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Can You Remove A Prostate

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How May Erectile Dysfunction Affect My Sex Life

Robotic Surgery to remove Prostate Cancer

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.

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.

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.

The Importance Of Quality Of Life

Its only normal to want to drive into the practicalities. Before you go any further, I want you to understand a key metric, which is particularly challenging to standardize.

Its called Quality of Life, usually shortened to QoL in the medical literature.

With Prostate Cancer, its a particularly important one, due to the high rates of survival for those with localized prostate cancer .

Thats why its so important to understand the impact that various surgeries or treatments will have on you.

Quality of Life is how they assess the suitability of any treatment.

Those sort of difficult questions is why QoL is a factor. If youre a sexually active man in your sixties or seventies and they are offering you preventative surgery after a biopsy, you need to ask yourself about the impact it will have, what alternatives are available to treat prostate cancer.

Furthermore, you should always ask what the quality of life after that surgery or treatment will be like.

Thats why we put together this quick guide to erectile function, mens health and sex after prostate surgery.

Its not exhaustive by any means, but should certainly give you a jumping off point to better make these decisions that will have a serious impact on a really key aspect of your life.

One last note before we get into it. If the cancer is malignant, surgeons will always push you for a radical prostatectomy, to prevent the cancer from spreading to your lymph nodes.

External Beam Radiation Therapy

In this type of therapy, a machine outside the body is used to focus the beams of radiation on the prostate gland. It is used to treat early stages of cancer and helps to relieve you from symptoms such as pain.

Before the procedure, you will undergo simulation, which is a planning session. During this session, the radiation team takes measurements to find the correct angles for aiming the beams and the proper dosage.There are various types of EBRT namely:

  • Intensity-modulated radiation therapy
  • Proton beam radiation therapy

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Success Of Radical Prostatectomy

The goal of radical prostatectomy is to cure prostate cancer. However, prostate cancer cure is only possible from prostatectomy if prostate cancer is limited to the prostate.

During radical prostatectomy, the removed prostate is examined under a microscope to see if prostate cancer has reached the edge of the prostate. If so, the prostate cancer has probably spread. In these cases, further treatments may be needed.

Men with no evidence of prostate cancer spread have an 85% chance of surviving 10 years after radical prostatectomy.Ã

What Are The Different Types Of Prostate Cancer Surgery

Have You Ever Thought Of Fixing Your Enlarged Prostate ...

The most common one is called a radical prostatectomy. In this procedure, the entire prostate gland is removed, along with some of the surrounding tissue. In some cases, nearby lymph nodes are removed as well. There are several surgical approaches for this, including traditional open surgery. We can also use minimally invasive procedures, such as laparoscopic surgery and robot-assisted laparoscopic surgery.

A critical aspect of a radical prostatectomy is tailoring it to the individual features of each mans cancer. One size does not fit all. This means the exact same procedure is not appropriate for every person. The location, size, and other features of the cancer are considered to design an operation that is appropriate for the person.

In a laparoscopic radical prostatectomy, a surgeon inserts a tiny camera called a laparoscope through a small cut in the abdomen. The camera gives doctors a magnified, high-definition picture of the prostate gland. With that image as a guide, the surgeon can remove the prostate, seminal vesicles, and lymph nodes using special tools.

To do a robot-assisted procedure, a surgeon sits at a console that has a screen as well as hand, finger, and foot controls. The surgeons hand, wrist, finger, and foot movements control the robotic instruments inside the patient in real time.

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After Prostatectomy: What To Expect

At the hospital : You should expect to be in the hospital for one night. At Johns Hopkins, all rooms on the urology floor are private. Here, nurses help patients get moving shortly after surgery to prevent blood clots and other postoperative risks.

First few days at home : After youre sent home, you might find that regular ibuprofen or acetaminophen will be sufficient pain management for the first few days. If over-the-counter medications arent enough, your doctor can help you with alternatives.

One week after surgery : After your surgery site heals, your catheter will be removed. This is usually seven to 10 days after surgery. This can easily be done at your doctors office. Some people decide to take out their catheter at home. If thats the case, ask your doctor for instructions first.

This is also about the time your surgeon will call you with the final pathology results. He or she will discuss what you should know and whether further treatment is necessary.

One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery. Most people take off work for three to four weeks. If you work from home, you could return to work sooner.

  • Urinary incontinence
  • Erectile dysfunction

Recovery from surgery takes time. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help.

Can Anything Be Done For Erectile Dysfunction Caused By Prostate Cancer Treatment

Yes, there are things you can try if you have erectile dysfunction after your prostate cancer treatment. You should keep in mind that the following things will affect your ability to have an erection after your prostate cancer treatment:

  • How good your erections were before your treatment
  • Other medical conditions you have like high blood pressure or diabetes
  • Some types of medicines you may take such as medicines for high blood pressure or antidepressants
  • Things you do in your life such as drinking or smoking
  • Your age
  • The type of prostate cancer treatment you had

It is important that you and your partner speak with your doctor or healthcare team about what you can do. Your doctor or healthcare team will speak with you about what might work best for you if you have erectile dysfunction. It is important that you speak with them since some treatments for erectile dysfunction can affect other medical problems you may have.

Types of treatment for erectile dysfunction include:

  • Penile implants. It is normal for your doctor to try and treat your erectile dysfunction with medicine or external medical devices first. If these options dont help you get an erection, you may want to talk to your doctor about the chance of getting a penile implant. A penile implant is a medical device put in your penis during an operation. The implant will help you have a mechanical erection .
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    Drinking Plenty Of Water

    This will help ensure that the urinary system functions as healthily as possible while it is recovering from surgery and will also keep the body hydrated. Taking care to stay hydrated is also necessary, because the affected person will be using stool softener in the postoperative period to avoid constipation.

    Using Medication To Reduce Symptoms

    Using Robotic Surgery to Remove Prostate Cancer at Stanford: Gil Khalil’s story
  • 1Recognize the symptoms of an enlarged prostate. Look for a weak stream of urine, dribbling at the end of urination, or an increased need to urinate at night. You may also have difficulty starting urination or need to strain to empty your bladder. If you notice these symptoms, make an appointment with your doctor for an official diagnosis.XTrustworthy SourceMayo ClinicEducational website from one of the world’s leading hospitalsGo to source
  • 2Try alpha-blockers if you have trouble urinating. Talk to your doctor about alpha-blockers, which can relax muscles around the bladder and prostate. These drugs help increase the flow of urine when you use the bathroom and keep you from needing to urinate too frequently.XResearch source
  • While adverse side effects are infrequent, alpha-blockers can cause dizziness. The good news is, they typically help relieve symptoms within a few weeks.
  • Take alpha-blockers, like tamsulosin, as directed by your doctor.
  • Most alpha-blockers are safe to take with other medications. Consult your pharmacist for any potential drug interactions with your current medication regimen.
  • 3Explore enzyme-inhibitors if you have a very enlarged prostate. Ask your doctor if enzyme-inhibitors, like finasteride and dutasteride, would be a good fit for your symptoms. These drugs shrink prostate tissue to reduce urinary problems and are often most effective on severely enlarged prostates.XResearch source
  • Like alpha-blockers, dizziness is the most common side effect.
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    What Is The Most Effective Treatment For Prostate Cancer

    The choice of treatment for prostate cancer depends on many factors such as the patients prostate cancer risk as calculated from prostate-specific antigen levels, Gleason score, and tumor staging. Patients can discuss the significance of these factors in the choice of treatment with their doctor.

    The standard effective treatment choices for men with early-stage prostate cancer are as follows

    • Active surveillance: Monitoring the progression/status of the low-risk or early-stage cancer with regular testing and not treating it right away.
    • Prostatectomy: Surgical removal of the prostate.
    • Radiation therapy: Use of high-energy waves to destroy cancer cells.

    Radiation therapy is one of the most effective treatments for many men with early-stage prostate cancer. It is also the best prostate cancer therapy for older men or those with other co-existing diseases. It can be delivered to the patient in any of the two ways

    • External beam radiation: Sending/focusing high-energy waves from an external machine into the tumor.
    • Brachytherapy: Placing a radioactive dye in the tumor through an implant or hollow tubes.

    For metastatic prostate cancer, androgen deprivation therapy is usually the choice of treatment. ADT is also the only option in patients with prostate cancer who are unfit or unwilling to undergo surgery or/and radiation therapy.

    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 canât 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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    Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes

    At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.

    • You are bleeding from your rectum.
    • You are urinating very little or not at all.
    • You have pain from your procedure that does not get better, even after taking pain medicines.

    The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

    What Is The Prostate

    modern surgery: Surgery for prostate cancer

    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.

    The prostate helps produce semen, the milky liquid that brings sperm from the testicles through the penis when a man ejaculates. Additionally, it encompasses part of the urethra, a cylinder that carries urine out of the bladder and through the penis.

    If you think you have a prostate problem, you might consider massaging them to regulate your prostate health.

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    Risks Of Radical Prostatectomy

    Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.

    Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:

    • Urinary incontinence: More than 95% of men younger than age 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
    • Erectile dysfunction : Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED , an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.

    Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.

    Other complications of radical prostatectomy include:

    • Bleeding after the operation
    • Groin hernia
    • Narrowing of the urethra, blocking urine flow

    Less than 10% of men experience complications after prostatectomy, and these are usually treatable or short-term.

    Cancer That Is Thought To Still Be In Or Around The Prostate

    If the cancer is still thought to be just in the area of the prostate, a second attempt to cure it might be possible.

    After surgery: If youve had a radical prostatectomy, radiation therapy might be an option, sometimes along with hormone therapy.

    After radiation therapy: If your first treatment was radiation, treatment options might include cryotherapy or radical prostatectomy, but when these treatments are done after radiation, they carry a higher risk for side effects such as incontinence. Having radiation therapy again is usually not an option because of the increased potential for serious side effects, although in some cases brachytherapy may be an option as a second treatment after external radiation.

    Sometimes it might not be clear exactly where the remaining cancer is in the body. If the only sign of cancer recurrence is a rising PSA level , another option for some men might be active surveillance instead of active treatment. Prostate cancer often grows slowly, so even if it does come back, it might not cause problems for many years, at which time further treatment could then be considered.

    Factors such as how quickly the PSA is going up and the original Gleason score of the cancer can help predict how soon the cancer might show up in distant parts of the body and cause problems. If the PSA is going up very quickly, some doctors might recommend that you start treatment even before the cancer can be seen on tests or causes symptoms.

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