Talking Counselling And Sex Therapy
Talking to your partner about your erection difficulties can help. Or it may help to talk to a close friend if you are not in a relationship.
Not talking to those close to you could be one of the main barriers to coping with this side effect. You might then find it easier to consider ways that could help.
Counsellors or therapists can help if youre worrying about anything to do with your sex life and sexuality. You can be referred by your GP to a counsellor or therapist within the NHS. You might need to go on a waiting list to see them.
Talk to your GP to find out what is available in your area. Your local hospital or your local Erectile Dysfunction Clinic might have this service.
The drugs used to treat erection problems include:
- tadalafil
- vardenafil
- avanafil
These belong to a group of drugs called phosphodiesterase type 5 inhibitors. They work by increasing blood flow to the penis. For the drugs to work, men need to be aroused and have some sort of sexual stimulation. In other words, the drugs wont cause an immediate erection, some foreplay is usually needed.
As drugs work best;in men who have sexual desire, they might not help some men who are having hormone therapy. There is limited evidence to say these drugs work when having hormone therapy. But some specialists believe that they are still worth a try if you would like to give them a go.
Possible side effects of PDE 5 inhibitors include:
- headaches
- dizziness
- temporary problems with vision
Does Viagra Work After Prostate Removal
Viagra is an effective treatment for impotency in men who have their prostate removed . For men whose nerves have been spared, the drug improves the ability to have an erection by nearly 60%, but the effectiveness drops to 20% in those with no nerves spared.
Making Changes To Your Sex Life
After prostate surgery and during this recovery period, you might need to make a few changes.;
Certain sex positions require a very hard erection to work.;
Others will do the trick, even if you cant maintain an erection. The downward doggy, the morning spoon, and the reverse cowgirl are just a few examples.;
Just be creative and try something new.
This moment can also become an occasion to learn about yourself and experience sex differently.;
You can try new types of stimulation, sex toys, and various kinds of non-penetrative sex.;
The whole idea behind this is to enjoy the moment and feel satisfied even if nothing goes as expected.;
Remember that sex is much more than penetration, and you can feel pleasure in many ways.
Patients with severe psychogenic erectile dysfunction sometimes need to take this approach.;
They need to stay clear from penetrative sex for a while.;
This period will allow them to look for alternative methods and other types of stimulation.;
Then, resuming penetrative sex feels more satisfying than ever, and erectile dysfunction starts to resolve.
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Are There Differences Between Orp Lrp And Ralrp
According to a 2010 of different surgery types for prostate cancer, the outcomes for open radical prostatectomy , laparoscopic , and robotic-assisted prostatectomy are not significantly different.
But people who choose LRP and RALRP may experience:
- less blood loss
- shorter hospital stay
- faster recovery time
Also, people who choose RALRP report faster recovery in continence and decreased hospital stay, in comparison to LRP. But the overall outcomes still depend on the surgeons experience and skill.
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Nerve Regeneration After Radical Prostatectomy
Filed in Life After Treatment
Nerve regeneration after radical prostatectomy usually does take some time, assuming that both nerve bundles around the prostate were able to be preserved by the surgeon. This is because the nerves and arteries that control erections need time to recover and heal. This article explains why this is the case, and what can be done to speed up the healing process.
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Restoring Sexual Function After Prostate Surgery
2 Minute Read
If you have prostate cancer or an enlarged prostate, you might undergo prostate surgery also called a prostatectomy. Like all surgeries, this one comes with potential risks. The Prostate Cancer Foundation reports that erectile dysfunction is the most common side effect of a prostatectomy. Fortunately, there are ways to restore sexual function during prostate surgery recovery.
But first, learn about why you might need a prostatectomy, what happens during the surgery, and what to expect during the recovery process.
The Prostate Gland And Prostate Cancer
The prostate gland is a male reproductive organ that sits around the urethra, the outlet tube for urine, just below the bladder. The glands surface is usually smooth and regular. The prostate is about the size of a walnut.
The prostate gland releases a clear fluid into the urethra that represents up to a third of the semen during ejaculation. One of the functions of the fluid is to carry the sperm and help sperm movement.
The prostate also helps the drive of semen during ejaculation.
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Are These Erections Lost For Good
Theres pretty good evidence to show that men can continue to recover erectile function up to two years after prostatectomy surgery , which we believe is partly because it takes time for the bruising and scar tissue after surgery to settle down. But if spontaneous erections do not recover by this point then it is unlikely that they will do so thereafter. Conversely, there is;good evidence that drugs such as Viagra can be used to enhance erections after surgery and that, even if such drugs do not work for example if the nerves have been removed to maximise cancer clearance mechanical devices such as vacuum pumps, cavaject injections into the side of the penis or MUSE therapy are effective.
