Prostate Surgery And Erectile Dysfunction
The short answer is yes prostate surgery is very likely to cause erectile dysfunction.
A prostatectomy, even though modern surgeries are nerve-sparing is likely to cause months of issues to a mans sex life.
Less invasive procedures that avoid the bundle of nerves and seminal vesicles next to the prostate will still likely cause ED, even if its a shorter-term issue.
Other surgeries are less likely to cause lasting damage, but the fact is that sexual dysfunction is a complicated issue. Men have to grapple with the mental side of it as well.
A cancer diagnosis can weigh heavily on a mans mind, which can impact both his sex drive as well as his ability to maintain an erection.
Theres also the fact that as we age, men experience a natural reduction in sex drive and are likely to be less able to get and maintain an erection.
The likelihood is that any surgery would just exacerbate the underlying issue.
Around 1 out of every 4 men over the age of sixty will experience some form of erectile dysfunction. Thats also the most likely group to undergo surgery, which is why the two are often linked, but not necessarily the sole cause.
If you have some pre-existing medical condition that impacts your floor muscles, sexual function or urine/ urinary function than you might find that the side effects of the surgery are more severe.
You should talk with your Urologist about any pre-existing medical conditions and how they might affect the treatment.
What Is The Prostate Gland
The prostate gland is about the size of a walnut and surrounds the neck ofa man’s bladder and urethrathe tube that carries urine from the bladder.It’s partly muscular and partly glandular, with ducts opening into theprostatic portion of the urethra. It’s made up of three lobes, a centerlobe with one lobe on each side.
As part of the male reproductive system, the prostate gland’s primaryfunction is to secrete a slightly alkaline fluid that forms part of theseminal fluid , a fluid that carries sperm. During male climax, the muscular glands of the prostate help to propel the prostatefluid, in addition to sperm that was produced in the testicles, into theurethra. The semen then travels through the tip of the penis duringejaculation.
Researchers don’t know all the functions of the prostate gland. However,the prostate gland plays an important role in both sexual and urinaryfunction. It’s common for the prostate gland to become enlarged as a manages, and it’s also likely for a man to encounter some type of prostateproblem in his lifetime.
Many common problems that don’t require a radical prostatectomy areassociated with the prostate gland. These problems may occur in men of allages and include:
Cancer of the prostate is a common and serious health concern. According tothe American Cancer Society, prostate cancer is the most common form ofcancer in men older than age 50, and the third leading cause of death fromcancer.
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How Does Prostate Surgery Affect You Sexually
If you are diagnosed with prostate cancer and opt for a prostatectomy, particularly a radical prostatectomy, the surgeons will have removed your prostate.
While the prostate isnt directly responsible for your libido or sexual sensation, in some men who have had a prostatectomy, there can be damage to nerves or blood vessels.
The prostate is next to a dense group of nerves and the seminal vesicles .
There is a heightened chance of an infection such as spermatocystitis which can cause you pain or in some cases impotence.
For men who have had an open prostatectomy, they will find that they can no longer ejaculate. This is known as a dry orgasm and can still be pleasurable.
Even with less invasive surgeries, the most common complaint or side effect tends to be sexual in nature.
However, according to systematic reviews and meta-analysis of the scientific data, these cases of sexual dysfunction are often associated with psychological factors that might be present before surgery or as a result of stress related to the surgical procedure.
Radiation therapy can impact the pelvic floor muscles and nerves that control erections and provide pleasure.
According to a 2016 study, around half of Prostate Cancer patients who have any form of radiation therapy go on to develop erectile dysfunction.
For a large section of men who opt for radiation-based therapies, the first stage is usually hormone therapy.
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Changes In The Prostate As You Age
Since the prostate gland tends to become bigger as you age, it might crush the urethra and cause issues in passing urine. At times, men in their 30s and 40s may start to have these urinary manifestations and need medical consideration. For other people, indications are not observable until much later in life. A tumor or an infection can likewise make the prostate bigger. Make sure to inform your doctor if you have any urinary issues listed below.
