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Kidney Problems After Prostate Surgery

Does Surgery On The Prostate Gland Interfere With Sexual Function

Bladder Control Problems After Prostate Surgery

Surgery for an enlarged prostate does not usually interfere with a man’s sexual functioning. However, about 10 to 15 percent of men may have trouble getting erections after surgery. Men may have a problem called retrograde ejaculation, which causes semen to go backward into the bladder instead of through the urethra to the outside. This means no longer being able to father children but causes no other harm.

Why Do Men Have Problems With This

It might seem counter-productive that men may have issues controlling their urination after prostate surgery, especially since many men undergo surgery to treat their urinary symptoms to begin with. The underlying causes of these symptoms arent limited to the prostate itself often other structures such as the bladder or urethra can undergo changes after surgery.

For example, a man may undergo surgery to reduce obstruction from his prostate gland so that he may more easily pass urine. Before surgery, his bladder must push harder than usual to pass urine beyond his prostate gland. When this obstruction is surgically removed, however, the bladder must adjust to changes caused by surgery. An unusual urge to urinate with or without leakage may occur during this recovery.

When It Would Be Performed

Your urologist will initially try to control your lower urinary tract symptoms with oral medications. In most cases, prostate enlargement symptoms will improve.

However, you might have a very large prostate gland that does not respond to conventional treatments. If that is the case, your doctor might consider laser treatment as an option.

It all depends on your health, the size of your prostate in imaging tests, and whether the equipment is available and the doctor is trained in this technique .

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What Is A Common Misconception You Find In Patients Regarding Complications That Might Occur After Prostate Cancer Surgery

I have found that patients often misunderstand the real meaning of percentages doctors give them about the likelihood of recovering their function. A patient might be told that their chance for recovery of erections is 75 percent. A lot of patients interpret that as meaning, I have a 75 percent chance of returning to my baseline function. It actually means 75 percent of patients will be able to get a functional erection, often with the aid of a pill. Unless the doctor makes this clear to them, many patients will be disappointed. When a percentage is quoted, patients should ask their surgeons what it actually means because as is usually the case the devils in the details.

Problems After High Intensity Focused Ultrasound

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Youre more likely to get urinary problems after HIFU if youve already had other treatments for prostate cancer. Possible urinary problems include:

  • difficulty urinating
  • urine infections.

Difficulty urinating

HIFU usually causes the prostate to swell for a week or two, so youll have a catheter to drain urine from your bladder until the swelling has gone. HIFU can also cause the urethra to become narrow, making it difficult to empty your bladder .

Leaking urine

HIFU can cause some men to leak urine when they cough, sneeze or exercise . This may be more likely if youve already had radiotherapy. There are ways to manage leaking urine.

Urine infections

Some men get a urine infection after HIFU. If this happens, youll be given a course of antibiotics to clear the infection.

Read more about urine infections in our fact sheet, Urinary problems after prostate cancer treatment.

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How Is Urinary Incontinence After Prostate Surgery Treated

If you find youre having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medications or physical therapy exercises for the pelvic floor muscles. These treatments may also cut down on the number of times that you have to get up each night to pee.

These methods can sometimes help men who have mild to moderate leakage. Men who have persistent leakage or a more severe problem may need surgery if they do not want to continue to use pads.

What Is Prostate Enlargement Or Bph

If you’re a man over 50 and have started having problems urinating, the reason could be an enlarged prostate, or BPH. As men get older, their prostate keeps growing. As it grows, it squeezes the urethra. Since urine travels from the bladder through the urethra, the pressure from the enlarged prostate may affect bladder control.

If you have BPH, you may have one or more of these problems:

  • A frequent and urgent need to urinate. You may get up several times a night to go to the bathroom.
  • Trouble starting a urine stream. Even though you feel you have to rush to get to the bathroom, you find it hard to start urinating.
  • A weak stream of urine.
  • A small amount of urine each time you go.
  • The feeling that you still have to go, even when you have just finished urinating.
  • Leaking or dribbling.
  • Small amounts of blood in your urine.

You may barely notice that you have one or two of these symptoms, or you may feel as though urination problems have taken over your life.

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Are Kidney Stones And Prostate Cancer Related

No. Prostate cancer is the most common non-skin cancer among men in the United States. The exact cause of prostate cancer is unknown but there are risk factors that elevate your chances of developing prostate cancer. These include:

Age You are more likely to develop prostate cancer if you are over the age of 50.

Family history Prostate cancer seems to run in families. Having a father or brother with prostate cancer more than doubles your risk of developing it.

Race / ethnicity Prostate cancer is more common in African-American men and Caribbean men of African ancestry than in men of other races.

