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How Long Does Erectile Dysfunction Last After Prostate Surgery

The Regeneration Rate Of The Genital Tissues Depends On The Following Significant Factors:

Is erectile dysfunction common after radical prostatectomy?
  • age and health status of men
  • orrectness of surgical intervention
  • level of erectile ability before surgical treatment.

The most effective way to treat erectile dysfunction after removal of the prostate gland is physiotherapy and the use of tonic medications based on Sildenafil, Tadacip or Vardenafil.

Men who survived a surgical intervention need to overcome the mental stumbling block. The patient for the adjustment of sexual life must feel confident in his abilities. To get rid of fear of failure and the syndrome of obsessive waiting will help support from the sexual partner and regular sexual activity.

Set of physical exercises will help to improve the power of sexual potency within the first year after the operation. This set designed to strengthen the muscles of the perineum and restore control over urination.

Doctors recommend to insert special candles into the urethra for additional relaxation of the muscles and optimal blood filling of the genital organs. In some cases, doctors recommend to undergo surgical treatment for impotence which has occurred after prostatectomy.

The doctor should explain to the patient and his partner all nuances concerning the loss of erection after prostatectomy and the importance of rehabilitation.

If Youre A Gay Or Bisexual Man

To be the active partner during anal sex you normally need a strong erection, so erection problems can be a particular issue. You could try using a constriction ring around your penis together with another treatment like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex.

If you are receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. Some men who receive anal sex find that their experience of sex changes if they have their prostate removed .

If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy. Its best to wait until your symptoms have settled before trying anal play or sex. If youve had permanent seed brachytherapy there is a risk in the first few months that your partner might be exposed to some radiation during sex. Talk to your doctor or nurse for further advice.

With all sexual changes you may be able to find ways to work through this.

Watch Martinâs story below for one gay manâs experience.

Watch other menâs personal stories about sex after prostate cancer.

Risks Of Radical Prostatectomy

Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.

Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:

  • Urinary incontinence: More than 95% of men younger than age 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
  • Erectile dysfunction : Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED , an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.

Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.

Other complications of radical prostatectomy include:

  • Bleeding after the operation
  • Groin hernia
  • Narrowing of the urethra, blocking urine flow

Less than 10% of men experience complications after prostatectomy, and these are usually treatable or short-term.

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Does Viagra And Cialis Work After Prostate Removal

During recovery, medications like Viagra and Cialis will help. Viagra can restore impotence and contributes to more pleasurable sex life.

A study published in the Journal of Urology reported that 53% from a total of 80 men who underwent radical prostatectomy had their erection function restored after taking Viagra.

But is Viagra an addictive drug?

Many men experienced a high rate of improvement in their sexual performance due to medications such as Viagra, Cialis, or Levitra. If you have been wondering whether these medications are addictive, you should know that the active ingredient in Viagra, sildenafil, is not an addictive substance.

These medications work by increasing the blood flow to the penis and facilitate the erection process. Addiction is brain-triggered, but Viagra does not target the nervous processes in the brain. That is why it is considered a safe option for those who want to faster recover their sexual potency after prostate cancer treatment.

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Prostate Cancer Surgery: Erectile Dysfunction

How long does Erectile Dysfunction last after Prostate Surgery

Side effects from having surgery for prostate cancer are common. They dont happen in all men, but some men can experience complications such as erectile dysfunction after surgery.

Erectile dysfunction is the inability to achieve and maintain an erection. There are many causes of erectile dysfunction, and having surgery for prostate cancer is a common cause in over 60% of men.

For many men, erectile dysfunction problems improve within 12 months following surgery, but for others, the problem doesnt get better. There are many treatments for the condition that can be tailored for each individual to guarantee good erectile function in the long term.

Here, King Edward VIIs Hospital Consultant Urologist Professor David Ralph discusses how surgery for prostate cancer can cause erectile dysfunction, and what can be done to treat it.

