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Erectile Problems After Prostate Surgery

Points To Take Into Consideration After A Prostate Surgery

How long does Erectile Dysfunction last after Prostate Surgery (Prostatectomy)?
  • Do not sit on hard floors.
  • Avoid getting constipated.
  • Consume at least 3 liters of water per day.
  • Regularly use the drugs prescribed by your doctor.
  • Do not drive for the first week during the recovery period after surgery. In addition, stay away from activities such as cycling, exercising, and horseback riding for 6 months, which may strain the groin area.
  • Do not wear trousers that tighten the groin area.
  • Do not consume drinks that contain alcohol and caffeine.
  • Do not shower in a sitting position after the surgery, unless your doctor tells you otherwise.

Talking About Orgasm Problems Is Important

Men and their partners have become much more open about talking erectile dysfunction, in general and as a consequence of prostate cancer treatment, notes Dr. Kacker.

Whatever you think about all those ads for Viagra and Cialis, they have made it easier to talk about ED and helped remove some of the stigma around the condition.

We should be having the same frank, open discussions about orgasm, says Dr. Kacker. Orgasms can bring a couple together and allow them to maintain sexual intimacy in the difficult period around diagnosis and treatment of prostate cancer.

Hormone Adjustments Can Help With Orgasm

Sometimes hormone levels contribute to orgasmic problem. Many men with low testosterone have problems with orgasm, but treating prostate cancer patients with testosterone is still very controversial. Other hormones can also play a role. For example, a low thyroid hormone level or a high prolactin level can make it more difficult to reach orgasm. Even if you have a normal hormone levels, there are a few hormonal medications that may be able to help.

Another hormone that plays a role in orgasm is oxytocin. The level of oxytocin increases in both men and women during sexual arousal. Taking an under-the-tongue formulation of oxytocin five to 10 minutes before sexual activity can help some men achieve orgasm. Its safe and no side effects have been reported, says Dr. Kacker. You need a prescription for oxytocin, and its available only through special compounding pharmacies, not through retail pharmacies.

Cabergoline is another medication that can help with orgasm problems. It blocks the release of prolactin, a hormone that appears to play an important role in the refractory period after orgasm when men cant have another orgasm for a while.

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What Treatments Are Available To Me If My Incontinence Doesnt Go Away After A Year

While kegels and behavioral therapy work well for most men with mild to moderate leaking, they may not be completely effective for some. Luckily, there are still some options for treating bladder leakage after prostate surgery.

Another surgery is sometimes needed when bladder leaks persist for more than a year after surgery. This may consist of having a urethral sling procedure, or an artificial urinary sphincter.

With a urethral sling procedure, a synthetic mesh tape is implanted to support the urethra. Up to an 80% improvement has been seen with this procedure and some men stop leaking completely.

An artificial urinary sphincter is used in patients who have more severe urinary incontinence that is not improving, or for those patients who may have had a lot of damage to the sphincter muscle after prostate surgery. An artificial urinary sphincter is a mechanical ring that helps close the exit from the bladder.

As will all surgeries, these come with pros and cons and potential complications. Be sure to discuss these options with your doctor.

Regaining Normal Sexual Functioning Is ‘rare’ After Prostate Operations

CasesBlog
Date:
European Association of Urology
Summary:
Regaining normal erectile function is rare after the most common prostate operation, radical prostatectomy, new research suggests.

Regaining normal erectile function is rare after the most common prostate operation, radical prostatectomy. This is the main result of a new study which is presented at the European Association of Urology Congress in Madrid.

Radical Prostatectomy is the removal of the prostate gland during a prostate cancer operation. This can often remove the cancer, but there is a major possible side-effect*, erectile dysfunction — the inability to have an erection. This is because the nerves which surround the prostate are often damaged during the operation, and these nerves control the ability to have an erection. In many cases, this improves with time, but now new research indicates that achieving an erection of the same quality as before the operation is rare, and may have been significantly overestimated by doctors.

The standard way of measuring erectile function is via a questionnaire, the International Index of Erectile Function , but this is not specifically aimed at prostate cancer patients. Some researchers had felt that the questionnaire did not take account of the special circumstances of a sudden change in erectile function brought on by surgery, or allow comparison with sexual activity prior to the operation .

*Incontinence is also a possible side-effect, but this is less common.

