Habits And Lifestyle Changes
Your healthcare provider may recommend making certain changes to your habits and lifestyle to promote blood flow and improve your erectile health. These may include:
Treating any underlying health issues
Changing your eating habits to maintain a healthy weight
Exercising regularly to improve your cardiovascular health
If you smoke, quitting smoking and nicotine products
Limiting your consumption of alcohol
Weve talked more about the effects of good habits and lifestyle changes on ED in our guide to naturally protecting your erection.
Although these changes are unlikely to treat prostatectomy-related erectile dysfunction on their own, they can contribute to an increase in blood flow, better overall health and improved sexual function.
What Is A Prostatectomy
A common surgical approach to prostatectomy includes making a surgicalincision and removing the prostate gland . This may beaccomplished with either of two methods, the retropubic or suprapubicincision , or a perineum incision .
Prior to having a prostatectomy, it’s often necessary to have aprostate biopsy. Please see this procedure for additional information.
Prostate Cancer: Treatment Advances You Should Know About
Prostate cancer treatment has entered the robotics age. Using advancedrobotic technology, Johns Hopkins surgeons can see the prostate in 3-D,magnifying everything 10 times. Johns Hopkins urologist Mohamad Allaf, M.D., explains what this means for patients, including fewer side effects.
What To Expect After Surgery
A prostatectomy is major surgery from which your body needs time to recover. Your doctor will discuss the details of your recovery with you.
Typically patients stay in the hospital overnight after surgery and then need to recuperate at home for a month before returning to work. Most men can start to drive a few weeks after surgery. You should avoid heavy lifting for several weeks after surgery. It usually takes about six weeks for most men to feel back to normal.
This page provides general information about what you can expect in the first hours and days right after surgery. You may also want to read more about:
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How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
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:
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When To Call Your Doctor Or Nurse
Its important to tell your doctor or nurse if:
- your bladder feels full or your catheter isnt draining urine
- your catheter leaks or falls out
- your urine contains blood clots, turns cloudy, dark or red, or has a strong smell
- your wound area or the tip of your penis becomes red, swollen or painful
- you have a fever
- you feel sick or vomit
- you get cramps in your stomach area that will not go away
- you get pain or swelling in the muscles in your lower legs.
Your doctor or nurse will let you know if you should go to the hospital.
Prostate Massage Therapy And Why It May Be Helpful
Prostate massage therapy , in which the prostate is stimulated through the rectum, was once a popular treatment for prostatitis.
The procedure is similar to a digital rectal exam, except rather than briefly looking for abnormalities on the prostate, the person performing the prostatic message rubs the prostate with light to moderate pressure until it secretes fluid through the urethra .
It was once thought that people could relieve symptoms related to prostatic congestion by expelling inflammatory cells and fluid from the obstructed glands. But this therapy largely fell out of favor in the 1960s, once antibiotics became available.
A study published in the journal Neurology tested whether prostate massage could be used as an adjunct treatment for people with chronic prostatitis, but the researchers found that the treatment did not significantly help patients.
In some cases, doctors have used prostate massage therapy to obtain sperm from men with spinal cord injuries, leading to successful pregnancies. But electroejaculation stimulating the prostate using an electric current delivered through a probe inserted into the rectum typically yields more sperm, noted an article published in the journal Nature Reviews Urology.
Using prostate massage to achieve ejaculation is sometimes called prostate milking. Both prostate massage and prostate milking can also be sexual techniques to stimulate pleasure.
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.
How Fast Will I Become Totally Continent After Prostate Surgery
During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.
The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.
It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.
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After Prostate Removal The Sperm Has To Go Somewhere But Where
Men who are facing prostate removal due to cancer will surely wonder where their sperm will go after removal of the prostate gland. Its fair to wonder about this.
First of all, sperm is produced in the testicles.
The testicles continue to make sperm, but because the vas deferens is clipped and cut, and because there is no prostate or seminal vesicles, there is no ejaculate, explains Michael Herman, MD, director of urologic oncology at South Nassau Communities Hospital in Oceanside, NY.
People can continue to have orgasms, though, because the nerves that have to do with climax are unaffected, and are actually not related to whether or not someone ejaculates.
The sperm gets broken down and reabsorbed by the body. This is the same process as if someone were abstinent or had a vasectomy.
In short, prostate removal will not affect sperm production or quantity. It only affects what happens to the sperm once its produced.
Unfortunately, removal of the prostate may be more of an issue to a woman than to the man, if she believes she cant enjoy intimate relations without ejaculations.
Men who have partners like this should focus on all that can be done to treat their prostate cancer and prevent a recurrence.
Women who feel deprived without the ejaculate need a harsh lesson in priorities.
Prostate cancer affects one out of six men as a lifetime risk, and the number it kills every year in the U.S. averages in the high 20,000s.
