Questions To Ask Your Doctor
- Is my grade and stage of cancer treatable or curable?
- How do I know if I need treatment?
- How do I decide what treatment is best for me, or what treatment to start with?
- Are there any clinical trials available to me?
- How long does treatment last?
- How will treatment affect my daily life? Will I still be able to do my normal activities?
- Can treatment affect my sex life or ability to have children?
- What are the long-term effects of prostate cancer treatment?
- What is my chance of cancer returning after treatment?
- What happens if I choose not to get treatment?
When Can I Return To Sexual Activity
Let the surgery heal for three to four weeks before attempting anything. After one month after the robotic prostatectomy, it is recommended that you resume sexual activity. Stimulation of the nerves is thought to be a first step on the journey back to potency. Remember that you can still experience the pleasures of orgasm and other sensual stimulations without full erections. The average time to recovery for erections adequate for intercourse is 6-12 months, but in some men it is even longer. You should also be performing kegel exercises regularly to help your return to potency.
The Need For Further Treatments
There is a chance of the sudden swelling of the prostate gland right after surgery. Some men may need a follow-up treatment after laser ablative surgery because all the tissues are not removed or these tissues may grow back over time, resulting in the prostate gland to become enlarged again. If laser surgery fails to provide lasting results, then it may be necessary to undergo more invasive treatments such as an open prostatectomy surgery.
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Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
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Caring For Your Incision
The incision runs from above the base of the pubic area to below the navel. It is important to keep it clean and dry. Showering once a day should be sufficient. If you notice extreme or increasing tenderness, progressive swelling, more than a small amount of drainage or any pus or redness, notify your doctor right away.
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Chest And Breathing Problems
Chest infections, including pneumonia, can be serious.
You can lower your risk by:
- stopping smoking before your operation
- getting up and moving as soon as possible after your operation
- doing any breathing exercises your physiotherapist teaches you
If you get an infection you have antibiotics to treat it.
Where Can I Find Prostate Cancer Support Groups
Even though once you complete the surgery you most likely will find yourself cancer-free, the anxiety and stress may never totally go away. The support of your friends and family is essential in these moments, but the most relief you will find is among people that have gone through the same experience.
We advise you to search locally for prostate cancer or cancer survivors support groups and discuss your journey in beating this. You will find there plenty of people that lived through the same emotions and painful experiences and you will gather your strength to overcome this and not let it define the rest of your life.
If physical presence is not an option for you, there are plenty of forums and online communities that gather around this subject. You can find people that share their experiences and advice below:
Prostate cancer surgery is not as severe of a surgery as other ones. The recovery, especially after robotic surgery, usually lasts up to 2 to 3 weeks and patients can return to work and to living their normal lives.
Enlarged Prostate Surgical Procedures
Here is a list of enlarged prostate surgery procedures:
- TUIP widens the urethra by making a few small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself.
- TURP surgery is the procedure used for 90% of all prostate surgeries for BPHit is the standard operation.
With TURP, an instrument called a resectoscope is inserted through the penis to remove the excess tissue. It is less traumatic than open forms of surgery.
It has a high risk of retrograde ejaculation, which is when semen works its way back into the bladder instead of coming out the tip of the penis when you come.
Other risks: impotence, incontinence, blood loss, and urinary tract infection. This procedure is now available using lasers.
- Simple or Partial Prostatectomy is the removal of the inner portion of the prostate through an incision in the lower abdomen. This is an invasive surgery used for very large prostate glands to remove the enlarged part of the prostate.
This BPH surgery procedure is open surgery performed while the patient is under general anesthesia.
Read more about BPH and medical procedures here:
Read these industry-funded sites that explain all the different procedures in greater depth. Buyer beware as despite the claims to being superior, many of these private state of the art procedures have not been proven over time to be superior to the standard TURP:
What Is Prostate Removal
A prostatectomy is a surgical procedure for the partial or complete removal of the prostate, which is a small gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum in men. The prostate supplies part of the seminal fluid , which mixes with sperm from the testes. Sperm needs this fluid to travel and survive for reproduction.
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Radiation Therapy Side Effects
Because the prostate is close to several vital structures, radiation therapy can disrupt normal urinary, bowel, and sexual functioning. Short-term Complications You may experience some temporary urinary symptoms, such as waking up in the night and needing to urinate, needing to urinate more often during the…
Side Effects Of Conventional Prostate Bph Treatments And Enlarged Prostate Surgery
If you are very lucky you may well have an improved urinary function and few side effects after enlarged prostate surgery. Unfortunately, that is not the case overall.
If you think that BPH operations are harmless, think again. In my experience, side effects are not fully explained and are minimized. Why? Because doctors:
- think they are providing the best treatment based on what they know and what they have available to offer,
- often directly benefit financially from the procedures, and
- are unaware of any other options.
If they do know of alternative options, they could risk losing their medical license by offering those alternative treatments.
All of the conventional treatment options I mention on this page have consequences of:
- major discomfort to pain
- possible incontinence
- impotence and sexual difficulties
- retrograde ejaculation
- and often the treatment will need to be repeated at a future date with scarring occurring with each attempt, which makes each procedure less successful and exacerbates the side effects.
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How Soon After Prostate Cancer Treatment Can I Be Sexually Active Again
This will depend on what type of treatment you have had and how you feel. It could be several weeks, for others it may be a lot longer for erections to return. Some men will never be able to keep an erection without the help of artificial methods like medicines or medical devices . If you were having problems having erections before treatment, this will not get better after treatment.
