Prostatectomy And Sexual Issues
As a man, your prostate gland plays several important roles in your bodys sexual and urinary function.
During sex, your prostate gland is responsible for releasing seminal fluid, or semen, into your urethra. As you reach orgasm and ejaculate, the muscle tissue of your prostate forces semen and sperm out from your penis.
The nerves that surround your prostate also play an important role in allowing blood to flow to the erectile tissue of your penis when youre sexually aroused.
Because prostate surgery involves removing the prostate gland, its normal to lose some parts of your normal sexual function after the surgery.
For example, radical prostatectomy involves cutting the connection between your urethra and your testicles. This means that sperm is no longer able to flow down your urethra and out the tip of your penis during sex.
As a result of this, men who undergo radical prostatectomy surgery can still reach orgasm, but arent able to ejaculate.
Several different approaches are used to remove your prostate gland during surgery. Some of these approaches particularly those used to treat prostate cancer may result in damage to the nerves that surround your prostate gland, testicles and penis.
Nerve damage caused by prostatectomy surgery may affect your erectile health. If your nerves need to be cut during the procedure , you may find it difficult or impossible to get and/or maintain an erection after surgery.
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.
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 maintains blood flow to the penis and therefore keeps erections strong.
They put pressure on the veins in your penis, preventing blood from flowing back into the rest of your body. If they arent strong enough then even if you can get an erection, you wont be able to keep it.
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.
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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.
Things You Should Expect After Prostate Surgery
Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.
In the immediate hours after surgery:
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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.
What Happens If Prostate Cancer Comes Back
The prostate is a small gland about the size of a walnut that helps make seminal fluid. Its intertwined with your urinary tract system, resting below your bladder and surrounding the urethra. As you age, this gland continues to grow, sometimes resulting in benign prostatic hyperplasia. While this growth is normal, cancerous growth is not. Cancer occurs when the cells in your prostate gland begin to grow out of control.
While prostate cancer is common, especially among older men, its got a fairly positive outcome. When caught early and treated, most men survive and continue on with remission after five years. Unfortunately, for a small percentage of men, the cancer returns. To give you some clarity on this situation, heres what happens if prostate cancer comes back.
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When Can I Return To Sexual Activity
Let the surgery heal for three to four weeks before attempting anything. After one month after the robotic prostatectomy, it is recommended that you resume sexual activity. Stimulation of the nerves is thought to be a first step on the journey back to potency. Remember that you can still experience the pleasures of orgasm and other sensual stimulations without full erections. The average time to recovery for erections adequate for intercourse is 6-12 months, but in some men it is even longer. You should also be performing kegel exercises regularly to help your return to potency.
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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How Will Sex After Prostate Cancer Be Different
One of the treatments of prostate cancer is to remove a portion of the prostate or the totality of the gland before cancer spreads beyond it You may have heard that the tumor is inside the capsule, but moving fast.
The procedure is known as radical prostatectomy and involves incisions, either above the perineum or on the lower abdomen.
Newer surgeries are sometimes robot-assisted, and we also have laparoscopic prostatectomies that do not require a large incision.
The end result is the removal of a portion or the totality of the prostate, and certain surgical approaches may be associated with a lower risk of nerve damage than others. Youll see this referred to as nerve-sparing prostatectomies throughout this guide.
As soon as a man is informed that he will need to go through a Radical Prostatectomy, the likelihood is that one of the very first questions will be about the effect that it will have on their sex life. In a lot of mens minds, the surgery is thought of like its castration.
However, now that there are multiple types of nerve-sparing prostate surgery, many men have found they can maintain sexual activity after surgery.
Likewise, there are plenty of sexual activities open to those who do find they still have the desire, even with some physical changes. We want to help you understand the changes that men can experience after prostate surgery, whether that is physical or mental.