Kidney stones are not an identified risk factor of developing prostate cancer. Recurrent kidney stones can cause other complications, like increasing your risk of developing chronic kidney disease.

Kidney stones, prostatitis, and prostate cancer can all cause difficult or painful urination, pain in your abdomen or pelvic area, and a frequent urge to urinate. If you are experiencing any of these symptoms, it is important talk with your doctor. Your doctor can determine the cause of your symptoms and provide you with an individualized plan to begin treatment as soon as possible.

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How The Surgery Works

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Different materials can generate laser radiation. Depending on the material, we can have a different type of laser . Holmium laser is optimized for clean incisions of the prostate tissue. Conversely, Greenlight laser surgery is much better for tissue vaporization.

Your doctor will choose one depending on what you need . The laser waves are generated by a scope that will be inserted through the tip of your penis. After numbing the area and lubricating, the doctor inserts a small probe through the urethra. After reaching the prostate, they will deliver energy to specific areas and remove tissue. Finally, excess prostate tissue is taken out along with the probe.

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Does An Enlarged Prostate Mean Cancer

Most men who have a prostate problem do not have cancer. Cancer does occur in the prostate gland and is more common as men age. It is important for your doctor to check your prostate gland for enlargement or abnormalities, particularly as you age. In addition, there is now a blood test called the PSA, or prostate specific antigen test, which measures a substance that increases in the blood when prostate cancer has spread. The American Urologic Association recommends a yearly prostate examination for all men over age 50. However, men who have a higher risk of developing prostate cancer, such as African-American men and men who have a family history of the disease, are advised to begin yearly prostate exams at age 40. Other tests, such as ultrasound, can also give information about the prostate gland.

How Long Does Urinary Incontinence After Prostate Surgery Last

It’s impossible to say exactly how long it lasts. The chances of you having urinary problems may be influenced by your age, weight and the physical characteristics of your urethra .

However, a majority of men are eventually continent after a radical prostatectomy. In many cases, men are able to go safely without any kind of incontinence product after about three months. This is especially true of men who are healthy overall and fall into the age range of 40 to 60 years. If you are having persistent problems, its important to know that there are ways to treat urinary incontinence after prostate surgery.

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Radical Prostatectomy Retropubic Or Suprapubic Approach

  • You’ll be positioned on the operating table, lying on your back.

  • An incision will be made from below the navel to the pubic region.

  • The doctor will usually perform a lymph node dissection first. The nerve bundles will be released carefully from the prostate gland and the urethra will be identified. The seminal vesicles may also be removed if necessary.

  • The prostate gland will be removed.

  • A drain will be inserted, usually in the right lower area of the incision.

  • Reasons To Have Prostate Surgery

    Nursing Mnemonics: TURP

    One of the most common reasons for having prostate surgery, or a prostatectomy, is to treat prostate cancer.

    According to the American Cancer Society, prostate cancer is the second most common form of cancer in American men, right behind skin cancer. Nearly 174,000 new cases are reported in the United States every year. If the cancer has not yet spread outside of the prostate gland, then surgery will be a great treatment option. Another reason to have prostate surgery is to treat an enlarged prostate.

    As the prostate grows, it may block the flow of urine which can create bladder, urinary tract, and kidney related problems. Removing a part of the prostate can help to solve or prevent these issues.

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    Providing Your Medical History

    At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?

    As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.

    If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.

    Prostate Stones What Are They

    All of us are familiar with kidney stones, either knowing someone whos had them or maybe have experienced them ourselves. But have you ever heard of prostate stones? Also known as prostatic calculi, these small brownish-gray stones, about the size of a poppy seed, can form in and around the prostate gland. A man may have only one calculus, or he could have hundreds of calculi.

    About 80% of prostate stones are made of calcium phosphate and can resemble nodules. What seems like a nodule is actually a tiny formation of calcified minerals with the prostate stone being harmless. It is believed these stones are formed either by secretions from the prostate thickening or when pus and another debris fuse together during an infection. The incidence of men with prostate stones is relatively unknown but has been reported to vary widely anywhere from 7% to 70% of men with prostate stones.

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    What Is Renal Failure

    Renal failure, or kidney failure, is when your kidneys can no longer do their job of fluid filtration and excretion. There are five different stages of kidney failure. In the most advanced stage, you must have ongoing dialysis or a kidney transplant to survive.

    Common causes of kidney failure include diabetes and certain autoimmune or genetic diseases. Certain drugs, high blood pressure, dehydration, infections, or obstruction to the outflow of urine can also hurt your kidneys.

