Can Other Treatments For Prostate Cancer Cause Erectile Dysfunction
Other treatments for prostate cancer, including radiotherapy and brachytherapy can also cause erectile dysfunction. Brachytherapy involves delivering doses of radiation therapy directly to the inside of the prostate rather than on the outside of the body as with normal radiotherapy.
Hormonal treatments, given as injections, tablets or a combination of the two, help to manage the progression of advanced prostate cancer by blocking the effects of the male hormone, testosterone. Testosterone helps prostate tumours grow, so blocking its action helps to prevent further growth of the tumour. It isnt a cure, but is often used in conjunction with other treatments. This kind of treatment can also cause erectile dysfunction due to the loss of testosterone.
Cryotherapy, where cancer cells are killed by freezing them using tiny probes inserted into the prostate can also cause erectile dysfunction. This is because cryotherapy also may damage the nerves controlling erection.
What type of treatment you have for your prostate cancer will be determined by the stage and speed of growth of your cancer.
If you suffer with erectile dysfunction after treatment, how long this may last and how much it affects your life will also depend on your type of treatment and the severity of your prostate cancer.
What Are Pelvic Floor Exercises And Can Improve Erection Quality
As we age, we lose muscle tone throughout your body. That includes the muscles that men need to maintain erections. However, there are physical exercises men can do to reduce erectile dysfunction. The best ones are known as pelvic floor exercises or kegels.
Those muscles are the core of how your body and therefore keeps erections strong.
The process starts with identifying the muscles you need to activate. Thats best achieved by lying down with knees bent and feet flat on the floor. Thats when you breathe out and squeeze your pelvic floor muscles for 3 seconds.
Its important that you identify the right group, at the base of your buttocks, on either side of your perineum. It can be easy to mistake other muscles, such as the legs or stomach for the pelvic floor.
Once you are confident you have the right muscle group, then doing the exercises in a seated or standing position three times a day can firm and strengthen the muscles, with a likely improvement within four to six weeks.
Some men find that after the initial strengthening that options like Pilates become appealing as not only are there many exercises which improve the pelvic floor, but they can improve overall posture and strength.
Your Emotions And Sex
Your prostate cancer and its treatment wonÃ¢t just affect your body. TheyÃ¢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 having sex. The more you worry, the worse the struggle. If youÃ¢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. Dont 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.
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.
Prostate Cancer Foundation: Erectile Dysfunction.
UCLA Urology: Prostate Cancer: Dealing with Erectile Dysfunction.
Albaugh, J. Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. Anthony J. Jannetti, Inc., 2012.
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How Do Doctors Perform Prostate Removal
During prostate removal the prostate gland and some tissue around the gland, including the seminal vesicles, are removed. A prostatectomy takes about two hours and is performed under general anesthesia.
There are two approaches used for a prostatectomy:
- Robotic surgery
- Minimally invasive procedure with faster recovery time
- Uses smaller incisions and robotic technology
The surgical process is as follows:
- The doctor will make a small incision to gain access to the prostate
- The prostate is removed
- The bladder is reconnected to the urethra
- A catheter is connected to the bladder to allow urine to drain while the area heals
What Happens During Prostate Surgery That Causes Erectile Dysfunction
Surgery to remove the prostate a radical prostatectomy is an extensive procedure that has many ongoing side effects that can take months or years to recover, including sexual issues. Although you may look and feel well immediately after this major event, there is a significant amount of surgical trauma that takes place around your privates.
One of the major breakthroughs with surgical techniques has been the adoption of robotic assisted procedures, which are known to improve outcomes for patients, particularly with preventing damage to nerves. Nerve sparing is a common term used by specialists and is a sign of a successful result that is aimed for when youre on their surgical table. Essentially this means your network of nerves surrounding the prostate has been saved from any damage occurring during surgery . These nerves have a complex role helping you to achieve normal erections, therefore when saved you have a better chance of regaining erections . Erectile dysfunction in the short term after surgery is often a result of your nerves experiencing damage from any applied stretching or incisions during the surgery itself keeping in mind that nerves typically dont recover quickly.
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What You Need To Know About Prostate Surgery
What is prostate surgery for?
The prostate is a gland located underneath the bladder, in front of the rectum. It plays an important role in the part of the male reproductive system that produces fluids that carry sperm.
Surgery for partial or complete removal of the prostate is called a prostatectomy. The most common causes for prostate surgery are prostate cancer and an enlarged prostate, or benign prostatic hyperplasia .
Pretreatment education is the first step to making a decisions about your treatment. All types of prostate surgery can be done with general anesthesia, which puts you to sleep, or spinal anesthesia, which numbs the lower half of your body.
Your doctor will recommend a type of anesthesia based on your situation.
The goal of your surgery is to:
- cure your condition
- minimize pain before, during, and after surgery
Read on to learn more about the types of surgery, risks, and recovery.
The goal of prostate surgery also depends on your condition. For example, the goal of prostate cancer surgery is to remove cancerous tissue. The goal of BPH surgery is to remove prostate tissue and restore the normal flow of urine.
Erectile Dysfunction After Prostate Surgery
At least one in five men over the age of 40 experience some degree of erectile dysfunction, which is the difficulty getting or maintaining an erection. Erectile dysfunction is more common if you have a chronic disease such as diabetes, are overweight, smoke cigarettes or dont exercise.
