoms can be helped by the use of herbal remedies, particularly saw palmetto and pygeum herbal extracts. Urinary issues can be helped using a flower pollen extract. Other natural prostate supplements include:
- Rye Grass Pollen Extract
- Ellagic Acid
Erectile dysfunction can often be improved by the use of medications called PDE-5 inhibitors. This includes the trade names of , Cialis, and Levitra at present. However, while these medications may improve or facilitate sexual function, they do nothing to solve the underlying problem.
Unfortunately, the dietary habits of the public do not foster healthy living. Poor eating habits tend to cause hormonal and nutritional disturbances. These imbalances add up. When severe enough, they can cause prostate enlargement, erectile dysfunction, or any one of a host of associated symptoms.
What Should I Tell My Roman
Tell your Roman-affiliated provider about all your medical problems, including if you:
- Have heart problems such as angina, heart failure, irregular heartbeats, or have had a heart attack. Ask your healthcare provider if it is safe for you to have sexual activity. You should not take CIALIS® and generic CIALIS® if your healthcare provider has told you not to have sexual activity because of your health problems.
- Have pulmonary hypertension
- Have low blood pressure or have high blood pressure that is not controlled
- Have had a stroke
- Have kidney problems or require dialysis
- Have retinitis pigmentosa, a rare genetic eye disease
- Have ever had severe vision loss, including a condition called NAION
- Have stomach or intestinal ulcers
- Have a bleeding problem
- Have a deformed penis shape or Peyronies disease
- Have blood cell problems such as sickle cell anemia, multiple myeloma, or leukemia
Tell your healthcare provider about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements.
Especially tell your healthcare provider if you take any of the following:
Withholding or providing inaccurate information about your health and medical history in order to obtain treatment may result in harm, including, in some cases, death.
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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.
Theme : Importance Of Intimacy
Intimacy, both physical and emotional, was a priority for men and their partners. Participants discussed the importance of non-penetrative sex. Most men and their partners felt that non-penetrative sex was a helpful way to maintain intimacy. Some participants felt the relationship was stronger after prostate cancer treatment. The participants said the following:
Man 21: I was fortunate to find this woman and it just enhances every single aspect, whatever, if youre going to a social event, youre going on a vacation, you are just being intimate around the house, youre sharing thoughts and dreams. It just encompasses what life is all about. Some people dont care about it, but for the men that do its devastating.
Partner 5: Anything I could tell anybody going through this is like, If you guys are not intimate, and able to talk with each other now you’d better get that straight before the surgery. Better get it straight because you’re gonna need each other, and you’re gonna need the intimacy more than you’ve ever had it
Man 15: I miss the holding of hands. I miss hugging and things like that. I dont thats not sex in the definition of this survey. But thats what is available to me in my current physical conditionand so yes, its important.
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Management Of Erectile Dysfunction
About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.
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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Transurethral Resection Of The Prostate
Transurethral resection of the prostate is a urological operation that involves cutting away a section of the prostate. It is most often used to relieve symptoms of urinary blockage, not necessarily to treat prostate cancer.
An instrument called a resectoscope is inserted through the opening of the urethra and the surgeon removes the inner part of the prostate gland .
The intervention lasts about an hour and it is most often used for non-cancerous blockage, but may also be used in cases of prostate cancer. The doctor doesnt need to make any incisions on the body. While most people can go home the same day, it is also likely that patients spend one or two days in the hospital. After the surgery, a urinary catheter will be placed because of the swelling that blocks urine flow.
Restoring Sexual Function After Surgery
Erections are controlled by nerves and blood vessels that run along both sides of the prostate. Because theyre very delicate, any trauma to these nerves or blood vessels can affect erectile function, says the Prostate Cancer Foundation. And if cancer is growing near the nerves, the surgeon might need to remove them.
Even if you dont have ED before surgery, you may experience it afterward. While ED usually lasts at least two to three months after surgery, it can last for up to two years.
To restore sexual function, your doctor may suggest:
- Oral medicine, such as Viagra® or Cialis®
- Penile injections that you use before having sex
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Percentage Of Men Obtaining Full Erections 2 Years After Open Prostatectomy
15% 13%
It is still unclear how using the da Vinci robot for prostatectomy will affect potency effects. While, as mentioned above, it would appear that using the robot may increase chances of potency, and research into how all this may translate into earlier return or increased percentage of potency is still ongoing. It is known that using the robot reduces blood loss during robotic prostatectomy surgery, and length of hospital stay. Presumably this is indicative of a decrease in trauma and inflammation, which leads us to speculate that there may be a higher chance of potency. Urinary continence at zero pads, bladder capacity, and urinary symptom scores at three months are all also improved over open surgery results. The robot certainly has its benefits.
As mentioned above, medical therapy may aid in return to erections, but this has not as of yet been fully substantiated. Usage of sildenafil and newer erectile medications may potentially increase the potency percentages in the table above but this has not been proven. A recently presented study found that daily doses of 50mg or 100mg sildenafil for 9 months increased full erections by 7 fold when compared with a group who did not receive any medication.
Can Prostate Biopsy Cause Erectile Dysfunction
If are recommended by your doctor to undergo prostate biopsy procedure for the detection of cancer, you must have a lot of questions and reservations. One of the most common question that people usually have is, can prostate biopsy cause erectile dysfunction or alter the quality of sex life at all?
The answer is yes erectile dysfunction may occur after prostate biopsy in some susceptible individuals but it is usually transient and self-limiting.
Accorded to a study published in the Journal of Urology, men who undergo prostate biopsy are at risk of temporary erectile dysfunction due to anxiety or pain however, in most men, symptoms improve within a couple of weeks.
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How To Treat Erectile Dysfunction After Prostate Surgery
Prostate surgery is challenging enough. But to make matters worse, such an operation may impact ones sex life. The prostate is a vital part of the reproductive system. Its responsible for producing fluids that carry sperm.
So when the prostate is affected, this can lead to conditions like erectile dysfunction.
But that doesnt mean you cant do anything about it. There are ways to bring back erectile function to your penis. In this post, well talk about some of the prostate erectile dysfunction treatment options available to you.
Open Or Laparoscopic Radical Prostatectomy
In the more traditional approach to prostatectomy, called anopen prostatectomy, the surgeon operates through a single long skin incision to remove the prostate and nearby tissues. This type of surgery is done less often than in the past.
In a laparoscopic prostatectomy, the surgeon makes several smaller incisions and uses special long surgical tools to remove the prostate. The surgeon either holds the tools directly, or uses a control panel to precisely move robotic arms that hold the tools. This approach to prostatectomy has become more common in recent years. If done by experienced surgeons, the laparoscopic radical prostatectomy can give results similar to the open approach.
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Reasons To Have A Prostatectomy
A common reason for having a prostatectomy is to treat prostate cancer. According to the American Cancer Society, prostate cancer is the most common cancer, after skin cancer, among men in America. More than 174,000 new cases are reported in the United States each year. If the cancer hasnt spread outside the prostate gland, surgery is a good treatment option.
You might also choose to have prostate surgery to treat an enlarged prostate. As the prostate grows, it can block the flow of urine and cause bladder, urinary tract, and/or kidney problems. Removing part of the prostate can solve these issues.