Monday, May 23, 2022

What Happens When A Man Loses His Prostate

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Sex After Surgery To The Prostate Gland

He Lost His Penis and Testicals Due To Prostate Cancer, Hormone Replacement.

When your prostate gland is removed, you will still make sperm, but it wonât come out through your penis. It will be absorbed back into the body. You may also have problems with erections or lose interest in sex after prostate surgery. Although you may feel embarrassed, doctors who deal with prostate cancer are very used to talking about these issues and will be able to give you advice. There are treatments that can help with this.

Why Erectile Dysfunction May Result From Prostate Disease

In the past, it was thought that most cases of erectile dysfunction were psychological in origin, the result of such demons as performance anxiety or more generalized stress. While these factors can cause erectile dysfunction, doctors now think that 70% of the time the problem can be traced to a physical condition that restricts blood flow, hampers nerve functioning, or both. Such conditions include diabetes, kidney disease, multiple sclerosis, atherosclerosis, vascular disease, and alcoholism.

However, some types of prostate disease and treatments may also be responsible.

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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What Types Of Hormone Therapy Are Used For Prostate Cancer

Hormone therapy for prostate cancer can block the production or use of androgens . Currently available treatments can do so in several ways:

  • reducing androgen production by the testicles
  • blocking the action of androgens throughout the body
  • block androgen production throughout the body

Treatments that reduce androgen production by the testicles are the most commonly used hormone therapies for prostate cancer and the first type of hormone therapy that most men with prostate cancer receive. This form of hormone therapy includes:

Treatments that block the action of androgens in the body are typically used when ADT stops working. Such treatments include:

Treatments that block the production of androgens throughout the body include:

Does Viagra And Cialis Work After Prostate Removal

What Happens To a Man When He Has His Prostate Removed?

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 Will I Know That My Hormone Therapy Is Working

Doctors cannot predict how long hormone therapy will be effective in suppressing the growth of any individual mans prostate cancer. Therefore, men who take hormone therapy for more than a few months are regularly tested to determine the level of PSA in their blood. An increase in PSA level may indicate that a mans cancer has started growing again. A PSA level that continues to increase while hormone therapy is successfully keeping androgen levels extremely low is an indicator that a mans prostate cancer has become resistant to the hormone therapy that is currently being used.

What Is Urinary Incontinence In Men

Urinary incontinence is the accidental release of urine. It’s not a disease. It’s a symptom of a problem with a man’s urinary tract.

Urine is made by the kidneys and stored in a sac made of muscle, called the urinary bladder. A tube called the urethra leads from the bladder through the prostate and penis to the outside of the body. Around this tube is a ring of muscles called the urinary sphincter. As the bladder fills with urine, nerve signals tell the sphincter to stay squeezed shut while the bladder stays relaxed. The nerves and muscles work together to prevent urine from leaking out of the body.

When you have to urinate, the nerve signals tell the muscles in the walls of the bladder to squeeze. This forces urine out of the bladder and into the urethra. At the same time the bladder squeezes, the urethra relaxes. This allows urine to pass through the urethra and out of the body.

Incontinence can happen for many reasons:

  • If your bladder squeezes at the wrong time, or if it squeezes too hard, urine may leak out.
  • If the muscles around the urethra are damaged or weak, urine can leak out even if you don’t have a problem with your bladder squeezing at the wrong time.
  • You can also have incontinence if your bladder doesn’t empty when it should. This leaves too much urine in the bladder. If the bladder gets too full, urine will leak out when you don’t want it to.
  • If something is blocking your urethra, urine can build up in the bladder and cause leaking.

Recommended Reading: Perineural Invasion Prostate Cancer Prognosis

The Three Parts Of Male Orgasm

Kacker starts by pointing out a common misconception that erections are necessary for male orgasm. They arent. Men can have experience orgasm without an erection. The converse is also true, of course: men can have an erection without having an orgasm.

When discussing orgasm and radical prostatectomy, its useful to think of the male orgasm as having three separate parts, says Dr. Kacker.