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What Will I Learn By Reading This

When you have treatment for your prostate cancer, you may have erectile dysfunction also known as impotence. Erectile dysfunction is a very common side effect . Side effects from prostate cancer treatment are different from one man to the next. They may also be different from one treatment to the next. Some men have no erectile dysfunction. The good news is that there are ways to deal with erectile dysfunction. In this booklet you will learn:

  • What erectile dysfunction is
  • Why prostate cancer treatment can cause erectile dysfunction
  • What can be done about erectile dysfunction
  • How erectile dysfunction may affect your sex life
  • What your partner can expect

It is important for you to learn how to deal with erectile dysfunction so that you can continue to have a satisfying intimate relationship.

Can Erectile Dysfunction Be Treated

Having prostate cancer is an upsetting and stressful experience having erectile dysfunction as a consequence of treatment to help treat your cancer can feel like a cruel twist of fate.

But the good news is, in most cases, erectile dysfunction can be treated, and often, erectile dysfunction will improve with time and require no further treatment.

There are numerous treatments for erectile dysfunction including:

  • Tablets

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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.

There Are Several Paths To Resuming A Satisfying Sex Life

Dr. John Aquino Discusses Erectile Dysfunction after Prostate Surgery

Its estimated that prostate cancer affects 1 in 9 men, with the average age of diagnosis around 66. If caught early, its a very treatable cancer. Though treatment can save lives, it also comes with serious side effects, one of which is erectile dysfunction .

Depending on the type of surgery required and your recovery, ED can range from the mild to severe. If you or your partner is having trouble getting or maintaining an erection post-surgery, there are several treatments you can explore to return to a satisfying sex life.

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How Can I Improve Incontinence After Prostate Surgery

Want to stop incontinence after prostate surgery? Kegels may be your answer! As mentioned above, kegels are a common treatment option for incontinence after prostate surgery. Among other things, the pelvic floor muscles help control bladder and bowel function and, like other muscles of the body, if they get weak they are no longer able to do their job effectively. To improve muscle function, kegels must be done regularly, every day. The good news is that they can be performed pretty much anywhere, anytime, and in a variety of positions . For a complete guide on performing a mens kegel, click here.)

Biofeedback can sometimes be used to determine if you are performing a kegel properly. And, electrical stimulation may also be used to help re-teach the muscles to contract.

Urinary Incontinence After Prostate Surgery: Everything You Need To Know

Undergoing a prostatectomy can be difficult. And for many men, finding that they are incontinent post surgery may come as a shock.

But rest assured that there are many treatments available to manage incontinence treatment after surgery. Read below for some of the most common questions we receive about incontinence after prostate surgery.

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Why Is Rehabilitation Important

Whether you are single, or in a relationship, you should have the opportunity to discuss penile rehabilitation with your doctor or specialist nurse. Self pleasuring is important for many people and this can play a part in rehabilitation. This might help to give you confidence and to become aware of the changes that your treatment might have caused.

It might still be worth talking to your doctor even if you are not sexually active, or dont plan to be. This is because penile rehabilitation has benefits in terms of keeping the penis healthy.

Ideally, rehabilitation should start soon after your prostate cancer treatment, or in some situations before treatment. For example, you should start rehabilitation within 3 to 6 months of starting hormone therapy or radiotherapy. Or within the first 3 months of surgery to remove the prostate gland.

Management Of Erectile Function

How Long Does Erectile Dysfunction Last After Prostate Surgery?

Whats the secret to having a good sex life after prostate cancer? In an interview with the Prostate Cancer Foundation Johns Hopkins urologist Trinity Bivalacqua, M.D., Ph.D. summed it up this way You use prescription erection pills. If they dont work, you move to injectable medications. If they dont work, you get a penile prosthesis. Theres also the vacuum pump.

Erectile Dysfunction Medications Viagra® , Cialis® , and Levitra® work by relaxing the muscles in the penis which allows blood to rapidly flow to achieve an erection. About 75% of men who undergo nerve-sparing prostatectomy or radiation therapy can successfully achieve erections with these medications.

Muse® is a medicated pellet about half the size of a grain of rice that when inserted into the urethra through the opening at the tip of the penis stimulates blood flow into the penis. About 40% of men have reported successfully achieving erections after using this drug.

End to End nerve grafting is a new technique recently reported to be effective in improving erectile function.

Injection therapy requires sticking a tiny needle into the base of the penis so Tri-mix which contains three drugs can be injected. The success rate is between 70 and 80% and each shot costs about $7. The specific formulation of drugs is based on the type of erection achieved with test dosages in the doctors office and the doctor teaches the patient how to self-inject.

