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.
Avoiding Risks During Cancer Treatment
You are less likely to make a partner pregnant when you are receiving chemotherapy. But it is still possible. Protect your partner and any future children by avoiding pregnancy until at least 2 months after finishing chemotherapy.
Chemotherapy, radiation therapy, and some types of surgery can take away your ability to make a woman pregnant. The medical name for this is infertility. Be sure to let your oncologist know before cancer treatment starts if you are concerned about infertility. You might want to freeze some of your sperm or try another fertility-preserving option. Learn more about fertility and cancer.
Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery
Neuromodulatory therapy, represents an exciting, rapidly developing approach to revitalize intact nerves and promote nerve growth. Therapeutic prospects include neurotrophins, neuroimmunophilin ligands, neuronal cell death inhibitors, nerve guides, tissue engineering/stem cell therapy, electrical stimulation, and even gene therapy.
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Who Has Nerve Preservation
Patient who are potent are understandably keen to retain this and so are we. As well as allowing erections following surgery, nerve preservation also allows an earlier return to continence so we always practice nerve preservation whenever the cancer control allows it, which is in about 80% of men. When the cancer is close to one of the nerves we might partially nerve preserve on that side if it is safe to do so and will discuss this with you beforehand if this seems likely.
The decision to nerve preserve is taken after considering the patients existing erections, PSA level, biopsy report, MRI scan, rectal examination under anaesthetic immediately before the operation starts and the way the NVB looks and feels during the operation. It is always discussed with patients before surgery.
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Pelvic Radiation Therapy Effect On Erections
Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
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Ed Pills And Benign Prostatic Hyperplasia
No part of the human body is immune to the effects of aging. Many men face the double whammy of smaller erections and larger prostates as the clock ticks on. Although both erectile dysfunction and benign prostatic hyperplasia become much more common as men age, they are very different problems with separate causes, unique symptoms, and unrelated consequences. Until now, treatments for the two conditions have also been different in fact, medical and surgical therapies for BPH can sometimes even cause ED. But research suggests that the most popular and effective drugs for ED may substantially reduce the symptoms of BPH.
Lifestyle Management Of Bph
In a few men, BPH is severe enough to require immediate treatment. But because BPH progresses slowly and serious complications are uncommon, most men can decide for themselves if and when they should be treated. And many men with mild to moderate symptoms find that simple lifestyle adjustments are able to take the BPH bother out of daily life. Here are a few tips:
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Synergy Of Cell Killing
The synergy of killing by sildenafil and DOX was analyzed by colony formation assays using median dose effect isobologram analysis . Briefly, DU145 cells were plated as single cells in sextuplicate. The cells were infected with an Ad.CMV or Ad.c-FLIPs adenovirus after 18 hours of plating. After 24 hours, cells were treated with doxorubicin , or/with sildenafil , at a fixed concentration ratio to perform median dose effect analyses for the determination of synergy. After drug exposure , the media was changed and cells cultured in drug free media for an additional 1014 days. Cells were fixed, stained with crystal violet, and colonies of > 50 cells/colony counted. Colony formation data were entered into the Calcusyn program and combination index and Fraction Affected values determined. A CI value of less than 1.00 indicates synergy.
About Dr Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
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Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.
An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.
What Current Options Exist To Treat Erectile Dysfunction After Radical Prostatectomy
Options include pharmacologic and nonpharmacologic interventions. Pharmacotherapies include the oral PDE-5 inhibitors , intraurethral suppositories , and intracavernous injections . Non-pharmacologic therapies, which do not rely on the biochemical reactivity of the erectile tissue, include vacuum constriction devices and penile implants .
Men who have undergone nerve-sparing technique should be offered therapies that are not expected to interfere with the potential recovery of spontaneous, natural erectile function. In this light, penile prosthesis surgery would not be considered an option in this select group, at least in the initial 2 year post-operative period, until it becomes evident in some individuals that such recovery is unlikely.
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Sildenafil And Dox Co
Immunoprecipitation with a CD95 antibody and immunoblotting with an active caspase-8 antibody showed showed an increase in the active form of caspase-8 after DOX treatment as compared to control and sildenafil alone .6). Sildenafil co-treatment with DOX further stimulated the active form of caspase-8 with enhanced recruitment of FADD with CD95 in DISC formation .
Sildenafil and DOX co-treatment increases recruitment of FADD with CD95 in DISC formation and activates caspase-8
Following 48 hr of treatment with Sild and/or DOX , total protein of DU145 cell was subjected to immunoprecipitated with rabbit CD95 antibody. The amount of co-immunoprecipitating caspase 8 was determined after SDS-PAGE and Western blotting with mouse caspase 8 and FADD antibodies. Abbreviations: doxorubicin DOX Sildenafil Sild.