First, secretions from the testicles, the prostate, and the seminal vesiclessmall, slender glands near the prostateflow into the urethra, the tube-like structure that carries semen through the penis and out the body. The emission of those fluids creates a feeling of fullness and a sensation of inevitability.

Second, theres ejaculation, which is accompanied by contractions of the pelvic floor muscles, the group of muscles used to hold in intestinal gas and urine.

And third is the mental componentall of the processing the brain does of incoming sensory signals from penis and pelvis that contribute to the mental experience of build up and release.

How Is Hormone Therapy Used To Treat Hormone

Elaine Orbach – Prostate Cancer (2008)

Hormone therapy may be used in several ways to treat hormone-sensitive prostate cancer, including:

Early-stage prostate cancer with an intermediate or high risk of recurrence. Men with early-stage prostate cancer that has an intermediate or high risk of recurrence often receive hormone therapy before, during, and/or after radiation therapy, or after prostatectomy . Factors that are used to determine the risk of prostate cancer recurrence include the grade of the tumor , the extent to which the tumor has spread into surrounding tissue, and whether tumor cells are found in nearby lymph nodes during surgery.

The use of hormone therapy before prostatectomy has not been shown to be of benefit and is not a standard treatment. More intensive androgen blockade prior to prostatectomy is being studied in clinical trials.

Relapsed/recurrent prostate cancer. Hormone therapy used alone is the standard treatment for men who have a prostate cancer recurrence as documented by CT, MRI, or bone scan after treatment with radiation therapy or prostatectomy.

Hormone therapy is sometimes recommended for men who have a “biochemical” recurrencea rise in prostate-specific antigen level following primary local treatment with surgery or radiationespecially if the PSA level doubles in fewer than 3 months.

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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.

Hormone Adjustments Can Help With Orgasm

Sometimes hormone levels contribute to orgasmic problem. Many men with low testosterone have problems with orgasm, but treating prostate cancer patients with testosterone is still very controversial. Other hormones can also play a role. For example, a low thyroid hormone level or a high prolactin level can make it more difficult to reach orgasm. Even if you have a normal hormone levels, there are a few hormonal medications that may be able to help.

Another hormone that plays a role in orgasm is oxytocin. The level of oxytocin increases in both men and women during sexual arousal. Taking an under-the-tongue formulation of oxytocin five to 10 minutes before sexual activity can help some men achieve orgasm. Its safe and no side effects have been reported, says Dr. Kacker. You need a prescription for oxytocin, and its available only through special compounding pharmacies, not through retail pharmacies.

Cabergoline is another medication that can help with orgasm problems. It blocks the release of prolactin, a hormone that appears to play an important role in the refractory period after orgasm when men cant have another orgasm for a while.

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Why Might A Person Have One Or Both Testicles Removed

Located in the scrotum, the testicles are a pair of glands that produce sperm cells and testosterone, the primary sex hormone and anabolic steroid in males. Testosterone plays a key role in the development of male characteristics. It is involved with sex drive, erections, and sperm production. It also helps build muscle and bone mass.

Surgery to remove one or both testicles is called an orchidectomy or orchiectomy.

Men who have one testicle removed usually dont experience sexual problems. The remaining testicle will produce enough testosterone to make up for the missing one. Erections and fertility also shouldnt be affected.

If both testicles are removed, the mans body will no longer produce testosterone. This may result in decreased sex drive and problems with erections. He will also become infertile, as sperm production will no longer be possible.