Sex When You’re Single
Being sexually active and feeling attractive can be just as important if you are a single man. All the treatments described here are available to you if you’re single – whether you want to be able to masturbate, have sex, or want to start a new relationship.
If you are starting a new relationship, sexual problems and other side effects like urinary or bowel problems could be a worry. Some men worry that having problems with erections will affect their chances of having a new relationship. Fear of rejection is natural, and everyone has their own worries, whether or not they’ve had cancer. If you’re single, you may want time to come to terms with any changes prostate cancer has caused before you start having sex or dating.
Try talking over your worries with someone you feel comfortable with, such as a friend. Counselling or sex therapy may also help if you would prefer to talk to someone you don’t know.
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How Soon After Prostate Cancer Treatment Can I Be Sexually Active Again
This will depend on what type of treatment you have had and how you feel. It could be several weeks, for others it may be a lot longer for erections to return. Some men will never be able to keep an erection without the help of artificial methods like medicines or medical devices . If you were having problems having erections before treatment, this will not get better after treatment.
Surgical Options And Implants
Surgical options for penile rehabilitation present a more severe approach to ED symptoms, once again sending the patient under the knife for results. The implant consists of an inflatable device inserted into the penis, a balloon-like structure filled with fluid in the abdominal wall, and a release button. The release button allows fluid to enter the tube, straightening the penis and creating an erection.
Penile prosthesis and inflatable devices should largely be considered a last option after other treatments have failed, as risks can include infection and erosion. But assuming theyre working properly, they are 100 percent effective.;
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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 doesnt work? Are there others I could try?
- What other support is available to me?
- Can my partner also get support?
What Do We Know About Potency After A Robitic Prostatectomy
The return of potency is dependent on several factors:
- Previous sexual function before surgery. Unfortunately, robotic prostatectomy will at best return you to your level of sexual function pre-surgery. It will not improve upon what you already had before surgery.
- Age. Theyounger you are, the better your chances. Men under 65 have abetter chance of regaining potency, or erectile function than those over 65.
- How many nerves are spared. As discussed previously, ideally both nerves can be spared and thiswill give you the highest chance of regain erections. However,even men with no nerve sparing can regain erectile function.
Ejaculation will no longer occur in any patient. This is because the seminal vesicles and the vas deferens , are removed and cut during the surgery. This means that you will no longer be able to father children
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Cavernous Nerve Interposition Grafting
Studies have shown that microsurgical end-to-side grafting of the sural nerve of the leg or the femoral nerve to the cavernous bodies could achieve effective results in patients whove had prostate surgery.;
This surgical technique helps to restore the nerve connection to the erectile tissues and cause an erection. With the help of medication, as high as 50% of patients following prostate surgery gains satisfactory erection for normal sexual activity;
The article is a part of our series on What is Erectile Dysfunction: A Complete Guide
References
John P MulhalCavernous Nerve Stimulation and Interposition Grafting: A Critical Assessment and Future Perspectives,Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1477600/
Ilan Gruenwald,Boaz Appel,Noam D. Kitrey and Yoram VardiShockwave treatment of erectile dysfunction,Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3607492/
Sexual Dysfunction After Prostate Surgery Is More Common Than Previously Reported Says Hutchinson Center Study
Media briefing: A media briefing will be held at 1 p.m. PST Tuesday, Jan. 18 at the Center’s Metropolitan Park East Campus, 1730 Minor Ave., between Olive and Howell streets. A Media Relations representative will greet you in the lobby and escort you to the briefing room. Free parking is available in an underground garage; entrance off Minor Ave. A map of the site is available upon request.
B-roll available: A related video news release, including sound bites and b-roll of Dr. Janet Stanford and a Seattle-area prostate-cancer survivor, will be available via satellite feed twice on Tuesday, Jan. 18: first between 6 and 6:30 a.m. PST and again between 11 and 11:30 a.m. PST .
SEATTLE — Sexual dysfunction among men who undergo prostatectomy appears more prevalent than previously reported, according to a multi-center study led by an investigator from the Fred Hutchinson Cancer Research Center in Seattle.
The results will appear in the Jan. 19 issue of the Journal of the American Medical Association.
Funded by the National Cancer Institute, the Prostate Cancer Outcomes Study is the first comprehensive, population-based assessment of sexual function and urinary continence among men treated with radical prostatectomy for early stage, localized prostate cancer. It is also the first study to examine the sexual and urinary side effects of such surgery in minority populations.
Age and education also had an impact on the frequency of impotence.