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Another type of prostate issue is chronic prostatitis, or chronic pelvic pain syndrome. This condition causes pain in the lower back and groin area, and may cause urinary retention. Symptoms include leaking and discomfort. In severe cases, a catheter may be required to relieve the symptoms. If the problem is unresponsive to other treatments, your doctor may suggest a surgical procedure. If these do not work, your symptoms could progress and become chronic.
An acute bacterial infection can cause a burning sensation. Inflammation of the prostate can affect the bladder and result in discomfort and other symptoms. This is the most common urinary tract problem in men under 50, and the third most common in men over 65. The symptoms of acute bacterial prostatitis are similar to those of CPPS. Patients may experience a fever or chills as a result of the infection.
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What Is The Problem
Some 6,500 radical prostatectomies are performed every year in the UK . In a negative association, an increase in one quantity corresponds to a decrease in the other. Association does not necessarily mean that one thing causes the other. of Urological Surgeons, 2019). While approximately half of these men have pre-existing erectile dysfunction, over 50% of the other half can expect to lose natural erections after prostatectomy surgery, especially if their cancers are locally advanced and require wide clearance to ensure removal of the whole tumour.
Do Erectile Dysfunction Drugs Reduce Prostate Cancer Risk
According to a new study conducted by researchers from Cedars-Sinai in Los Angeles and published in the Journal of Urology, it has been revealed that the use of erectile dysfunction drugs, or phosphodiesterase type 5 inhibitors such as sildenafil may not reduce the risk of developing prostate cancer.
In vitro mouse studies have suggested that these drugs might have some anticancer activity, but the evidence in human subjects is mixed. Given the routine use of PDE-5 inhibitors and the possibility that these agents may have anticancer activity, we wanted to test the association between their use and risk of developing prostate cancer.Lead investigator Stephen J. Freedland, MD
For the study, Freedland and colleagues followed 6,501 men for a period of four years. Of these men, 364 were using PDE-5is drugs. Over the course of the study, 19.5% of the men prescribed with erectile dysfunction drugs were diagnosed with prostate cancer. The rate was 22.7% in men who were not prescribed the drugs, a difference that the researchers considered as statistically insignificant. Additionally, researchers also looked at men in North America, where use of the erectile dysfunction drugs is more prevalent. The treatment was associated with an inverse trend of prostate cancer that approached but did not reach a statistical significance.
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A Comparison Of Medications For Inducing Erections After Prostate Surgery
HomeNews & MediaNewsA comparison of medications for inducing erections after prostate surgery
04 February 2020
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Surgery for prostate cancer reduces erections
Treatment for localised prostate cancer can have terrible consequences for a mans sex life. Soon after surgery, most men find that achieving and maintaining an erection is difficult. For some men, this gradually improves over 12 months or more. Unfortunately, many have long term problems having sex. Radiotherapy for prostate cancer can also affect a mans sex life, but these effects are usually delayed.
Improving erections
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An enlarged prostate can also be the cause of other problems. If the enlarged prostate is causing symptoms, the best treatment would be a natural remedy. In the meantime, there are treatments for a wide range of conditions that cause a man to experience pain. A common surgical procedure involves an electric loop, laser, or electro-stimulation. The procedure is a safe and effective option for treating enlarged or symptomatic BPH.
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How Long Does Erectile Dysfunction Last After Prostate Surgery
Is erectile dysfunction a possibility after prostate surgery?
Many patients are concerned about it and prefer other prostate cancer treatments.
However, they should know that most erectile issues are temporary and improve after a while.
These patients usually recover from this problem after a few months.
In this article, we cover sexual function after prostate cancer surgery thoroughly, tell you how long ED can last, and how to cope with erectile problems.
What You Can Do Now
Sexual side effects from prostate cancer treatment are often temporary, especially if your doctor used nerve-sparing surgery. While your body recovers, you can try a few things to maintain your sex life:
- Let your doctor know about any sexual problems youre having right away. Although it can be hard to talk about sex, being open and honest will help you get the treatment you need.
- See a therapist. Couples therapy can help you and your partner understand and deal with sexual issues.
- Take care of yourself by exercising, eating a well-balanced diet, reducing stress, and getting enough sleep. Looking and feeling your best will give your self-esteem and mood a boost.
