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:
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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.
How Important Is The Psa Test After Prostatectomy
The answer is: very . A major milestone in prostate cancer treatment is obtaining your PSA level close to zero after surgery. The expected result after prostatectomy is an undetectable PSA or level of 0.;The surgery itself is a cornerstone of a mans life, but the tests that follow, especially the PSA test, can be very dreaded.;
The PSA test is a blood analysis that checks for the level of the prostate-specific antigen in the blood cells. The PSA is an enzyme secreted only by the prostate cells. When the PSA level is zero or close to zero after radical prostatectomy, the patient is reassured that he is cancer-free and can regain peace of mind. In the majority of cases, this is the scenario. There are also rare cases when the follow-up tests reveal an elevated PSA after prostatectomy. What to do if this is your case?;
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Enlarged Prostate Surgery: The Real Risks And Side Effects
Enlarged prostate surgery unfortunately has real risks and side effects that are often downplayed or minimized by urologists making you the guinea pig with very possible impotence and incontinence as a result.
Furthermore, you will often have to repeat the operation later on as your prostate continues to grow because the real causes of this prostate disease have not been addressed by radical surgeries.
Also known as a TURP surgery or BPH surgery, this is the gold standard of prostate surgeries for enlarged prostate symptoms.
TURP stands for Transurethral Resection of the Prostate. The surgery consists of passing a flexible instrument up your penis and into the prostate gland to shave off pieces of the prostate.
The bloody pieces are removed allowing more space for the urethra tube to pass urine from your bladder.
The operation is done under anesthesia… and you will usually spend a couple of days recovering. You will have to wear a catheter for some time while you heal, and then it can be removed.
It would be great if that was all there was to it. Yet, it’s not so simple…
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
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Treatment Options For Prostate Stones
Most men with prostate stones will not require any treatment, again due to lack of symptoms. Also, sometimes, prostate stones may pass on their own in a mans urine. However, if they do become infected and are causing prostate or urinary tract problems, then they may require antibiotics. In more severe cases, they can be removed surgically. Prostatic calculi can be easily removed with a transurethral electro-resection loop or holmium laser if they cause difficulty in urination or chronic pain.
Any man, having urinary symptoms or pain in the lower pelvic region, needs to see his doctor right away for a thorough examination and diagnosis of what the problem may be.
Side Effects From Radiation
Urinary symptoms from radiation treatment for prostate cancer are different from those caused by prostate surgery. “It’s more like a urinary tract infection-increased urgency and frequency, and men may some have bleeding or pain when they urinate,” Calvaresi said. These problems often go away once treatment is complete.
Radiation also may cause bowel changes, such as constipation, loose stools or both. These can be managed by over-the-counter medication. Men may also see some blood in their stool during treatment-if so, let your health care provider know about this.
Men undergoing radiation are likely to have ED, but not immediately. “It slowly sets in after radiation treatment,” Calvaresi said. Treatments for radiation-related ED are the same as ED caused by prostate cancer surgery.
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What Is The Prostate
The prostate is a small gland in the male reproductive system, and it is about the shape and size of a walnut. It lies low in the pelvis, underneath the bladder, and simply before the rectum.
The prostate helps produce semen, the milky liquid that brings sperm from the testicles through the penis when a man ejaculates. Additionally, it encompasses part of the urethra, a cylinder that carries urine out of the bladder and through the penis.
If you think you have a prostate problem, you might consider massaging them to regulate your prostate health.
Things That Can Happen When You Live Without A Prostate
Beyond the oft-reported effects of urinary incontinence and impotence following surgery, there are a number of less widely known possible side effects of prostate removal.
Fun fact number one: Half of all men who die in this country this year will be killed by heart disease, stroke, or cancer. Fun fact number two: Half of all doctors seem to have different ideas about how to prevent the biggest killers of men. We spoke to the best of them, and we’ve simplified, clarified, and prioritized their advice on minimizing the risks of dying before your time. For more tips, .;Reporting by Sarah Z. Wexler.
