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Does Removing Prostate Cause Impotence

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Can You Get Erections After Prostate Cancer Treatment

A breakthrough treatment for men with enlarged prostates

If you have ever wondered whether youâll be able to have an erection after prostate cancer treatment, you are not alone. Many men who are facing a prostate cancer diagnosis, or who have undergone prostate cancer treatment, are worried about whether or not they will be able to have an erection after prostate cancer.

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Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery

Neuromodulatory therapy, represents an exciting, rapidly developing approach to revitalize intact nerves and promote nerve growth. Therapeutic prospects include neurotrophins, neuroimmunophilin ligands, neuronal cell death inhibitors, nerve guides, tissue engineering/stem cell therapy, electrical stimulation, and even gene therapy.

How May Erectile Dysfunction Affect My Sexual Relationships

Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.

If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.

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Prostate And Ed Problems: Does Prostate Cancer Cause Impotence

Prostate cancer is a serious health problem that kills around 25,000 men a year in the United States alone. Although this disease can be deadly, prostate cancer generally doesnt affect male sexual function, but the treatments can. Benign prostatic hyperplasia is an enlargement of the prostate and is the leading cause of incontinence and prostatitis impotence in men over the age of 50.

Some treatments for prostate cancer and other prostate and ED problems have sexual side effects. The prostate itself doesnt work to help men achieve erections. It simply produces an alkaline fluid that comprises over 50% of the seminal volume.

How Prostate Cancer Treatments Affect Erectile Function?

Nearly all men will experience some erectile dysfunction for the first few months after prostate cancer treatment. The severity varies on factors like contributing disorders, surgeons skill, and whether radiation therapy was used.

In some cases, penile nerves are damaged during radical prostatectomy. As a result, it can severely affect sexual function and may lead to erectile dysfunction and impotence.

Here are several treatments that can result in prostate and ED problems:

Radical Prostatectomy

This is a surgical removal of the prostate and the seminal vesicles from the body. The goal of the surgery is to help the patient regain urinary control and clear the pathway for the urethra. However, this procedure can cause serious prostate problems and erectile dysfunction.

Radiotherapy

Management Of Erectile Dysfunction

Does Enlarged Prostate Affect Erectile Dysfunction

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.

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What Does The Biopsy Say About Your Prostate Cancer

When abnormal results are discovered from prostate cancer screen tests, the Digital Rectal Exam and PSA Blood Test, a biopsy may be recommended. The Gleason Score is the rating system assigned to the results of the biopsy. This type of biopsy is normally performed using transrectal ultrasound guidance. The ultrasound allows the physician to take distributed samples from the prostate. Typically twelve separate samples are taken. A pathologist will then examine the tissue samples under a microscope to determine whether or not the prostate contains cancerous tissue. A grade is assigned to the tissue samples. The two most common grades are added together to create the Gleason Score.

When abnormal results are discovered from prostate cancer screen tests, the Digital Rectal Exam and PSA Blood Test, a biopsy may be recommended. The Gleason Score is the rating system assigned to the results of the biopsy. This type of biopsy is normally performed using transrectal ultrasound guidance. The ultrasound allows the physician to take distributed samples from the prostate. Typically twelve separate samples are taken. A pathologist will then examine the tissue samples under a microscope to determine whether or not the prostate contains cancerous tissue. A grade is assigned to the tissue samples. The two most common grades are added together to create the Gleason Score.

Can You Have Sex After Prostate Removal

The good news is that sex after prostate removal is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.

Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.

Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.

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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
  • 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:

Should You Worry About An Elevated Psa After Prostate Removal

High PSA & Prostatitis | Ask a Prostate Expert, Mark Scholz, MD

PSA stands for prostate-specific antigen and is often a very good indicator of how effective treatment has been, in case of prostate removal or other prostate surgeries.

After prostate surgery, the PSA level gets very low, but this result isnt always reliable. Thats why the patient should discuss the expected PSA levels after prostatectomy with their doctor.

A lower PSA level following the removal of the prostate gland is only a part of the overall picture. There are many factors to monitor closely after prostate surgery.

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Recovering From Prostate Surgery

The patient can usually leave the hospital within a day or two, but the incision site will likely feel sore for a few days after. The patient will most likely not be able to drive for at least a week, but should be able to return to normal activities within a few weeks.

During the recovery, the patient may experience several side effects including:

  • Urinary tract infection
  • Ejaculatory dysfunction
  • Erectile dysfunction

After the surgery, its possible to experience erectile dysfunction for a few weeks, a year, or even longer in some cases. This is because the surgery might potentially injure one of the nerves, muscles, or blood vessels that are involved with getting and maintaining erections. There are other factors that could influence the severity of the erectile dysfunction during recovery as well and so it can be difficult to predict how any specific person may recover from the surgery.

The Prostate Cancer Foundation has reported that about half of all men undergoing nerve sparing surgery will regain their pre-surgery function within the first year of the surgery.

Theme : Importance Of Support And Understanding

Not surprisingly, the men and partners we interviewed impressed upon us the need and importance of support and understanding, from their partner and from others in their lives, including their families and support groups like the Us TOO International Prostate Cancer Education and Support Network. An essential element of this support was communication, especially with the partner, which could be very difficult for both parties. To enable this communication, it was crucial for men and their partners to be open about their intimate feelings and concerns. The participants said the following:

Man 13: Im in a great relationship really for the first time in my life with a woman who really I dont think doesnt care what we do as long as were together. We enjoy sex a lot not just to be active, just to have intercourse. Without her I dont think I would be as far along in getting my sex life back to where I want it to be. Its got to do with her and shes put up with so much.

