Who Has Nerve Preservation
Patient who are potent are understandably keen to retain this and so are we. As well as allowing erections following surgery, nerve preservation also allows an earlier return to continence so we always practice nerve preservation whenever the cancer control allows it, which is in about 80% of men. When the cancer is close to one of the nerves we might partially nerve preserve on that side if it is safe to do so and will discuss this with you beforehand if this seems likely.
The decision to nerve preserve is taken after considering the patients existing erections, PSA level, biopsy report, MRI scan, rectal examination under anaesthetic immediately before the operation starts and the way the NVB looks and feels during the operation. It is always discussed with patients before surgery.
Talk About How You Feel
First off, it is essential to evaluate how you feel.
It is vital to talk about it if you want to improve.
Most men prefer not to talk about this with a professional, and they avoid the topic with their partners.
However, this position will only make things worse with your partner and cause anxiety to you.
After talking it out with a professional, you will see how easy it is.
They are trained to answer your questions and give you recommendations and a variety of options.
Sometimes men are anxious about erections after surgery because they read so much about it.
Their anxiety plays against them, turning a weaker erection function into a complete failure.
Thus, one of the first aspects to consider is your mindset, feelings, and emotions.
Therapy can help a lot if youre struggling.
It is sometimes appropriate to incorporate your partner in the talking, but it is not always required.
Cancer Treatments And Erectile Dysfunction
Following surgery, many men experience erectile dysfunction , but for many, the disruption is temporary. Nerves damaged during surgery may result in erectile dysfunction. A nerve-sparing prostatectomy may reduce the chances of nerve damage. Another factor is the surgeons skill level for performing the nerve-sparing technique, which if done correctly, may improve patients likelihood of retaining erectile function, says Dr. Shelfo.
Prostate cancer may also be treated with various types of radiation therapybrachytherapy, external beam radiation or stereotactic body radiation therapy. Each type of therapy causes somewhat different side effects. About half of all prostate cancer patients who undergo any of these types of radiation therapy are likely to develop erectile dysfunction, according to a 2016 article published in Advances in Radiation Oncology.
When you compare surgery with radiation, both may affect erections, says Dr. Shelfo. Surgery is usually more immediate, and sexual dysfunction has the potential with time to improve. With radiation, erections are usually less affected in the beginning, but over timemonths or, sometimes, yearssexual dysfunction may develop. Both treatments may affect sexual function, resulting in no ejaculate or the ability to attain erections.
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Where To Get Prostate Surgery In Nyc
At New York Urology Specialists, we offer specialized treatment for enlarged prostate for men. Same-day virtual video appointments and in-person appointments are available.
Call/text today: or make an appointment online.
We perform a cystoscopy, urodynamic testing, prostate and bladder ultrasound in our office. We offer Urolift procedure, Rezum water-vapor procedure in our office, and laser enucleation of the prostate in a hospital setting. We treat urinary and erection problems. We offer confidential appointments.
Our appointment costs are affordable with or without insurance. We offer free insurance verification.
Surgery For Prostate Cancer
Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.
The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.
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Restoring Erectile Function After Prostatectomy
In todays world, the overall mortality for almost every cancer is falling. In many cases, the incidence of various cancers is also declining.
However, for prostate cancer, the incidence has been steadily rising since the advent of the Prostate Specific Antigen test. 1
Considering that the American Cancer Society lists the 10 year survival rate for prostate cancer at 98 percent, this poses a problem. Is the 10 year survival rate due to excellent early detection and treatment, or was treatment not needed?
For many years, the medical paradigm for all cancer, including prostate cancer, has been to find and treat it early to effect a cure. It is well-known that prostate cancer can be very slow-growing and that some prostate cancer is of an indolent type that may never rise to a level of a significant problem.
Early detection and treatment of indolent prostate cancer that will likely never become life-altering are often more damaging than allowing natural disease progression. This is especially true regarding a mans quality of life.
In autopsy studies of men that died from causes other than prostate cancer, many were found to have long-term, undetected cancer in their prostates. This overdiagnosis and overtreatment can cause more harm to a man than living with the disease.
Scheduling Appointments For Enlarged Prostate Treatment At New York Urology Specialists
We have excellent reviews from patients and their partners. Information for out-of-state and international patients. Find out our office hours or directions to our office.