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Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery

Recent strategies have included cavernous nerve interposition grafting and neuromodulatory therapy. The former, as a surgical innovation meant to reestablish continuity of the nerve tissue to the penis may be particularly applicable when nerve tissue has been excised during prostate removal. In the modern era of commonly early diagnosed prostate cancer, nerve-sparing technique remains indicated for the majority of surgically treated patients.

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.

What Is A Penile Implant

A penile implant, or penile prosthesis, is a treatment for erectile dysfunction .

The surgery involves placing inflatable or flexible rods into the penis. Inflatable rods require a device filled with saline solution and a pump hidden in the scrotum. When you press on the pump, the saline solution travels to the device and inflates it, giving you an erection. Later, you can deflate the device again.

This procedure is usually reserved for men who have tried other ED treatments without success. Most men who have the surgery are satisfied with the results.

Continue reading to learn about different types of penile implants, who is a good candidate, and what you can expect after surgery.

You may be a candidate for penile implant surgery if:

  • You have persistent ED that impairs your sex life.
  • Youve already tried medications such as sildenafil , tadalafil , vardenafil , and avanafil . These drugs result in erection appropriate for intercourse in as many as 70% of men who use them.
  • Youve tried a penis pump .
  • You have a condition, such as Peyronies disease, that is unlikely to improve with other treatments.

You may not be a good candidate if:

  • Theres a chance ED is reversible.
  • ED is due to emotional issues.
  • You lack sexual desire or sensation.

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What Should I Expect When I Get Home

When you are discharged from the ward you will need some baggy trousers or track pants as you may find that your abdomen is uncomfortable and the catheter is easier to manage if your clothing is loose.

There will be some blood, urine, and mucus which passes alongside or through the catheter and is particularly noticeable after passing a bowel motion this is normal. You should wash the area with soap and water to remove this discharge to reduce any irritation. Keeping a high oral fluid intake reduces the risk of catheter blockage.

You may notice some swelling and bruising around the wounds, the penis, and the scrotum which takes several weeks to resolve. You may also notice small firm lumps below the wound these are normal and are simply the knots in the suture material used to close the wound. The suture slowly dissolves and will disappear within 3 months. Most men feel quite tired after surgery and this takes several weeks to resolve.

Following surgery, you will be given a prescription for regular pain medication as well as some laxative medication to keep your bowels regular and thus avoid any straining.

Light walking is encouraged straight after the surgery. After four to six weeks you may resume heavy lifting.

Showering, bathing, and getting the wounds wet is fine the skin has been sealed with glue.

Driving is safe once you are comfortable to do so and feel able to make an emergency stop. This would normally be around 3 weeks following surgery.

Can Erectile Dysfunction Be Treated

ED after Surgery, Prostatitis, and Testosterone Replacement | Ask a Prostate Expert

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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Erectile Dysfunction After Prostate Cancer Treatment

  • Original: May 2, 2020

Erectile dysfunction is the most common side effect after prostate cancer treatment irrespective of precision dose and delivery of radiation therapy or if the nerves were spared during surgery. Sexual dysfunction occurs because the nerves and blood vessels that control the physical aspect of an erection are incredibly delicate, and any trauma or stress to them can result in temporary or permanent damage.

Within one year after treatment, most men with intact nerves that were not significantly damaged will see a substantial improvement in sexual function. The skill of the surgeon or radiation oncologist can have a significant impact on long term sexual function, so its important to select your treatment and team very carefully.

When selecting treatment make sure your doctor explains the type and probability of side effect from their treatment facility. Sometimes treatment selection will depend on which side effects are most tolerable for you age and lifestyle.

Age, obesity and the ability to spare the nerves are the major determinants of the type and severity of side effects. In general, it is more challenging to spare the nerves in men with higher risk disease because the prostate cancer may have already spread past the nerves outside the prostate capsule.

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 to remove a prostate tumour can have devastating effects on a mans ability to have sex. Many men try devices and medications such as Viagra to help them have sex after surgery. This weeks research blog discusses the help available to achieve erections and the latest research comparing erection medications.

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.