Man 9: I come here shaking like a leaf, man. I get in here with a bunch of guys that had been where I was about to go and man they gassed me up with that strength. And like I said, when I came in I was shaking like a leaf. When I left out I was empowered.

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How The Test Will Feel

During the procedure you may feel:

  • Mild discomfort while the probe is inserted
  • A brief sting when a sample is taken with the biopsy needle

After the procedure, you may have:

  • Soreness in your rectum
  • Light bleeding from your rectum

To prevent infection after the biopsy, your provider may prescribe antibiotics to take for several days after the procedure. Be sure you take the full dose as directed.

Does Prostate Cancer Cause Sexual Dysfunction

Why Does Prostate Surgery Cause Impotence

Oftentimes, the cause of erectile dysfunction is not prostate cancer itself but the treatments you take to cure it.

Prostate cancer treatments like radical prostatectomywhich is the removal of the entire prostate glandor radiation therapy as well as hormone therapy can all cause men to develop erectile dysfunction.

Heres how each treatment can impact your ability to have sexual intercourse:

  • Radical Prostatectomy When you have radical prostatectomy, youll immediately feel the effects of erectile dysfunction. There are two types of radical prostatectomy. One method will spare the nerves while the other one doesnt. With the former, youll likely recover from ED in about a year. The latter procedure might cause permanent ED though there are a few cases where the patient regains erectile function.
  • Radiation Therapy With radiation therapy, ED will occur a couple of years down the road. It typically happens two to three years after treatment. It should be noted that without ED treatment, it will become permanent.
  • Hormone Therapy This therapy works a bit differently. ED sets it two to four weeks after the start of the treatment. However, its worsened by the accompanying decreased desire to have sex. If left untreated, it can lead to permanent ED as well.

Even if you dont undergo surgery , other forms of treatments can still lead you to experience erectile dysfunction.

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Damage To The Nerves Used During An Erection

Radical prostatectomy can damage the nerves you need to get an erection. Nerve sparing surgery can help lower this risk. But not everyone is suitable for this type of surgery. Nerve sparing surgery means that your surgeon removes the cancer without cutting or damaging the nerves. But if your cancer is growing close to the nerves, they will have to remove them.

Some men will get back their ability to have erections. But this can take anything between 3 months to 3 years. And some men will need help to get an erection for the rest of their lives.

What Are The Side Effects

The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .

Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.

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What Is Prostate Enlargement

Enlargement of the prostate occurs when the prostate gland cells begin to multiply and cause the prostate gland to swell. This swelling tends to compress the urethra, limiting urine flow and causing symptoms known as lower urinary tract symptoms . BPH is a condition that many men encounter with aging.

Most of the symptoms of BPH are associated with urinary function. They are:

  • Frequent need to urinate
  • Urinary retention inability to empty the bladder
  • An intense urge to urinate, even shortly after urinating
  • A weak urine stream or an interrupted urine stream
  • Difficulty starting or stopping urination

While BPH itself is not a directly linked cause of sexual problems, most men that suffer from it do indeed find it affects sexual performance. Some common sexual side effects of BPH are:

  • Inability to maintain an erection

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What Causes Benign Prostatic Hyperplasia

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Its a little hard to say for sure what causes BPH.

What we do know for a fact is that men go through two main stages of prostate growth in their lives first at puberty, where the prostate doubles in size, and then growth begins around the age of 25 and continues during most of a mans life.

BPH is known to surface in this second stage, and mostly affects men above the age of forty. Autopsy data has found evidence of the condition in about 90 percent of men above the age of eighty.

The growth of the prostate in this second stage may be linked to androgens in the body. Men produce testosterone throughout their lives. They also produce estrogen the female hormone but only in small amounts.

When testosterone levels drop as they inevitably do with age a higher proportion of estrogen may remain.

This increase in the ratio of Estrogen or its receptors to testosterone may directly and indirectly affect the growth of prostate cells.

Another possible cause is DHT or dihydrotestosterone. This male hormone is a bit of a villain. It is a major cause of alopecia in men, but is however useful for the development and maintenance of the prostate.

Unfortunately, this role can be dangerous for the adult prostate, as DHT can cause excessive growth.

BPH may also result when there is an imbalance between the production and death of prostate cells. When the imbalance is in favor of cell proliferation, it can lead to BPH.

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Does Enlarged Prostate Cause Ed

Of the many symptoms caused by BPH, one of the most common complaints men have when visiting a urologist is Erectile Dysfunction or ED. This is defined as the inability of a man to attain or maintain an erection sufficient for vaginal penetration and satisfactory sexual performance.

BPH does not directly cause ED, but many men with BPH seek medical attention to relieve ED.

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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Providing Your Medical History

At first, the doctor will probably ask you about your medical history. Do you have any chronic illnesses? What illnesses and operations have you had in the past? What medications are you taking, if any? Your doctor is also likely to ask about your psychological well-being and lifestyle: Do you suffer from depression? Are you under a lot of stress? Do you drink alcohol? Smoke? Use illegal drugs? Have you felt a loss of affection for your partner? Have you recently grown interested in a new partner?

As part of this health history, be prepared to tell your doctor specific details about the symptoms that brought you to the office and when they began. Your doctor might want to know how often you had sex before the problem started and if there have been weeks or months in the past when youve had erectile dysfunction. Your doctor may conduct a written or verbal screening test.

If the cause is clear a recent operation for prostate cancer, for example the conversation may move directly to your treatment options. Otherwise, you may need to answer more questions to help the doctor narrow down the possible causes and avoid unnecessary testing.

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