We offer affordable appointment prices with or without insurance. We offer weekday, weekend, and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist and specialist in the treatment of urinary problems in men. He is one of the few urologists who offers a full range of treatment options for BPH . He specializes in all aspects of care for men with an enlarged prostate and urinary problems, including frequent urination at night, difficulty emptying the bladder, urinary urgency, and incontinence. He has successfully treated thousands of men with urinary problems, including urinary retention, painful urination, and frequent urination.
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The Three Parts Of Male Orgasm
Kacker starts by pointing out a common misconception that erections are necessary for male orgasm. They arent. Men can have experience orgasm without an erection. The converse is also true, of course: men can have an erection without having an orgasm.
When discussing orgasm and radical prostatectomy, its useful to think of the male orgasm as having three separate parts, says Dr. Kacker.
First, secretions from the testicles, the prostate, and the seminal vesiclessmall, slender glands near the prostateflow into the urethra, the tube-like structure that carries semen through the penis and out the body. The emission of those fluids creates a feeling of fullness and a sensation of inevitability.
Second, theres ejaculation, which is accompanied by contractions of the pelvic floor muscles, the group of muscles used to hold in intestinal gas and urine.
And third is the mental componentall of the processing the brain does of incoming sensory signals from penis and pelvis that contribute to the mental experience of build up and release.
Does Prostate Treatment Cause Permanent Sexual Dysfunction
- Date : 11 Nov 2021
Erectile dysfunction is the most common side effect after prostate cancer treatment no matter precision dose and transport of radiation therapy or if the nerves had been spared throughout surgical treatment. Sexual disorder happens due to the fact the nerves and blood vessels that manage the bodily component of an erection are quite delicate, and any trauma or pressure to them can bring about transient or everlasting damage.
Radical prostatectomy is surgical treatment to put off the prostate gland and surrounding structures. This surgical treatment is most usually executed to deal with prostate most cancers. The achievement costs are exact if the most cancers has now no longer unfold past the prostate. However, there are facet outcomes to the surgical treatment. One is erectile disorder .
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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.
What Concerns Could Arise
Some men experience a loss of desire for sex, an inability to achieve or maintain an erection, inability to reach orgasm or have a change in orgasm , experience pain during sex, or just do not find sex pleasurable. Sexuality is an important factor in their quality of life for many men. Know that these concerns are common and your healthcare team can provide guidance. Write down your questions and concerns so you don’t forget to ask about them. If your provider cannot help, ask them to recommend someone who can.
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Viagra Useful For Impotence Following Prostate Surgery
Nov. 30, 1999 — Men with prostate cancer who have their prostate removed are usually free of cancer, but the procedure often comes with a cost — impotence. A new study, however, shows that Viagra , the popular medication for erectile dysfunction, can restore impotency lost in surgery. Whether men respond, however, depends on how much nerve damage occurred during surgery.
Each year some 200,000 men are diagnosed with prostate cancer and, of those, 50,000 will have to undergo surgical removal of the prostate.
“Incontinence and impotence are the two most common side effects. A large number of patients, even with nerve-sparing techniques, end up with erectile dysfunction,” Milton Lakin, MD, who leads the medical urology section at Cleveland Clinic Foundation, tells WebMD. “The first thing want to do is a very good cancer operation. Cancers are being discovered early enough that in many cases it is possible to spare both nerves, or at least one.”
The new study, which appears in the November Journal of Urology, was completed by physicians at Baylor College of Medicine in Houston. It involved about 80 men who ranged in age from 47 to 76 years old. All were prescribed Viagra following prostate removal surgery. Based on their responses to a series of questionnaires, 53% had improved erections and 40% had improved ability to have intercourse.
Can I Do Or Take Anything To Speed Up Nerve Regeneration
I recommend to my patients that they stimulate themselves 2-3 times a week and take a Viagra tablet at least once a week as well. This encourages nerve regeneration and increases blood flow to the penis. There are three tablets in the same family as Viagra that you can take: Cialis , Levitra and Viagra itself . There is evidence that taking one of these tablets regularly after prostate surgery speeds recovery of potency. All three work by increasing blood flow to the penis, and while they wont give you an erection on their own, they make it easier to get one with stimulation.