    Various Studies Link Benign Prostate Hyperplasia To Chronic Kidney Disease

    Urinary Incontinence After Prostate Cancer Surgery

    Numerous studies have linked BPH with an increased risk of kidney disease. Much research has revealed complications associated with BPH obstruction as well as chronic kidney disease. Andrew Rule, M.D., specialist at the Mayo Clinic, said, Several studies show men with chronic kidney disease have increased chance of death, hospitalization and cardiovascular events.

    Epidemiologist Dr. Steven Jacobsen added, We were surprised at how much kidney disease can be attributed to BPH. An obstruction on the urethra is like a dam on a river men can still void, but the constant build-up and pressure will ultimately cause damage. BPH affects 90 percent of males in their 70s and 80s.

    Other research that analyzed the relationship between BPH and kidney disease revealed an enlarged prostate will almost always contribute to bladder obstruction, which impairs the function of the kidneys. The link comes from the residual urine that remains in the body when the bladder cannot be fully emptied.

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    What Is The Prostate

    The prostate is part of a man’s sex organs. It’s about the size of a walnut and surrounds the tube called the urethra, located just below the bladder.

    The urethra has two jobs: to carry urine from the bladder when you urinate and to carry semen during a sexual climax, or ejaculation. Semen is a combination of sperm plus fluid that the prostate adds.

    What Matters Most To You

    Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

    Reasons to have surgery for an enlarged prostate

    Reasons not to have surgery

    I don’t want to keep taking medicine every day for my symptoms.

    I don’t mind taking daily medicine.

    I’m willing to try surgery because my symptoms bother me so much.

    I don’t like the idea of having surgery.

    I don’t think medicines are helping my symptoms.

    Medicines are helping my symptoms.

    I don’t think the side effects of surgery will be as bad as my symptoms.

    I think the side effects of surgery would bother me more than my symptoms do.

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    Radical Prostatectomy And Rhabdomyolysis

    Radical prostatectomy is the main surgical treatment for PCa. Radical retropubic prostatectomy is performed with patients in the supine position, while in radical perineal prostatectomy , patients are placed in an exaggerated lithotomy position. More recently LSP and RARP have been developed, and these minimally invasive procedures are replacing open radical prostatectomy in some countries.

    The first description of position-induced RM with subsequent AKI after a knee-chest position was in 1953 by Gordon. Renal failure following radical prostatectomy is uncommon, and the incidence of subclinical RM following this procedure is currently unknown. In a recent retrospective study of 175699 patients subjected to robotic or non-robotic radical prostatectomy, the incidence of RM was 0.08%. In a prospective study of 60 patients undergoing RARP and lymph node dissection with prolonged positioning in a steep Trendelenburg position, Mattei et al demonstrated that ten patients developed RM . Although AKI following radical prostatectomy appears to be rare, there are a number of case reports that suggest RM secondary to an exaggerated lithotomy position as a cause of AKI in this setting.

    Life After Prostate Cancer Treatment

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    Adjusting to life after prostate cancer treatment can take time. For some men, the emotional impact of what they have been through may not hit them until they have finished treatment. For others, working through the physical side effects is their immediate focus.

    Although prostate cancer treatment can be lifesaving, it can also take a toll on the body. This can result in a disruption to normal urinary, bowel and sexual function.

    Whether you have surgery, radiation or hormone therapy, you are likely to have side effects.

    “It’s important to talk with your health care provider about these side effects before you start treatment, so you can learn about the range of options to treat them,” says Anne Calvaresi, DNP, CRNP, RNFA, Urology Nurse Practitioner at the Kimmel Cancer Center, Thomas Jefferson University in Philadelphia.

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    Rhabdomyolysis Associated With Prostatectomy Prevention And Management

    To prevent RM associated with surgical position, all pressure points should be protected, including paying special attention to the shoulders, back, and sacrum. The vascular status of the patients lower extremity should be evaluated with a preoperative vascular examination, and repositioning the lower extremities every two hours could improve perfusion and avoid the occurrence of injury. Some investigators have suggested noninvasive or invasive intraoperative monitoring to assess for impending limb compartment syndrome. Others have recommended obtaining preoperative CPK levels, levels every two hours intraoperatively and levels six to eighteen hours postoperatively if the procedure is expected to be prolonged, especially in high-risk groups.

    Difference Between Benign Prostatic Hyperplasia And Prostate Cancer

    Benign prostatic hyperplasia is a non-cancerous growth of the prostate and it does not increase a mans risk of developing prostate cancer. Prostate cancer begins in the outer peripheral zone and grows outward to invade surrounding tissue. In BPH, the growth moves inward towards the prostates core, causing the urethra to become tighter and making it difficult to urinate.

    The way BPH and prostate cancer grow determines their symptoms. BPH can have annoying symptoms, such as the inability to urinate or only being able to release a small amount. Prostate cancer is referred to as a silent killer because its symptoms can take months or years to even appear.

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