What Does The Prostate Do
The prostate is a male gland that releases prostate fluid, one of the components of semen.
The muscles of the prostate gland help propel this fluid into the urethra during ejaculation.
It is a muscular gland that is often described as walnut or small apricot-sized.
An enlarged prostate can be a sign of prostate cancer, the third biggest cancer killer.
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Risks Of Prostate Surgery
The risks with any type of radical prostatectomy are much like those of any major surgery. Problems during or shortly after the operation can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
- Infections at the surgery site.
Rarely, part of the intestine might be injured during surgery, which could lead to infections in the abdomen and might require more surgery to fix. Injuries to the intestines are more common with laparoscopic and robotic surgeries than with the open approach.
If lymph nodes are removed, a collection of lymph fluid can form and may need to be drained.
In extremely rare cases, a man can die because of complications of this operation. Your risk depends, in part, on your overall health, your age, and the skill of your surgical team.
Side Effects From Hormone Therapy
Hormone therapy for prostate cancer, known as androgen deprivation therapy , suppresses production of testosterone. ADT can cause several side effects. These include fatigue, hot flashes, decreased bone density, ED, depressed mood, decreased sex drive, weight gain, heart risks, breast growth and cognitive decline.
The severity and length of side effects depend on how long treatment lasts. “If a man has only six months of treatment, their level of testosterone rises again, and they’ll go back to feeling like themselves,” Calvaresi said.
Often, mood changes in men on ADT are caused by other side effects such as weight gain and hot flashes. “If we can manage those other side effects, then often that improves mood,” she said. Following a healthy diet and exercising regularly often helps to decrease fatigue, prevent weight gain and improve overall mood. Before beginning hormone therapy, you should discuss the effects of ADT with your doctor, and talk about how you can change your exercise and eating habits to help head off side effects before they occur.
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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.
However, it does mean that you may need to make some changes to how you and your partner have sex. These may include using ED medications, erection-promoting devices or engaging in penile rehabilitation exercises to keep your penis stimulated and healthy.
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.
How Radical Prostatectomy Affects A Relationship
A 2011 study of 63 men that had undergone a radical prostatectomy found that about 75 percent of them sought treatment for erectile dysfunction. Additionally, more than 50 percent reported having less sexual desire, and roughly an additional 40 percent were unable to have a satisfying orgasm.
The mental health effects of these symptoms were worse in highly sexually motivated participants. 52 percent reported that this had affected their self-esteem, and 36 percent said having performance anxiety.
Additionally, the last three items on the list above can be show-stoppers for a relationship. Few women can tolerate a high degree of urine leakage during sexual activity, and few men can handle the pain during intercourse.
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Reasons For The Procedure
The goal of radical prostatectomy is to remove all prostate cancer. RP isused when the cancer is believed to be confined to the prostate gland.During the procedure, the prostate gland and some tissue around the gland,including the seminal vesicles, are removed. The seminal vesicles are thetwo sacs that connect to the vas deferens , and secrete semen.Other less common reasons for radical prostatectomy include:
Inability to completely empty the bladder
Recurrent bleeding from the prostate
Bladder stones with prostate enlargement
Very slow urination
Increased pressure on the ureters and kidneys from urinary retention
There may be other reasons for your doctor to recommend a prostatectomy.
Who Needs A Prostatectomy
As men age, the likelihood of medical problems associated with the prostate increases. Medicines, lifestyle modifications, and a proper diet can help with many conditions, but oftentimes issues with the prostate require more extensive medical intervention.
Less severe conditions are more likely to be treatable without the need for surgical work. Some prostate conditions that can generally be treated without prostatectomy include:
- Benign prostatic hyperplasia .
Other prostate conditions, though, do necessitate the removal of the prostate gland and/or other tissues. Although some patients might opt for a prostatectomy for more minor reasons like inability to empty the bladder or bladder stone, by far the most common reason for prostatectomy is cancer.
Here is everything you need to know about prostatectomy and prostate cancer.
Three Common Prostate Problems
Growing older increases the danger of prostate problems. The three most common problems in the prostate gland are prostatitis, benign prostatic hypertrophy, and prostate cancer.
One change does not prompt another. For instance, having prostatitis or benign prostatic hypertrophy does not raise your risk of prostate cancer. Also, you can have more than one issue simultaneously.
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.
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What Does The Prostate Actually Do
One of the prostates most important functions is helping in the creation of semen. It does this by creating a fluid that combines with sperm cells from the testicles and fluids from other glands to create semen.
The muscles of the prostate also play a pretty important role in helping expel the semen during ejaculation as well as letting urine flow out of the body. This function is why its common for those who have had surgery or radiation treatment for prostate cancer to experience the loss of the ability to control urination.
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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
- maintain the ability to have erections
- minimize side effects
- 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.
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