- Fewer urine flows
- Passing urine more during the day
- Feel burning when you pee
- Have an urgent need to urinate
- The need to get up many times during the night to pee
How Do You Achieve A Prostate Orgasm
As with any new sexual activity, learning how to have a prostate orgasm takes preparation and practice. Here are some expert-approved tips, techniques, and other important things to know.
Learn where your prostate is.
If youre new to anal play, the first step is finding your prostate. The walnut-sized gland is located underneath the bladder and in front of the rectum, and you can stimulate it by putting fingers or toys about three inches into your butt.
Try it on your own first.
Kenneth Play, sex educator and creator of the Sex Hacker Pro Series, suggests experimenting with yourself before trying with your partner. I recommend masturbation rather than partner play to start this exploration because you have a direct feedback loop,” he says. “Without having to instruct someone else or worry about being comfortable, things are much simpler and more effective.”
Know that there are two ways to achieve a prostate orgasm: through internal and external stimulation.
Now, we know you might be scratching your head in confusion, wondering how there can be an external prostate orgasm when the prostate is located inside your anus. But heres a quick bio lesson: an external prostate orgasm is when you stimulate your prostate externally, by applying pressure between your anus and your testicles, Saynt explains . No insertion required.
Internal orgasms, on the other hand, involve massaging your prostate .
Massage your perineum.
If you’re going up the butt, clean out beforehand.
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What Other Tests Do I Need
After prostatectomy, youll probably have a PSA test in about six weeks or so. Your doctor will recommend a follow-up schedule, usually every three months for two years. Depending on the results, you may need to test once or twice a year thereafter. Testing may be more frequent if it appears to be rising.
If your PSA levels are high and you have symptoms such as bone pain, imaging tests can be used to determine if cancer has spread. These may include bone scans and CT scans. If a mass is found, a biopsy can determine if its cancerous.
You might not need treatment right away. If youve had multiple PSA tests and it appears that your PSA level is rising, a number of other factors determine the next steps. These factors include:
- age and life expectancy
- if cancer has spread and where
- previous treatments
Radiation therapy after prostatectomy, also known as salvage radiotherapy, can be quite effective after a prostatectomy. External beam radiation can be delivered directly to the area around where the prostate was. The goal is to destroy prostate cells that may have been left behind after surgery. This lowers the risk of recurrence and metastasis, or of the cancer spreading.
Metastatic prostate cancer may not be curable, but there are treatments to slow progression and manage symptoms. Treatments may include:
How Soon After Prostate Cancer Treatment Can You Be Sexually Active Again
Different Prostate Cancer treatments have various periods before one can resume sexual activity. Its also down to an individuals recovery time, which has to factor in age.
A man who has had a prostatectomy in his eighties will find that it will take him a lot longer to resume any sexual activity than a man in his fifties who has had external beam therapy.
The individuals general health and genetics all play a part in the healing process. With a prostatectomy, studies tend to show that it is at least several months before erectile function returns, but it can be up to a year.
For more limited surgery, such as TURPs, one can expect to be sexually active again within 4 6 weeks if that is the only surgery and treatment. Often it happens in conjunction with other treatments, such as hormone or radiotherapy, which have much longer recovery times.
There are still options that are open to men before that. If a man still feels sexual desire, then sexual activity is still possible.
There are three parts to orgasm, and while the sensation of fullness or ejaculate may no longer be present, the mental part of orgasm which takes place in the brain is just as possible as before surgery. Plus theres absolutely nothing stopping a man from being more focused on his partners sexual pleasure.
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How Is Urinary Incontinence After Prostate Surgery Treated
If you find youre having issues with mild to moderate leakage after surgery, your healthcare provider might suggest starting with noninvasive therapies like medications or physical therapy exercises for the pelvic floor muscles. These treatments may also cut down on the number of times that you have to get up each night to pee.
These methods can sometimes help men who have mild to moderate leakage. Men who have persistent leakage or a more severe problem may need surgery if they do not want to continue to use pads.