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Role Of Flip In Synergistic Killing Effect Of Sildenafil And Dox Co
FLIP-s was overexpressed in DU145 cells by adenoviral infection . cell death assessed by trypan blue exclusion assay confirmed that sildenafil potentiated DOX-induced cell killing in cells infected with control virus . The overexpression of FLIP-s inhibited the additive cell killing effect of sildenafil as compared to DOX alone .3). DOX-induced cell death was increased with sildenafil co-treatment from 19.4±2.3% to 43.1±3.5% in adeno-CMV infected cells . In cells overexpressing FLIP-s, sildenafil co-treatment also increased DOX-induced cell death from 18.2±1.1% to 26.5±1.6% although said increase was not as high as adeno-CMV infected cells. Colony formation assays performed using median dose effect isobologram analysis also showed the overexpression of FLIP-s inhibited the DOX and sildenafil-induced synergistic killing of DU145 cells 1) with CI > 1.
Overexpression of FLIP-s abolished synergistic effect of sildenafil and DOX co-treatment on DU145 cells
Upper panel shows overexpression of FLIP-s by adenoviral construct. Bar chart represents cell death following overexpression of FLIP-s or empty vector and 24 hr treatment with DOX and/or Sild . Abbreviations: doxorubicin DOX Sildenafil Sild.
Sexual Dysfunction After Prostate Surgery Is More Common Than Previously Reported Says Hutchinson Center Study
Media briefing: A media briefing will be held at 1 p.m. PST Tuesday, Jan. 18 at the Centerâs Metropolitan Park East Campus, 1730 Minor Ave., between Olive and Howell streets. A Media Relations representative will greet you in the lobby and escort you to the briefing room. Free parking is available in an underground garage entrance off Minor Ave. A map of the site is available upon request.
B-roll available: A related video news release, including sound bites and b-roll of Dr. Janet Stanford and a Seattle-area prostate-cancer survivor, will be available via satellite feed twice on Tuesday, Jan. 18: first between 6 and 6:30 a.m. PST and again between 11 and 11:30 a.m. PST .
SEATTLE â Sexual dysfunction among men who undergo prostatectomy appears more prevalent than previously reported, according to a multi-center study led by an investigator from the Fred Hutchinson Cancer Research Center in Seattle.
The results will appear in the Jan. 19 issue of the Journal of the American Medical Association.
Funded by the National Cancer Institute, the Prostate Cancer Outcomes Study is the first comprehensive, population-based assessment of sexual function and urinary continence among men treated with radical prostatectomy for early stage, localized prostate cancer. It is also the first study to examine the sexual and urinary side effects of such surgery in minority populations.
Age and education also had an impact on the frequency of impotence.
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Sildenafil And Cancer: The Potential Positives
As drug development costs continue to rise and the level of attrition for new drug candidates remains intimidating, the search for new therapeutic agents within oncology has become increasingly challenging. Researchers both within and outside of the pharmaceutical industry will occasionally look at certain non-chemotherapeutic medications that have been in the market for a substantial amount of time for off-label indications within oncology. It is more typical for researchers to examine generic medications based on the idea that there may be fewer potential legal blockades with generic therapies. This type of strategy is sometimes called repurposing a medication. These medications typically have years of safety and efficacy data that helps reduce some of the financial burden associated with developing a new drug. One such medication that may have a role within oncology is the popular erectile dysfunction drug sildenafil.
Unfortunately, there hasnt been as much success and data to support the use of sildenafil for different cancers within humans. One of the earliest positive reports was in a small group of 5 patients treated with sildenafil for Waldenström macroglobulinemia.5 Sildenafil was shown to lower serum immunoglobulin M levels and induce apoptosis of certain B cells in these patients. A larger, follow-up study to this found that 63% patients treated with sildenafil had lower serum IgM levels and lack of disease progression.6
Ed Pills And Sexual Function
An erection is a hydraulic event that depends on a sixfold increase in penile blood flow. The crucial chemical for erections is nitric oxide, which transmits the impulses of arousal between nerves and also relaxes muscle cells in the penile arteries, causing them to widen and admit more blood.
In ED, pills are generally safe and well tolerated. In a few cases, they can produce painful prolonged erections . And they can occasionally lower blood pressure by widening arteries elsewhere in the body. That’s why men who take any form of nitrate medication should never use ED pills, and it’s why men with ED who take alpha blockers for BPH should choose a selective alpha blocker and must use ED pills with caution. Although these medications are generally safe for the heart, men with recent heart attacks or strokes, uncontrolled hypertension, or unstable angina should also abstain from ED pills.
The more common but less serious side effects of ED pills may also involve the arteries. Flushing, headaches, and nasal congestion head the list other adverse reactions include backaches, muscle pain, indigestion, and rashes. These are all temporary symptoms, but sudden visual impairment or abrupt hearing loss, though rare, are serious indeed and can be permanent.
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