Surgically Removing The Prostate Gland
A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing prostate cancer that has not spread beyond the prostate or has not spread very far.
Like any operation, this surgery carries some risks.
A recent trial showed possible long-term side effects of radical prostatectomy may include an inability to get an erection and urinary incontinence.
Before having any treatment, 67% of men said they could get erections firm enough for intercourse.
When the men who had a radical prostatectomy were asked again after 6 months, this had decreased to 12%. When asked again after 6 years, it had slightly improved to 17%.
For urinary incontinence, 1% of men said they used absorbent pads before having any treatment.
When the men who had a radical prostatectomy were asked again after 6 months, this had increased to 46%. After 6 years, this had improved to 17%.
Out of the men who were actively monitored instead, 4% were using absorbent pads at 6 months and 8% after 6 years.
In extremely rare cases, problems arising after surgery can be fatal.
Its possible that prostate cancer can come back again after treatment. Your doctor should be able to explain the risk of your cancer coming back after treatment, based on things like your PSA level and the stage of your cancer.
After a radical prostatectomy, youll no longer ejaculate during sex. This means you will not be able to have a child through sexual intercourse.
Management Of Erectile Dysfunction
Oral medications relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin working, and the erection-helping effects can last from 8 to 36 hours.
About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs. However, they are not for everyone, including men who take medications for angina or other heart problems and men who take alpha-blockers.
How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
Questions To Ask Your Doctor Or Nurse
- How could my prostate cancer treatment affect my sex life?
- How soon after treatment can I masturbate or have sex?
- Which treatments for erection problems would be best for me? Can I get them on the NHS?
- Is there anything I can do to prepare myself before I start my prostate cancer treatment?
- What happens if the treatment doesn’t work? Are there others I could try?
- What other support is available to me?
- Can my partner also get support?
How Your Doctor Monitors You After Treatment
After treatment you have follow up appointments, which usually include regular blood tests to check the levels of a protein called prostate specific antigen . They check to see if your PSA level rises. And they also look at how quickly it rises.
An increase in PSA can mean there are prostate cancer cells in your body. The cells might be in or around the prostate. Or they might have spread to other parts of your body. You might need treatment if it rises.
Prostate cancer that comes back after treatment is called recurrent prostate cancer.;
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How To Maintain Your Sex Life After Prostate Surgery
Although prostate surgery can affect your sexual experience and performance, getting surgery to remove part or all of your prostate doesnt mean that you can no longer have sex or enjoy a satisfying sexual life.;
However, it does mean that you may need to make some changes to how you and your partner have sex. These may include using ED medications, erection-promoting devices or engaging in penile rehabilitation exercises to keep your penis stimulated and healthy.;
If youve recently had prostate surgery, its important to talk to your healthcare provider before you make any changes to your health habits. Theyll be able to inform you about what you can do to restore and improve your sexual function after surgery.;
Orgasm After Prostatectomy Is It Possible
You can expect to enjoy sex and orgasm after prostate surgery.
Many men are surprised to find that they even experience pleasurable orgasm without an erection. Keep in mind that your sexual pleasure does not depend on penetration.
Dr. David Samadi says restoring an enjoyable sex life after prostate cancer surgery is in part dependent on prostate cancer treatment and choice.When men and their partners know what to expect, they can accelerate recovery, experiment, and work together. Sex-related activities should be resumed as soon as you are ready but keep in mind some changes are temporary, and some might be permanent, but the bottom line is that all of the problems can be overcome.
Patients that recover from robotic prostatectomy can expect one significant change regarding orgasm, the orgasm without ejaculation. It will feel different but the pleasure part will still be there.
Note that the male orgasm has 3 main components:
Even though the first 2 parts of the orgasm are affected by the radical prostatectomy, the third one that involves brain stimulation and generates the sensation of pleasure still remains.
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Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission can be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. Although there are treatments to help prevent a recurrence, such as hormonal therapy and radiation therapy, it is important to talk with your doctor about the possibility of the cancer returning. There are tools your doctor can use, called nomograms, to estimate someones risk of recurrence. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
In general, following surgery or radiation therapy, the PSA level in the blood usually drops. If the PSA level starts to rise again, it may be a sign that the cancer has come back. If the cancer returns after the original treatment, it is called recurrent cancer.
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence, including where the recurrence is located. The cancer may come back in the prostate , in the tissues or lymph nodes near the prostate , or in another part of the body, such as the bones, lungs, or liver . Sometimes the doctor cannot find a tumor even though the PSA level has increased. This is known as a PSA-only or biochemical recurrence.
Erectile Dysfunction Recovery After Treatment
You may be offered an ED recovery package soon after treatment. This is usually called penile rehabilitation. You regularly use one or more treatments, such as tablets or a pump, to encourage blood flow to the penis after surgery;or radiotherapy. This is to help the penis recover it is not just for sex. When you are ready to start having sex, you should have a better chance of getting an erection. Your doctor or nurse can tell you more about this.
We have more information on managing ED.
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Sex Life And Prostate Cancer
On this page
We have included information about managing side effects in our information on individual treatments. As your side effects improve, you may feel more interested in having sex.
If cancer and its treatments affect your sex life, it can feel like a serious loss. You do not need to be in a relationship to feel this. But there are different ways to manage sexual difficulties.