Using Medication To Reduce Symptoms
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Can You Remove The Prostate For Prostate Cancer If You Have Had Radiation Wellyes And No
One of the most common reasons I am given by patients choosing to have their prostate removed is the argument that one can do radiation after surgery but you cant do surgery after radiation. It is a valid argument and I think something to consider in the decision-making process. The concept is, however, not that cut and dried. Here are some caveats.
So, the rationale for choosing surgery because you can do radiation later is a reasonable decision, but not one that will always make a difference in your ultimate outcome. I feel it does make a difference in the situations I mention above, but you really wont know until you have the radiation and over an extended period of time your PSA goes down and never goes up again.
|Salvage Prostatectomy with Bladder Neck Closure, Continent Catheterizable Stoma and Bladder Augmentation: Feasibility and Patient Reported Continence Outcomes at 32 Months|
Remedies For An Enlarged Prostate
Even if you have an enlarged prostate, that does not mean you must live with the symptoms for the rest of your life. Your doctor might advise one of several approaches to coping with BPH, including lifestyle changes, medication changes, and other treatments. The remedies and treatments available will depend on your own health situation and how disruptive the symptoms have become.
Get Sufficient Exercise
Exercise can improve with your overall fitness, as well as benefit your prostate health. Studies have shown a connection between increased physical activity and reduced risk of BPH, with exercise of any type having some degree of benefit.
Seated activities, such cycling, can put pressure on the perineum and groin. This can lead to numbness or pinched nerves. To avoid these issues, make sure you utilize a wide seat and engage in a variety of activity types.
You can also try Kegel exercises to strengthen your pelvic muscles and reduce urine dribbling. To do these exercises, squeeze the muscles that affect urine flow and then release, repeating several times to train the muscles.
When you head to the bathroom, make sure you slow down. When you relax your muscles and leave time to account for delayed urine and possible dribbling, you’re much more likely to completely empty your bladder. Urine that remains in the bladder because of an enlarged prostate can lead to urinary tract infections or painful bladder stones.
Reduce Caffeine and Alcohol Consumption
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Day Before Your Surgery
Follow a light diet
Follow a light diet, such as a small sandwich, eggs, toast, crackers, or soup. Limit the amount of dairy products you eat and drink, and avoid fried foods and foods with a lot of seasoning.
Note the time of your surgery
A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, theyll call you on the Friday before. If you dont get a call by 7:00 pm, call .
The staff member will tell you what time to arrive at the hospital for your surgery. Theyll also remind you where to go.
Do your bowel preparation
The night before your surgery, use a saline enema as instructed on the box.
Shower with a 4% CHG solution antiseptic skin cleanser
The night before your surgery, shower using a 4% CHG solution antiseptic skin cleanser.
Sex After Prostate Surgery
Youll often hear people say that men think about sex every 12 seconds, or some other ridiculous number.
While we may know that isnt exactly the case, theres no denying that for most men its at the forefront of their mind.
So when undergoing treatment for an enlarged prostate or even prostate cancer, its inevitable that questions about your sex life will arise.
This article will look at the most common concerns for men who have undergone, are in the middle of, or are thinking about undergoing treatment.
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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.
What Can I As A Partner Expect
One of the effects of prostate cancer treatment is erectile dysfunction or impotence. This means that your partner may not be able to have erections that are hard enough for him to have sex with you or that he may not be interested in sex because of the medicine he is taking to treat his prostate cancer. This affects not only the man, but you, too, as his intimate partner. If you are the partner of a man with erectile dysfunction, it can be difficult to cope with changes in your sexual relationship. Sometimes men struggle to come to terms with changes in their body image or their ability to perform sexually. This can sometimes result in him staying away from intimate situations where he may feel under pressure to make love. As a partner you may feel rejected by what seems like a lack of sexual interest or intimacy. This may not have anything to do with his feelings for you, but is a result of his cancer treatment. Erectile dysfunction can be difficult for both of you. You may want to reassure your partner that:
- Sex is not as important as long as he is healthy and that he is no less of a man to you
- You will work through it with him
- You understand his feelings
- He is important to you
It may help if you explain to your partner how important nonsexual touching and intimacy such as kissing and cuddling is to you.
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