What Are The Side Effects Of Prostate Radiation
Even though both external beam radiation and brachytherapy use the same radiation as the cure from the cancer cells, they have some common side effects.
- Bowel problems: Radiation proctitis is a very common inflammation of the rectum that occurs as a result of the radiation treatment of prostate cancer where damage to the rectum was acquired. Proctitis can lead to diarrhea, with the blood in the stool, and rectal leakage. Most of these problems go away over time, but in rare cases, normal bowel function does not return. In order to minimize bowel problems, doctors will advise what kind of diet to follow during radiation therapy to help limit bowel movement during treatment.
- Urinary problems: Radiation cystitis is the side effect of inflammation and subsequent destruction of the normal work of the urinary bladder at the cellular level after the usage of radiation in the treatment. Patients will feel the need to urinate more often, have a burning sensation while the urinate process, and/or find blood in the urine itself. Urinary problems usually improve over time, but in some men, they never go away.
- Erection problems : Patience after the treatment, with radiation or through surgery, has the same rate of impotence level. These problems do not occur right after radiation therapy but are slowly developing over time. The effect of radiation treatment is more visible if the patient is elderly, where impotence is already on the low level.
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Prostate Cancer Treatment: Radiation Therapy
Radiation, focused as a beam, can be used to kill cancer cells, especially those cells that have migrated from the prostate gland. Beams of radiation can be used to reduce bone pain caused by invasive cancer cells.
Low Dose Rate Brachytherapy
In another type of radiation therapy termed low dose rate brachytherapy, radioactive pellets about the size of a grain of rice are inserted into the prostate.
High Dose Rate Brachytherapy
High dose rate brachytherapy applies more radioactive sources temporarily into the cancerous prostate gland.
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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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How To Return To An Active Sex Life After Prostate Cancer Treatment
No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them. Surgery, radiation therapy and other treatments may impact a patients sex life, causing challenges like low sex drive, loss of penis length, dry orgasm or low sperm counts. Despite the angst these issues may cause, experts say most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment.
Unfortunately, sexual dysfunction is a possibility for nearly all treatment options for prostate cancer, including surgery, says Scott Shelfo, MD, FACS, Medical Director of Urology at our hospital near Atlanta. The degree of dysfunction depends on many factors, including the patients overall health, co-existing medical problems, as well as the patients level of sexual function and ability before treatment.
What Are Pelvic Floor Exercises And Can Improve Erection Quality
As we age, we lose muscle tone throughout your body. That includes the muscles that men need to maintain erections. However, there are physical exercises men can do to reduce erectile dysfunction. The best ones are known as pelvic floor exercises or kegels.
Those muscles are the core of how your body maintains blood flow to the penis and therefore keeps erections strong.
They put pressure on the veins in your penis, preventing blood from flowing back into the rest of your body. If they arent strong enough then even if you can get an erection, you wont be able to keep it.
The process starts with identifying the muscles you need to activate. Thats best achieved by lying down with knees bent and feet flat on the floor. Thats when you breathe out and squeeze your pelvic floor muscles for 3 seconds.
Its important that you identify the right group, at the base of your buttocks, on either side of your perineum. It can be easy to mistake other muscles, such as the legs or stomach for the pelvic floor.
Once you are confident you have the right muscle group, then doing the exercises in a seated or standing position three times a day can firm and strengthen the muscles, with a likely improvement within four to six weeks.
Some men find that after the initial strengthening that options like Pilates become appealing as not only are there many exercises which improve the pelvic floor, but they can improve overall posture and strength.
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When To Call Your Doctor Or Nurse
Its important to tell your doctor or nurse if:
- your bladder feels full or your catheter isnt draining urine
- your catheter leaks or falls out
- your urine contains blood clots, turns cloudy, dark or red, or has a strong smell
- your wound area or the tip of your penis becomes red, swollen or painful
- you have a fever
- you feel sick or vomit
- you get cramps in your stomach area that will not go away
- you get pain or swelling in the muscles in your lower legs.
Your doctor or nurse will let you know if you should go to the hospital.
Side Effects Of Prostate Surgery
The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.
Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:
- Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
- Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
- Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
- Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.
After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
There are several options for treating erectile dysfunction:
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
Types Of Radical Prostatectomy
There are three main types of radical prostatectomy:
- Retropubic. In this procedure, the surgeon uses an incision in the lower abdomen to remove the prostate and the lymph nodes for examination. This procedure allows for a nerve-sparing approach, which can lower but not totally eliminate the risk of impotence following surgery. In the nerve-sparing approach, the surgeon tries to preserve one or both of the small nerve bundles needed for unassisted erections. However, if the cancer has spread to the nerves, this approach may not be advised.
- Laparoscopic. In this recently developed procedure, the prostate is removed in a fashion similar to a retropubic prostatectomy, but the procedure is performed through five very small incisions using lighted, magnified scopes and cameras. The prostate specimen is then removed in a small bag through one of the incisions, which is expanded to 2 to 3 cm to allow specimen removal.Potential benefits of this procedure are less pain and earlier return to full activities. Nerve-sparing methods and lymph node dissections can be performed with this technique as well.
- Perineal. In this procedure, the prostate is removed through an incision in the skin between the scrotum and anus. The lymph nodes can’t be removed through this incision. If the lymph nodes need to be examined, removal can be done through a small abdominal incision or by a laparoscopic procedure. A nerve-sparing approach can be performed perineally.
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