As more men deemed to be at genetic risk of prostate cancer opt to have the organ removed preemptively, lesser-known side-effects of the procedure are coming to the fore. In addition to the oft-reported effects of urinary incontinence and impotence following surgery, here are some symptoms more rarely accounted for:
Shrunken penises. As many men are prescribed antiandrogen treatments to block testosterone effects on advanced prostate-cancer tissue, Dr. Celestia Higano of the University of Washington reports that up to 68 percent of men experience penile shortening after radical prostatectomy surgery.
“Dry orgasm”or, rather, orgasm without ejaculation, which occurs after surgery when retrograde ejaculation sends semen back into the bladder instead of out the penis.
This article originally appeared in;Esquire‘s November issue.
What Is Considered An Elevated Psa After Prostatectomy
After radical prostatectomy, the doctors will perform a PSA test in order to determine whether there are some prostate cells left in the body. This usually happens when the disease is advanced at the time of surgery and could have already spread to other parts of the body. It is considered elevated PSA after prostatectomy a PSA greater than 0.2 ng/ml. If the prostate cells are grown enough to generate detectable levels of PSA, this could be an alarming point both for the patient and the doctor.;
It is important to note that a level of PSA that is not alarming when first diagnosed with prostate cancer is a reason for concern when being tested after surgery. The reason is that usually, the prostate generates a certain level of PSA. But after being removed, the level of PSA is expected to be zero unless the prostate cells had already spread to other parts of the body.;
According to the Prostate Cancer Foundation, about 20-30% of men have PSA recurrence after five years of initial prostate cancer treatment . As a patient, the prospect of PSA recurrence can be very worrisome. What many patients do not know is that not all modified levels of PSA after prostate cancer treatment indicate the same diagnosis. Some types of levels are much more troublesome than others and treatment approaches can vary tremendously case by case. Not all changes in the PSA mean a recurrence of prostate cancer after robotic surgery or other forms of treatment.
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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What Happens During Radical Prostatectomy
You will have general anesthesia during your prostate surgery. Your surgical team inserts a catheter to drain urine.
After your surgeon removes your prostate, they check it under a microscope to see if cancer has extended beyond the edge of the prostate or into the seminal vesicles or lymph nodes. If it has, the cancer may have spread. In that case, you may need other treatment.
Immediately After A Prostatectomy
- You will stay in hospital for two to five days.
- Nurses will monitor your vital signs.
- Your pain will be managed with medication.
- You may be given antibiotics to reduce the risk of infection.
- You may have a drip inserted into your arm or hand for a few days.
- You will most likely have a drain tube out of your abdomen that will be removed in the first day or two after the surgery.
- You will be fitted with a small tube in your penis. The catheter drains urine into an attached bottle or bag. This catheter will be removed about one to three weeks after the operation. Your surgeon will tell you when it can be removed.
- In most cases, you will have to go home still wearing the catheter. You will be taught how to care for it.
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Sex After Prostate Surgery And Achieving Orgasm
Sex after prostatectomy is an important concern for most men. The total removal of the cancerous tissues is the primary goal, but the quality of life after prostate surgery is also important. Worrying about ED makes men be nervous and anxious when thinking about undergoing radical prostatectomy.
However, whilst most patients focus on erectile dysfunction, orgasm is somehow under-considered. But is it possible to achieve orgasm after prostatectomy? Erections and orgasm are equally important for a healthy sex life.
The good news is that sex after prostate surgery 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.
What Is Prostate Removal
A prostatectomy is a surgical procedure for the partial or complete removal of the prostate, which is a small gland about the size of a ping-pong ball, located deep inside the groin, between the base of the penis and the rectum in men. The prostate supplies part of the seminal fluid , which mixes with sperm from the testes. Sperm needs this fluid to travel and survive for reproduction.
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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.
Newly Diagnosed With Prostate Cancer Why Choose Robotic Prostatectomy
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.
Dr. Samadi explains how the preservation of sexual function is possible:
If my only responsibility was to remove the cancerous prostate, my job would be much easier, he acknowledges, But patients deserve much more than that. It was paramount that I find a way to remove the prostate gland without damaging functions critical to a comfortable and enjoyable life after recovery.
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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.