How To Treat Erectile Dysfunction After Prostate Surgery
Prostate surgery is challenging enough. But to make matters worse, such an operation may impact ones sex life. The prostate is a vital part of the reproductive system. Its responsible for producing fluids that carry sperm.
So when the prostate is affected, this can lead to conditions like erectile dysfunction.
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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.
Physiotherapy Treatment Before And After Prostatectomy Prostate Surgery
Prostate cancer is the most common cancer in men. It is known to affect 1 in 6 men over the age of 65 years . Fortunately, the treatment options AND outcomes are improving. The role of physiotherapy is often overlooked and not considered in the treatment journey before and after prostatectomy- prostate surgery. This post aims to raise some awareness of the impacts of cancer and how physiotherapy can play a crucial role in recovery. Prostatectomy is one of the treatment options your surgeon may advise, which is the removal of the whole prostate .
As a result of this type of treatment, urinary incontinence and/or erectile dysfunction can occur which can be quite distressing. Your surgeon may recommend that you visit a pelvic floor physiotherapist prior to having surgery to assist with your recovery. A review of the anatomy, the image below shows the pelvic floor muscles these are a group of muscles and connective tissues which create a supportive sling underneath the bladder and bowel for men. The prostate is located underneath the bladder. The valves that control the bladder are known as the internal and external sphincter as shown. The internal sphincter can be affected with surgery resulting in urinary incontinence.
The role of pelvic health physiotherapy
Pre-operation rehabilitation aims to provide the following:
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Francisco Julimar Correia De Menezes
1Masters degree in Public Health, University of Fortaleza UNIFOR, Ceará, Brazil
Masters degree in Public Health, University of Fortaleza UNIFOR, Ceará, BrazilPublic Health Masters Degree Program, University of Fortaleza UNIFOR, Ceará, BrazilSurgery Department of the Federal University of Ceará Fortaleza, Ceará, Brazil
Thread The Needle: 1 X 15 Reps
Again, more mobility for your thoracic spine but this time by adding in rotation movements. This exercise will feel great in your upper back to reduce joint stiffness. If you have a foam roller this can be helpful to get more range of movement. Push down on it with the back of the forearm during the rotation movement.
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Prostate Cancer Is Common But Treatable
Recently, there has been a movement within the urological community to not treat prostate cancer. Some cases of prostate cancer may never spread to other parts of the body, so treatment may be unnecessary. The benefits of radical surgery or radiation may not be worth the consequences if the cancer is not developing or moving.
The challenge is in knowing which cancers will not spread. No urologist knows when a prostate cancer should be treated. There is no definite signal that tells us that a prostate cancer has already spread. While PSA monitoring, repeated biopsies and MRI studies are of some benefit, the reality is that many patients, while be being watched can have their cancers spread so that a cure is no longer possible.
Another problem with observation or surveillance is that more than 1/3 of prostate cancers have more aggressive cell types or are more extensive than what is found from a biopsy. Not treating these larger or faster growing cancers increases the risk of cancer spread outside the prostate. This is called metastatic cancer and it is not curable.
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The Purpose Of Prostate Surgery
Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.
It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.
Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:
Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.
The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.
Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.
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Am I Too Old To Have Prostate Surgery
How old is too old to have a radical prostatectomy?
William D. DeWolf, M.D., Chief of the Division of Urology at Beth Israel Deaconess Medical Center, says:
For surgery to make sense that is, for the benefits to outweigh the risks you need to be young enough to take advantage of the added survival time that surgery can offer. Thats why I generally dont recommend this surgery for a man whose life expectancy is less than 10 years, or for a man who is older than 75, depending on his personal and family health history.
Radical prostatectomy is a major operation that can cause serious and life-threatening complications such as blood clots in the legs and lungs, abnormal heart rhythms, heart attack, pneumonia, and infections. The risk increases in older men and in those with other medical conditions, such as heart and lung disease, high blood pressure, diabetes, or a history of blood clots. Some studies have shown that side effects, namely urinary incontinence and erectile dysfunction, also increase with age.
What Happens Right After Prostate Surgery
After surgery, youll stay in the hospital for a day or two. You may feel sore, but nurses will encourage you to get up as soon as possible. Walking helps your body start to recover from the surgery and function normally again.
Your doctor may prescribe pain medicine for a few days immediately following surgery. After that, youll switch to over-the-counter pain meds.
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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.
Diet Fluids And Bowel Movements
Constipation is a common side effect of pain medications and surgery. You should have received prescriptions for an oral stool softener and a laxative.
You should start drinking fluids as soon as you are comfortable after surgery, and you can resume your normal diet the first day after surgery. But while waiting for normal bowel function to return, you should avoid large meals in favor of several small meals a day. To prevent constipation, we recommend drinking at least eight to 10 glasses of fluids each day and eating lots of fruits and vegetables. Avoid carbonated beverages and cruciferous vegetables such as broccoli, cauliflower, brussels sprouts and cabbage for approximately two weeks, as they frequently cause gassy discomfort and distention.
Take your stool softener and laxative as prescribed. Normal trajectory for return of bowel function is one to two days to pass gas, three to five days for the first bowel movement.
If you haven’t had a bowel movement by day three after your surgery, take oral Miralax , an over-the-counter laxative. You can combine Miralax with the prescribed stool softener and laxative. Follow the instructions on the box. Do not use any enemas or take stronger laxatives, such as magnesium citrate. Contact the clinic if you still haven’t had a bowel movement by day five.