A man might have an orchidectomy for the following reasons:

Resources

  • American Cancer Society – Surgery for Testicular Cancer
  • YourHormones.info – Testes
  • CancerResearchUK.org – Surgery to remove your testicles

Prostate Removal: 8 Things To Know

What Happens To a Man When He Has His Prostate Removed?
  • BPH: Surgical Management. Urology Care Foundation.
  • How Cancer Treatment Can Affect Ejaculation. American Cancer Society.
  • Prostate Cancer FAQs. Prostate Cancer Foundation.
  • Prostate Cancer Treatment Option Overview – Surgery. National Cancer Institute.
  • Prostate Enlargement: Benign Prostatic Hyperplasia. National Institute of Diabetes and Digestive and Kidney Diseases.
  • Prostatectomy . Prostate Cancer Foundation.
  • Surgery for Prostate Cancer. American Cancer Society.
  • Transurethral Resection of the Prostate . Johns Hopkins Medicine.
  • What is Radical Prostatectomy for Prostate Cancer? American Urological Association.
  • Read Also: Does Enlarged Prostate Affect Ejaculation

    What Are The Current Expectations With Regard To Outcomes After Radical Prostatectomy

    Following a series of anatomical discoveries of the prostate and its surrounding structures about 2 decades ago, changes in the surgical approach permitted the procedure to be performed with significantly improved outcomes. Now after the surgery, expectations are that physical capacity is fully recovered in most patients within several weeks, return of urinary continence is achieved by more than 95% of patients within a few months, and erection recovery with ability to engage in sexual intercourse is regained by most patients with or without oral phosphodiesterase 5 inhibitors within 2 years.

    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 doesn’t work? Are there others I could try?
    • What other support is available to me?
    • Can my partner also get support?

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    If Youre The Receiving Partner

    Youll want to be as relaxed and aroused as possible, because itll make the experience easier and more enjoyable.

    The whole poop-comes-out-of-the-butt thing gives some people a case of the heebie-jeebies even when its their own butt.

    Remedy this by taking a shower and paying a little extra attention back there to get it squeaky clean. Some people like to use an enema before engaging in butt play, but it isnt necessary.

    Use the bathroom before getting started. Prostate stimulation can make you feel like you need to pee, and anal penetration can cause the sensation of needing to poop.

    Even though you wont actually do either, worrying that you might can interfere with your ability to let go and enjoy yourself. Knowing your bladder and bowels are empty can help.

    Getting used to the sensation of having your prostate touched can help, too. Practice with an anal sex toy, like a butt plug, or your fingers.

    Be sure to set the mood so that youre turned on and primed for action. Light candles, watch porn, or engage in some good old-fashioned masturbation or foreplay to get there.

    Finally, be sure to lube up real good. Applying a water-based lubricant will allow for easier penetration and make for some easy gliding if stimulating your prostate externally.

    How To Return To An Active Sex Life After Prostate Cancer Treatment

    Understanding Late Stage Prostate Cancer

    No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them. Surgery, radiation therapy and other treatments may impact a patients sex life, causing challenges like low sex drive, loss of penis length, dry orgasm or low sperm counts. Despite the angst these issues may cause, experts say most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment.

    Unfortunately, sexual dysfunction is a possibility for nearly all treatment options for prostate cancer, including surgery, says Scott Shelfo, MD, FACS, Medical Director of Urology at our hospital near Atlanta. The degree of dysfunction depends on many factors, including the patients overall health, co-existing medical problems, as well as the patients level of sexual function and ability before treatment.

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    What Is A Radical Prostatectomy

    Surgery to remove the prostate is called a radical prostatectomy. Before the operation, the surgeon will explain what will happen and tell you about the possible side effects. They may also tell you about other treatments that may help in your situation, such as radiotherapy.

    The aim of the surgery is to remove all of the cancer cells. It is usually only done when the cancer is contained within the prostate and has not spread to the surrounding area.

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    What Current Options Exist To Treat Erectile Dysfunction After Radical Prostatectomy

    Options include pharmacologic and nonpharmacologic interventions. Pharmacotherapies include the oral PDE-5 inhibitors , intraurethral suppositories , and intracavernous injections . Non-pharmacologic therapies, which do not rely on the biochemical reactivity of the erectile tissue, include vacuum constriction devices and penile implants .

    Men who have undergone nerve-sparing technique should be offered therapies that are not expected to interfere with the potential recovery of spontaneous, natural erectile function. In this light, penile prosthesis surgery would not be considered an option in this select group, at least in the initial 2 year post-operative period, until it becomes evident in some individuals that such recovery is unlikely.

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