Not all patients want to take a tablet for potency and there is no compulsion to do so. Please do be aware that there are common side-effects associated with this increased blood flow, including headaches, facial flushing and indigestion.
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What Is The Problem
Some 6,500 radical prostatectomies are performed every year in the UK . In a negative association, an increase in one quantity corresponds to a decrease in the other. Association does not necessarily mean that one thing causes the other. More of Urological Surgeons, 2019). While approximately half of these men have pre-existing erectile dysfunction, over 50% of the other half can expect to lose natural erections after prostatectomy surgery, especially if their cancers are locally advanced and require wide clearance to ensure removal of the whole tumour.
What Causes Ed After Prostate Surgery
Is it essential to know what causes ED after prostate surgery.
When you learn about it, you will know what to expect and what type of surgery you prefer.
There are different techniques to deal with prostate cancer and benign prostate hyperplasia .
Some are minimally invasive, while others involve complete prostate removal.
In general, the largest the extension of the prostate that is taken out, the higher the possibility to experience sexual dysfunction.
For example:
- Minimally invasive procedures such as transurethral incision of the prostate alleviate urinary symptoms. They have little to no adverse effects on sexuality.
- More invasive procedures such as transurethral resection of the prostate take out a portion of the prostate gland. Depending on the size, the patient may experience erectile dysfunction.
- Theres also a procedure known as radical prostatectomy. It involves the complete removal of the prostate. Thus, it has a higher chance of erectile problems.
So, the first step is asking your doctor what proportion of the prostate gland will be taken out.
It usually correlates with the chance of sexual dysfunction. But why is that?
The answer is simple: When the prostate gland is removed, the doctor needs to pull and create traction.
These movements drag along the nerves that run beside the gland.
The nerves could be either sliced altogether or simply scratched in the process.
These nerves go directly to the penile tissue and have a significant role in erectile function.
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Why Does Prostate Surgery Cause Erectile Dysfunction
In men with prostate cancer that has not spread outside the gland itself, surgery is often the recommended treatment. Radical prostatectomy involves removing the entire gland along with the seminal vesicles and some surrounding tissue. There are several types of prostate surgery, including laparoscopic and robotic-assisted procedures.
In the retropubic approach, the surgeon makes an incision in the lower abdomen, from the navel to the pubic area. The prostate is carefully separated from surrounding nerves and blood vessels before it is removed along with adjoining tissue. In the perineal approach, an incision is made between the anus and the scrotum.
This is a shorter operation and is preferred when lymph nodes do not need to be removed. However, the perineal approach is associated with a higher incidence of post-surgery erectile dysfunction.
Erectile dysfunction is one of the most common side effects of prostate surgery. Nerves in the penis play a critical role in the development of erections. Two bundles of nerves are present on either side of the prostate gland. Although surgeons take great care to avoid cutting these nerves during the procedure, some degree of damage does occur. This is the reason that erection problems are common after prostate removal even with a nerve-sparing approach.
Not everyone suffers from loss of spontaneous erections after prostatectomy. The ability to have an erection after prostate surgery depends on a number of factors, including:
What Determines Erection Recovery After Surgery
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.
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How To Cope With Ed After Prostate Surgery
Even when you know that erectile problems are temporary after surgery, it is not easy to experience such a change.
It can turn into a significant burden for your relationship and yourself.
Thus, knowing how to cope with erectile dysfunction is useful, even if you dont experience a complete lack of erections.
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.
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Avoidance And Difficulty Sustaining Ed Treatments
Although there are effective treatments for ED, many men avoid seeking medical help for this condition. In a study of men who were found that have ED, 69% of men did not accept that they had ED and the median time to pursue treatment for ED was 2 years . In men with prostate cancer , a study found that only 50% of men who were interested in seeking treatment for ED actually took steps to find treatment . Of men who seek help to treat their ED, compliance is poor. It is estimated that 50 to 80% of men discontinue their use of ED treatments within a year of starting them . This applies to men with and without PC. Considering the importance of penile rehabilitation following PC surgery, the difficulty starting and sustaining treatment could have a negative impact on mens ability to recovery erections following RP.