Its believed that these issues are caused by damage occurring during surgery. Damage to the nerves and blood supply to the penis and surrounding tissue reduces erections. The nerves connecting to the penis are very close to the prostate gland. So surgery in this area can easily affect them. Even if nerve-sparing surgery is performed, the nerves need to be separated from the prostate in order to remove the gland. This causes damage through bruising and inflammation. Over time, this damage can heal, leading to improvements for some men.

Improving erections

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What Is The Treatment For Ed After A Prostatectomy

Penile rehabilitation is designed to preserve penile blood vessels and tissues so that they remain healthy and active. The therapy has the patient purposefully maintain an erection two to three times each week, often starting within a few weeks after surgery. Your surgeon may also prescribe a low-dose ED medication, designed to increase blood flow to the penis by relaxing the blood vessels.

The ED medication may take a while to work as the nerves recover, even in men who have undergone nerve-sparing surgery. Men with more severe nerve damage may not respond to the medication, while those with heart problems or who take alpha-blockers do not typically qualify for the medication.

If ED medications dont work, other options may help, including:

Penile injections: These medications, injected into the shaft of the penis using a thin needle, are considered the most reliable treatment for ED, according to the American Cancer Society. Your doctor will show you how to give yourself these injections when you want to have an erection.

Urethral pellets: One pellet is placed into the opening of the penis, where it melts, leading to an erection. However, this approach is less reliable than injections.

Availability Of Data And Materials

Dealing with Erectile Dysfunction

The datasets generated and/or analyzed during the current study are not publicly available due to the large size of the transcripts from each interview and sensitivity and specificity of some of the information from the interviews, but the demographic information and some of the de-identified descriptions can be made available upon reasonable request to the corresponding author.

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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.

How Fast Will I Become Totally Continent After Prostate Surgery

During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.

The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.

It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.

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Theme : Treatment/provider Satisfaction/dissatisfaction

Some men reported dissatisfaction with the treatment they received, while others were happy with the treatment and the care they received around the treatment. The majority of men talked about being happy they were cancer free. Several men talked about their frustration with their providers sole focus on the surgery and the lack of resources or help with side effects from treatment. Men who were dissatisfied talked about the lack of support and help from their providers while men who were satisfied with their care commented on the support and help they got from the provider throughout treatment. Some men felt the provider did not really understand them in terms of their priorities and their feelings about sexual function. Some patients regretted the particular treatment they received or that they received treatment at all. The participants said the following:

Man 17: Uh, were alive, ok? I was Gleason 7. My statistical life expectancy would be about 12 years, you know, thats average. Could be less, could be more. If I did not get treatment. And, uh, my mentality– and still isI got it out, out of my body.

Man 1: I think back. Maybe I shouldnt have done it . And go with the shorter quality of life rather than a long life a longer life with the situation.

Recovery Of Erectile Function After Surgery

Erectile Dysfunction Solutions after Prostate Cancer Treatment

Upon removing the catheter after surgery, many of you are probably hopeful that things return to normal again but this is often far from the case. As expected, the timeline of recovery varies from man to man, although erectile function can usually be the final hurdle to overcome. This is regularly the symptom holding you back from moving on with your life.

Up to 90% of men have erectile dysfunction in the early stages following a radical prostatectomy, therefore its mostly inevitable. Many of you wont feel any hints of sustaining an erection within the first 3-6 months, which can kill off any sort of hope for a spontaneous return. However, this emphasises the need to complete an early penile rehabilitation program which often includes a daily dose of Viagra, a vacuum device, lube and a box of tissues. Encouraging erections through sufficient stimulation is important, even if you dont achieve 100% of normal, to ensure that your penis tissue qualities are preserved.

Overcoming erectile dysfunction after prostate surgery is a long and enduring path for all men. Ensuring that youre covering all bases early and consistently within your recovery and not having too high of expectations are important elements to successfully manage. Visit us at www.onlineprostate.physio and let us help you get started!

LEARN MORE ABOUT EFFECTIVE MANAGEMENT STRATEGIES FOR ERECTILE DYSFUNCTION WITH OUR ONLINE COURSES

References

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