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What Advice Would You Give To A Patient Who Wants To Keep The Risk Of Surgical Complications As Low As Possible
There are some things that patients cant control, such as their age, their baseline functionality, or the nature of their cancer. But they can control the treatment choices they make. Patients should be aware that some cancers are found so early that immediate treatment is not necessary, and these tumors can be monitored closely through an approach called active surveillance a method weve pioneered very successfully here at MSK.
For patients opting to undergo radiation therapy or surgery, its critical to know the outcomes of the individual doctor. Its well established that surgeons or radiation oncologists who specialize in a specific treatment and do a high number of procedures have better outcomes.
These therapies are very effective. Its always a balance between removing the cancer and trying to preserve function, and the balance is different for each person because each cancer is different. One of the benefits of places like MSK is that we have experts who can help guide patients in regaining urinary and erectile function.
Ultimately its all about finding a surgeon or a radiation oncologist with whom you feel comfortable someone who sets realistic expectations based on your situation as a patient.
Your Emotions And Sex
Your prostate cancer and its treatment wonââ¬â¢t just affect your body. Theyââ¬â¢ll also have a serious impact on your emotions. Stress and anxiety can trigger your body to make adrenaline, which gets in the way of havingà sex. The more you worry, the worse the struggle. If youââ¬â¢re in a relationship, your partner will be going through many of the same feelings.
One of the most important things you can do is to talk to your partner. Have an honest conversation about your fears and expectations when it comes to sex. Don’t assume they know how you feel. Being open with each other will help you both feel supported and help you work together to make any adjustments that you may need to stay intimate. Ã
Talking with a mental health professional — either one-on-one or with your partner — can be a powerful way to help manage your emotions. A therapist can also prescribe medications that may ease stress and anxiety. A professional sex therapist can help you and your partner find ways to improve your sex life. It may also be helpful to join a support group where you can talk with others who share your experience.
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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.
What Happens After Urethral Sling Surgery
Patients usually recover from this surgery quickly. Its best to limit demanding activities for approximately six weeks after surgery to avoid having the sling loosen before healing is complete.
After surgery, there may be swelling that makes it difficult to urinate. Youll have a catheter coming out of the urethra for two to three days. After this, the catheter is removed and just about everyone is able to void on their own. In rare cases, the catheter may have to be reinserted for a few days or up to a week if you cannot urinate.
After the swelling goes down, youll gradually be able to urinate on your own and empty your bladder. However, your normal urination pattern may not return for a few weeks.
The majority of men whove had this procedure have been cured of their urinary incontinence and no longer use pads. The others usually improve to the point where they dont use as many pads as they were before.
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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
- 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.
Life After Prostate Removal: What To Expect
The prostate gland is prone to inflammation and developing cancer.
Almost half of the men above the age of 60 have benign prostate hyperplasia or prostate enlargement.
However, BPH does not cause removing the prostate, but the presence of cancer or its early sign is the reason for prostate removal.
Prostate cancer has become a significant concern in recent years. Its incidence is increasing, and now its diagnosis is becoming more common even among middle-aged men.
Prostate cancer is now among the most common cancers in older men.
Aging indeed has lots to do with the increased prostate cancer rate, but it is not the only cause. It seems that this disproportionate increase in the annual incidence of prostate cancer also has to do with other lifestyle issues like a high-fat diet, greater prevalence of metabolic disorders, environmental toxins, hormonal changes, and more.
The prostate plays an important role in male fertility and sex life. Although men can survive without a prostate, unfortunately, for many men, prostate removal results in poor quality of life, issues like erectile dysfunction, and more.
Some men can expect to recover well from proctectomy. However, for others the journey to recovery is prolonged and distressing. Keep reading to find out more about life after prostate removal and what you can expect.
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Prostatectomy: What To Expect During Surgery And Recovery
If youve been diagnosed withprostate cancer, your doctor will consider many factors before recommending the besttreatment. For many men, that may mean a prostatectomy. In this surgery,doctors remove the entire prostate.
The Johns Hopkins Hospital performs more of these procedures than almostanywhere else in the world. One of the most common questions they hear frompatients: What should I expect after surgery?
Johns Hopkins urologistMohamad Allaf, M.D., explains the surgery and recovery.
What Is The Prostate
The prostate is a small gland in the male reproductive system, and it is about the shape and size of a walnut. It lies low in the pelvis, underneath the bladder, and simply before the rectum.
If you think you have a prostate problem, you might consider massaging them to regulate your prostate health.
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What Are The Types Of Radical Prostatectomy
Your surgeon will choose among several types of radical prostatectomy:
- Open radical prostatectomy: During this traditional type of surgery, your surgeon makes a vertical incision between your belly button and pubic bone. Your surgeon inserts tools through the incision to remove the prostate and surrounding tissue.
- Robot radical prostatectomy: Your surgeon makes several small incisions or one single incision across your abdomen. During the surgery, your surgeon operates state-of-the-art robotic controls outside your body. They can see the surgical area with a magnified view on a 3D screen.
What Necessitates Prostate Removal
Prostate cancer and sometimes benign prostatic hyperplasia can necessitate the removal of prostate gland. However, the most common cause is prostatic cancer as BPH can nowadays be managed with other treatment options. The prostate gland removal surgery is known as prostatectomy. The risks, benefits and side-effects of prostatectomy should be discussed with the patient, before making the decision to get prostate gland removed.
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