# # #
LOCALIZED PROSTATE CANCER
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How Long Ed Lasts After Prostate Surgery
But theres good news despite the high rate of symptoms. The same data shows that as many as half of men affected will have returned to their normal, pre-treatment function within a year, and up to 60 percent after two years.
Its important to note that one of the key indicators of potential to return to normal function is normal function prior to surgery; previous or existing ED could mean a longer road to recovery.
Recovery rates are still dependent on a multitude of factors, but there are a variety of treatments to help in recovery, regardless of the severity of sexual dysfunction post surgery.;
What Can I Expect Before And After Robotic Prostatectomy
If after consulting with Dr. Engel, becoming educated on the topic of prostate cancer, potentially seeking other opinions, and being presented all options, a patient opts for robotic prostatectomy, he will then be taken extensively through what to expect. Dr. Engel currently performs robotic surgery exclusively at George Washington University Hospital, and a date and time will be scheduled for surgery there. The patient will generally be urged to see his internist for a pre-operative physical, although this can also be accomplished at the hospital itself. Tests to rule out spread of cancer such as a bone scan and CT scan, looking for spread to bones and lymph nodes, may be performed in higher risk cases. The patient will be given detailed instructions regarding a bowel preparation regimen and the patient must follow this strictly. The purpose of the bowel prep is not only to create more space in the abdomen, but also for safety in the very unlikely event that there is an inadvertent injury to the intestine or rectum during the surgery. If this occurs, a bowel prep will likely keep this from being a life threatening problem.
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Is Another Treatment Option Better For Preservation Of Erectile Function
The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.
Differences Between Hcp Opinions
Importantly, we found considerable differences between HCP opinions regarding lead roles in the initiation, monitoring and follow-up of ED management; such confusion could easily lead to inadequate management and contradictory advice, as was evident from the menâs survey results. These findings may reflect financial considerations and, in the case of nurses, whether or not they have a prescribing role. The increased role of primary care in the follow-up of patients with prostate cancer requires unified management guidelines and support from Clinical Commissioning Groups regarding GP prescribing of relevant treatments with local guidelines and shared care protocols. While urologists and specialist ED clinics were most commonly identified as being responsible for prescribing ED treatment, this management route inevitably leads to delays, due to the need for specialist referral and limited access to specialist ED clinics.
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If You’re A Gay Or Bisexual Man
To be the active partner during anal sex you normally need a strong erection, so erection problems can be a particular issue. You could try using a constriction ring around your penis together with another treatment like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex.
If you are receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. Some men who receive anal sex find that their experience of sex changes if they have their prostate removed .
If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy. Its best to wait until your symptoms have settled before trying anal play or sex. If youve had permanent seed brachytherapy there is a risk in the first few months that your partner might be exposed to some radiation during sex. Talk to your doctor or nurse for further advice.
With all sexual changes you may be able to find ways to work through this.
Watch Martin’s story below for one gay man’s experience.
Watch;other men’s personal stories;about sex after prostate cancer.
Does Viagra And Cialis Work After Prostate Removal
During recovery, medications like Viagra and Cialis will help. Viagra can restore impotence and contributes to more pleasurable sex life.
A study published in the Journal of Urology;reported that 53% from a total of 80 men who underwent radical prostatectomy had their erection function restored after taking Viagra.
But is Viagra an addictive drug?
Many men experienced a high rate of improvement in their sexual performance due to medications such as Viagra, Cialis, or Levitra. If you have been wondering whether these medications are addictive, you should know that the active ingredient in Viagra, sildenafil, is not an addictive substance.;
These medications work by increasing the blood flow to the penis and facilitate the erection process. Addiction is brain-triggered, but Viagra does not target the nervous processes in the brain. That is why it is considered a safe option for those who want to faster recover their sexual potency after prostate cancer treatment.
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How Long Does Erectile Dysfunction Last After Surgery
According to Cancer Research UK, after prostate surgery you may experience erectile dysfunction from anything between three months to three years. This is because prostate surgery may injure the nerves, muscles or blood vessels required for an erection. Some men may also experience erectile dysfunction for the rest of their lives and require treatment to achieve an erection.
Having a radical prostatectomy will also leave you with a higher chance of getting erectile dysfunction than having a nerve sparing prostatectomy. According to the NHS, before treatment, 67% of men who had prostate cancer said that they could get erections firm enough for intercourse. After getting a radical prostatectomy, they were asked again after 6 months, and this decreased to 12%. In contrast, according to the Prostate Cancer Foundation, approximately 50% of men who receive a nerve sparing prostatectomy who could have erections before surgery will maintain this ability long term.