Cancer and its treatments can also affect how you feel and think about your body. You may feel less sexually attractive. If you are having issues with your body image, ask your doctor or nurse for advice.
Certain lifestyle changes may help improve body image concerns, such as being more physically active, eating healthily and managing your weight. Ask your doctor or nurse for advice.
Prostate cancer treatments can have a direct effect on your sex life.
Different cancer treatments may:
- cause difficulties getting or keeping an erection
- affect your ability to have an orgasm or to ejaculate
- the penis and testicles to get smaller if you are taking hormonal therapy for a long time.
If you are having sexual difficulties, there are different treatments and types of support to help you.
Dealing With Erectile Dysfunction: For You And Your Partner
The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.
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Can I Have An Orgasm Without An Erection
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.
Erectile Dysfunction Following Radical Prostatectomy
Assuming the management of erectile dysfunction requires expert diagnosis and treatment.
Diagnosis includes sexual function history, general medical history, psychosocial history, medication history, physical examination, and appropriate laboratory testing.
Treatment follows diagnosis, and we provide a range of treatment options through the Clinic. Minimally invasive treatment options range from oral medications to medications administered directly to the penis to a mechanical vacuum device applied to the penis. Invasive treatments include implants or vascular surgery. We are particularly expert in the surgical treatment of patients with erectile dysfunction. The range of conditions we manage include penile prosthesis complications, penile vascular abnormalities, penile curvature, and abnormally prolonged erection consequences.
Psychological treatment is an important adjunct to managing erectile dysfunction. If our diagnosis suggests a psychological association with your erectile dysfunction, we may recommend that you pursue counseling with a qualified psychologist available through the Clinic.For instance, there may be relationship problems that negatively affect sexual functioning with your partner. Referrals can be made to the Johns Hopkins’ noted Sexual Behaviors Consultation Unit.
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Sex After Prostatectomy: How To Have A Healthy Sex Life After Surgery
Medically reviewed by Kristin Hall, FNP
Prostate health issues such as benign prostatic hyperplasia and prostate cancer affect hundreds of thousands of men in the United States every year.;
If youve been diagnosed with a serious prostate issue, your healthcare provider may suggest a prostatectomy a surgical procedure in which your part or all of your prostate gland is surgically removed from your body.
Prostate removal surgery is usually highly effective at treating cancer and prostate enlargement , but it can potentially lead to complications.
These include some sexual performance issues, such as erectile dysfunction and difficulty ejaculating normally.
Although these effects can change your sexual experience, many men are still able to enjoy a fulfilling, satisfying sex life after prostate surgery by making certain lifestyle changes and using medication.;
Below, weve talked about what to expect if youre scheduled to undergo a prostatectomy and want to maintain an active sex life after surgery.;
Weve also explained how you can have a healthy sex life after a partial or complete prostate removal, whether through exercises to improve sexual functioning, medications, devices or a combination of different approaches.
Questions To Ask About Sex Or Your Sexuality
People with cancer might be concerned about changes in appearance due to scars or hair loss, loss of a body part, sexual function, sexual performance, being able to have a child, and if it’s safe to have sex. Depending on the type of cancer, surgery, and treatment needed, there are some situations when precautions need to be taken or when sex may need to be avoided for a while. This can be different for everyone, so we cannot list all possible situations here. It’s important to ask questions so your cancer care team can answer them and your stress, anxiety, and fears can be lessened.
Don’t assume your doctor or nurse will ask you about these and anyother concerns you have about sexuality.You might have to start this conversation yourself. Many studies have found that doctors, nurses, and other members of a health care team dont always ask about sexuality, sexual orientation, or gender identity during check-ups and treatment visits. Because of this, patients might not get enough information, support, or resources to help them deal with their feelings and sexual problems. But if you are concerned about how cancer or its treatment might affect your sex life, its important to bring it up and to get answers to your questions, even if it makes you uncomfortable.
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What Treatment Options For Sexual Dysfunction Are Safe After Prostate Surgery
All of the treatment options come with risks, even the all-natural ones. You need to be careful about sourcing supplements, being confident in the supply.
Many US-based manufacturers were caught by the FDA selling natural Tongkat Ali which actually contained prescription ED drugs! Likewise, overtraining can lead to injury or soreness. However, theres no doubt that the natural approach is safer than the alternative.
Only purchase Tongkat Ali supplements from a reputable company that provides 3rd party lab tests to prove that it is an unadulterated and safe supplement.
If you are looking for a safe and natural testosterone boosting supplement that contains Tongkat Ali, we recommend our Testo-Booster supplement.
The side effects from the most commonly used ED pharmaceuticals include minor ones, such as headache, flushing, runny nose and pains in the stomach or back.
In some cases, dizziness and a sudden drop in your blood pressure can take place. Thats why men with heart conditions have to be evaluated by a physician before they take it, and may have to rely on a lower dose.
Around 1 out of every fifty men who take those drugs will also experience painful or persistent erections.
The highest risk group, however, is those who undergo surgery to get an implant. Thats why its always the last choice. As the surgeon needs to make an incision into the scrotum, penis and often the abdominal wall, there is a risk of infection.
Talking With Your Partner
Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship.
You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.
This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.
If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.
If you are not sure how to begin a conversation with your partner, consider using the questions below as conversation starters.
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