References:

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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.

How Does Prostate Surgery Cause Erectile Dysfunction

Surgery to remove the prostate is usually offered to men who have prostate cancer that hasnt spread outside of the prostate, or has only spread a small way.

A radical prostatectomy procedure completely removes the prostate plus the tissues and lymph nodes that surround it. It also removes the seminal vesicles, the tubes that carry semen from the testicles. This means that although youll still be able to experience an orgasm after this kind of surgery, you wont ejaculate as no fluid is now being formed.

Its possible, if your cancer is confined to your prostate, to have a procedure called a nerve sparing prostatectomy. This means that your surgeon aims to leave the nerves that are either side of the prostate behind. These nerves are responsible for controlling erections. If theyre left undamaged, then theres more chance that youll be able to achieve an erection unaided after surgery.

If the nerves are damaged or removed, then youre likely to experience erectile dysfunction. In some men, this is permanent, in others they are able to achieve an erection within a few months, with or without medical help.

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Urinary Incontinence After Prostate Surgery

Urinary incontinence and/or inability to urinate are the common side effects after prostate surgery. This side effect usually ends in a short time.

Transient urinary incontinence develops in consequence of disruption or discomfort in the sphincter muscles which control the release of urine. This type of incontinence is generally similar to the stress incontinence that women often experience after vaginal delivery.

After prostate cancer surgery, the goal is basically to recover quickly, have full control over the bladder and become sexually active again.

Talking Counselling And Sex Therapy

Erectile Dysfunction Treatment Options | post Prostate Removal Surgery

Talking to your partner about your erection difficulties can help. Or it may help to talk to a close friend if you are not in a relationship.

Not talking to those close to you could be one of the main barriers to coping with this side effect. You might then find it easier to consider ways that could help.

Counsellors or therapists can help if youre worrying about anything to do with your sex life and sexuality. You can be referred by your GP to a counsellor or therapist within the NHS. You might need to go on a waiting list to see them.

Talk to your GP to find out what is available in your area. Your local hospital or your local Erectile Dysfunction Clinic might have this service.

The drugs used to treat erection problems include:

  • tadalafil
  • vardenafil
  • avanafil

These belong to a group of drugs called phosphodiesterase type 5 inhibitors. They work by increasing blood flow to the penis. For the drugs to work, men need to be aroused and have some sort of sexual stimulation. In other words, the drugs wont cause an immediate erection, some foreplay is usually needed.

As drugs work best in men who have sexual desire, they might not help some men who are having hormone therapy. There is limited evidence to say these drugs work when having hormone therapy. But some specialists believe that they are still worth a try if you would like to give them a go.

Possible side effects of PDE 5 inhibitors include:

  • headaches
  • temporary problems with vision

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Dealing With Erectile Dysfunction: For You And Your Partner

The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.

Complications And Recovery After Prostate Surgery

The healing process and possible complications should be well monitored after prostate cancer. As with any surgery, postoperative care and the recovery process is important after prostate surgery. Some complications such as bleeding and pain are quite common in the postoperative period of prostate surgery. In addition, it is recommended to check the patient for the signs of infection in the surgical site.

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Beyond Drugs And Rehabilitation

Sometimes, even with all the best efforts by the doctor and his patient, there is no improvement in erectile function over several years, and a man may decide it is time to review other methods.

  • Prostaglandin : One of these can be direct penile injections. While most men initially balk at the thought of injecting a needle into their penis, once the psychological hurdle is overcome, it is a viable method that many men use successfully for years. Prostaglandin is a hormone-like substance that has a strong effect on the penis. It relaxes the penile vascular smooth muscle in and around the corpus cavernous of the penis. This causes penile arteries to dilate and is instrumental in producing a natural erection. When injected, with or without other chemicals, directly into the penis, it will cause an erection, regardless of the mans sexual arousal state.
  • Misoprostol: For men that are absolutely opposed to a penile injection, misoprostol can be inserted in liquid form into the urethra. This method requires that the user dissolve the misoprostol tablet in water, place a restrictive band on the head of his penis, and then insert, via an eyedropper or similar device, a measured solution of the chemical into his urethra. The restrictive ban is removed after allowing about 10-15 minutes for the chemical to take effect. Because the drug does not depend on functional erectile nerves, it can be very useful for men with nerve damage that does not respond to other ED drugs.

How May Erectile Dysfunction Affect My Sexual Relationships

Dealing With Erectile Dysfunction After Prostate Surgery

Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.

If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.

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