Dealing With Erectile Dysfunction: For You And Your Partner
The following information is based on the general experiences of many prostate cancer patients. Your experience may be different. If you have any questions about what prostate cancer treatment services are covered by your health insurance, please contact your health care provider or health insurance provider. This education material was made possible by a Grant from the California Department of Justice, Antitrust Law Section, from litigation settlement funds to benefit Californians diagnosed with cancer or their families.
Where Can I Find Prostate Cancer Support Groups
Even though once you complete the surgery you most likely will find yourself cancer-free, the anxiety and stress may never totally go away. The support of your friends and family is essential in these moments, but the most relief you will find is among people that have gone through the same experience.
We advise you to search locally for prostate cancer or cancer survivors support groups and discuss your journey in beating this. You will find there plenty of people that lived through the same emotions and painful experiences and you will gather your strength to overcome this and not let it define the rest of your life.
If physical presence is not an option for you, there are plenty of forums and online communities that gather around this subject. You can find people that share their experiences and advice below:
Prostate cancer surgery is not as severe of a surgery as other ones. The recovery, especially after robotic surgery, usually lasts up to 2 to 3 weeks and patients can return to work and to living their normal lives.
Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
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What Happens To A Man When He Has His Prostate Removed
Prostate is a male reproductory gland located anterior to the rectum and inferior to the bladder surrounding the urethra. It is involved in the secretion of prostate fluid that forms an important constituent of semen. It also works in the propulsion of seminal fluid into the urethra and also blocks the connection between the urethra and the bladder by contracting at the time of ejaculation. The prostatic fluid constitutes about one third of the total seminal fluid containing various enzymes of which PSA is of specific importance, not only in thinning of the seminal fluid and helping proper motility of the sperm, but also in the testing procedure for prostate related diseases, such as BPH .
The location of prostate is such that, if the patient experiences BPH then it might lead to urethral compression causing difficulty in urination and leading to LUTS . Unfortunately, BPH is a common problem in adult men and the chances of BPH drastically increases after the age of 60 years. A growth in size of prostate is also a sign of prostatic cancer.
What Changes Do I Need To Make To My Diet
Discuss your post-surgery diet with your doctor as you will probably want to avoid or at least minimize issues such as constipation. The lack of exercise, the medication, even the stress, might affect your bowel functions. Your diet will be focused on eating more vegetables, fruits, grains and avoiding meat, especially the red one, pasta, alcohol, fast-food, sugar and processed desserts.
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What Will I Learn By Reading This
When you have treatment for your prostate cancer, you may have erectile dysfunction also known as impotence. Erectile dysfunction is a very common side effect . Side effects from prostate cancer treatment are different from one man to the next. They may also be different from one treatment to the next. Some men have no erectile dysfunction. The good news is that there are ways to deal with erectile dysfunction. In this booklet you will learn:
- What erectile dysfunction is
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
It is important for you to learn how to deal with erectile dysfunction so that you can continue to have a satisfying intimate relationship.
After Prostatectomy: What To Expect
At the hospital : You should expect to be in the hospital for one night. At Johns Hopkins, all rooms on the urology floor are private. Here, nurses help patients get moving shortly after surgery to prevent blood clots and other postoperative risks.
First few days at home : After youre sent home, you might find that regular ibuprofen or acetaminophen will be sufficient pain management for the first few days. If over-the-counter medications arent enough, your doctor can help you with alternatives.
One week after surgery : After your surgery site heals, your catheter will be removed. This is usually seven to 10 days after surgery. This can easily be done at your doctors office. Some people decide to take out their catheter at home. If thats the case, ask your doctor for instructions first.
This is also about the time your surgeon will call you with the final pathology results. He or she will discuss what you should know and whether further treatment is necessary.
One month after surgery : Doctors recommend no strenuous activity or heavy lifting for at least one month after surgery. Most people take off work for three to four weeks. If you work from home, you could return to work sooner.
- Urinary incontinence
- Erectile dysfunction
Recovery from surgery takes time. These side effects are often temporary. However, if they are affecting your quality of life, ask your doctor about options that can help.