Prostate cancer treatment increases your likelihood of erectile dysfunction considerably, with up to 85% of men having problems with getting and keeping an erection after surgery2. This is because your prostate is located next to the nerves, blood vessels and muscles that help you have an erection, and surgery to treat prostate cancer can damage these areas. However, surgical techniques and technologies can help prevent damage to the nerves that allow erections and lower the chance of permanent erectile dysfunction. Factors such as your age, erectile function before surgery, other health conditions you may have, how well the nerves are preserved during surgery and the recovery process can influence your outcomes. It can take between 18 and 24 months after prostate surgery for your erections to improve.
The process can be particularly distressing for transwomen. The diagnoses of prostate cancer and the interaction with the health system can be a rather traumatic period for these individuals, Brett-Renes says.
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How Long Does It Take For Nerves To Heal After Prostatectomy
How long does nerve regeneration take? Recovery of potency may be very rapid in younger patients and is sometimes immediate. However, for most patients the recovery is gradual and can take up to 3 years to plateau, although typically a patient sees a return to erectile function after about 12 months .
Reasons To Have A Prostatectomy
A common reason for having a prostatectomy is to treat prostate cancer. According to the American Cancer Society, prostate cancer is the most common cancer, after skin cancer, among men in America. More than 174,000 new cases are reported in the United States each year. If the cancer hasnt spread outside the prostate gland, surgery is a good treatment option.
You might also choose to have prostate surgery to treat an enlarged prostate. As the prostate grows, it can block the flow of urine and cause bladder, urinary tract, and/or kidney problems. Removing part of the prostate can solve these issues.
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The Basics: How An Erection Occurs
Image: Hank Grebe/Getty Images
Its usually difficult for a man to get another erection right away. The length of the interval between erections varies, depending on a mans age, his health, and whether he is sexually active on a regular basis. A young, sexually active man in good health may be able to get an erection after just a few minutes, whereas a man in his 50s or older may have to wait 24 hours. One reason may be that nerve function slows with age.
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.
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.
- 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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Your Cancer Care Team
People with cancer should be cared for by a multidisciplinary team . This is a team of specialists who work together to provide the best care and treatment.
The team often consists of specialist cancer surgeons, oncologists , radiologists, pathologists, radiographers and specialist nurses.
Other members may include physiotherapists, dietitians and occupational therapists. You may also have access to clinical psychology support.
When deciding what treatment is best for you, your doctors will consider:
- the type and size of the cancer
- what grade it is
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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.
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.
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How Does Prostate Surgery Cause Erectile Dysfunction
Surgery to remove the prostate is usually offered to men who have prostate cancer that hasnt spread outside of the prostate, or has only spread a small way.
Its possible, if your cancer is confined to your prostate, to have a procedure called a nerve sparing prostatectomy. This means that your surgeon aims to leave the nerves that are either side of the prostate behind. These nerves are responsible for controlling erections. If theyre left undamaged, then theres more chance that youll be able to achieve an erection unaided after surgery.
If the nerves are damaged or removed, then youre likely to experience erectile dysfunction. In some men, this is permanent, in others they are able to achieve an erection within a few months, with or without medical help.
Can Impotence Occur After Prostate Surgery
Consider your options
If youre undergoing prostate surgery, you may be concerned about how it will affect your sexual function. Erectile dysfunction is the inability to become sexually aroused and have an erection.
The condition has many complex causes. It can be caused by a physical problem, an emotional issue, or both. Regardless of the cause, ED can affect both you and your partner.
Many body systems play a role in sexual arousal. These include:
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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.
Theme : Psychological Ramifications Of Sexual Dysfunction
Some of the men we interviewed reported psychological issues due to the sexual dysfunction that resulted from prostate cancer treatment. This included many reports of depression and anxiety, in addition to some suicidal ideation. One man reported that hed rather have his legs cut off than exist in his current state of sexual dysfunction. Men who might not have used clinical terms like depression or anxiety nevertheless reported the psychologically devastating effects of feeling abnormal, unnatural, and less of a man due to their sexual dysfunction. There was a sense from men and their partners that sexual dysfunction has a great impact on every aspect of life. Like depression, it can change the very lens with which men and their partners view and experience their whole existence. The participants said the following:
Man 14: And that made me very depressed. I was really surprised about that because nowhere in our research prior to my surgery did I run across that a whole lot about how one of the side effects mentally would be depression. And even now I still have some issues with depression, but its been over a year and a half and I think Ive adjusted somewhat because I found that to combat depression I need to stay active, find things that I used to enjoy that I still enjoy and not focus so much on the depression aspect because I had a lot to be pleased about.
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Sex After Prostate Surgery
When first diagnosed with prostate cancer, its common for men to wonder what the future will hold. Certainly, a prostate cancer cure is a top priority, but then what?
Dr. David Samadi understands that men want to know:
Will I have sex after prostate cancer?
How will sex after prostate cancer be different?
For many men, prostate cancer treatment choice determines these answers.
If you select robotic prostate surgery your chances of enjoying sex after prostate surgery are very high. Robotic prostatectomy is a minimally invasive prostate removal. It is considered one of the best treatment options for prostate cancer due to its success rate and fast recovery rate.
The da Vinci robotic prostate cancer surgery system enables the surgeon to make precise movements. This ensures cancer-removal efficiency and sparing of the nerves and muscles that are responsible for the sexual function.
However, it is absolutely critical to choose a robotic surgeon with a high case volume and extensive prostate surgery experience. The robot does not perform the surgery and technology is no guarantee of success. Enjoying sex after prostate surgery is only possible if the procedure was performed by an experienced, highly-trained robotic surgeon.
Dr. Samadi explains how the preservation of sexual function is possible: