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:
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Will I have sex after prostate cancer?
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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.
Going Home With A Catheter
You will be discharged from the hospital with a catheter in place to drain urine from your bladder into a bag. The doctor will remove this in the office in five to 14 days. Be sure to clean the catheter where it exits your penis twice a day with soap and water and to empty the bag frequently. The bag should always be positioned lower than your bladder.
On occasion, the catheter may irritate the bladder, causing bladder spasms that can be quite uncomfortable. If these occur, your doctor can prescribe medication that can help. Leakage of urine around where the catheter exits the penis also may occur and can be managed by wearing incontinence pads as described in the next section.
It is normal for your urine to look cloudy for a few weeks after surgery. Occasionally, bleeding may occur around the catheter or be noticed within the urine. This also is common. If you see large clots â more than an inch in length â or if the catheter becomes plugged, contact your doctor. No anesthesia is required for catheter removal, and most patients experience only a little discomfort.
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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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- Will I need other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- What can I do about side effects that I might have?
- Is there a clinical trial that might be right for me?
- What about special vitamins or diets that friends tell me about? How will I know if they are safe?
- How soon do I need to start treatment?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
Side Effects Of Prostate Surgery
The major possible side effects of radical prostatectomy are urinary incontinence and erectile dysfunction . These side effects can also occur with other forms of prostate cancer treatment.
Urinary incontinence: You may not be able to control your urine or you may have leakage or dribbling. Being incontinent can affect you not only physically but emotionally and socially as well. These are the major types of incontinence:
- Men with stress incontinence might leak urine when they cough, laugh, sneeze, or exercise. Stress incontinence is the most common type after prostate surgery. It’s usually caused by problems with the valve that keeps urine in the bladder . Prostate cancer treatments can damage this valve or the nerves that keep the valve working.
- Men with overflow incontinence have trouble emptying their bladder. They take a long time to urinate and have a dribbling stream with little force. Overflow incontinence is usually caused by blockage or narrowing of the bladder outlet by scar tissue.
- Men with urge incontinencehave a sudden need to urinate. This happens when the bladder becomes too sensitive to stretching as it fills with urine.
- Rarely after surgery, men lose all ability to control their urine. This is called continuous incontinence.
After surgery for prostate cancer, normal bladder control usually returns within several weeks or months. This recovery usually occurs slowly over time.
There are several options for treating erectile dysfunction:
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How Will Prostate Surgery Affect My Sex Life
Experienced robotic surgeons like Dr. David Samadi dont open the endopelvic fascia during surgery, which spares the rick of damage to nerve bundles that control sexual function. The recovery of the function, however, is not immediate and you should not feel discouraged if weeks or even a few months after surgery you experience erectile dysfunction. It is not an indication of long-term damage.
One major change that you will notice in your sex life is the absence of sperm. Having no prostate, the body will not produce semen during the orgasm. The sperm cells will be simply reabsorbed by the body them. This is not harmful and you shouldnt be worried about it. Plenty of men deal with the problem with the help of medication that improves erectile dysfunction.
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 Necessitates Prostate Removal
Prostate cancer and sometimes benign prostatic hyperplasia can necessitate the removal of prostate gland. However, the most common cause is prostatic cancer as BPH can nowadays be managed with other treatment options. The prostate gland removal surgery is known as prostatectomy. The risks, benefits and side-effects of prostatectomy should be discussed with the patient, before making the decision to get prostate gland removed.
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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.
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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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Does Incontinence Happen If I Treat Prostate Cancer With Radiation
Some men need radiation therapy after prostate removal. During radiation therapy, some of the normal tissues around the urinary sphincter, urethra and bladder may be exposed, causing irritation to occur post therapy, leading to incontinence. This typically subsides within a few months after radiation therapy, however if it persists, additional treatments described below may be helpful.
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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:
How May Erectile Dysfunction Affect My Sex Life
Most men find that their sex life is different after prostate cancer treatment. Some men question their manliness when they cannot have an erection or find that they are not interested in sex. This can happen even if you are not currently in an intimate relationship. You may find this upsetting. Even if one of the medications or erection aids is helpful, having sex using these things may take some getting used to. It may not feel entirely natural. You can talk with your doctor or healthcare team about these feelings. Counseling may also help.
If you have an intimate partner, it is important for you to talk to your partner about how you are feeling. There is an old saying that a problem shared is a problem halved. Not everyone wants a sexual relationship. Dont try to guess or assume what your partner wants. Have an open and honest discussion with your partner.
This may seem unnecessary in long-term relationships as people tend to assume they know all there is to know about their partner but this is not always the case. With time, you and your partner may be able to find satisfying ways to have a sex life even though you have erectile dysfunction. Your partner will also have concerns about your sex life as well as concerns about your health. Talking about your feelings is very important during this time.
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Overall Outlook Following Prostate Cancer Surgery
Surgery for prostate cancer has been refined over the years, and is now associated with fewer complications and a good long-term success rate. Nonetheless, complications such as incontinence and erectile dysfunction do still occur and can be very distressing.
It is important to ask your surgeon for information about all the things that are important to you before the operation. However, they can only give you statistics and probabilities and will not be able to tell you exactly what will happen to you every man has a different story to tell.
Can You Live Without A Prostate
You can live without a prostate, though there are some side-effects.
The prostate is removed to prevent the spread of prostate cancer, while it might also be removed because it has enlarged through normal ageing and is putting pressure on the uretha .
A prostatectomy is the removal of all or part of a prostate, with the most common procedure being the transurethral resection of the prostate .
Laser prostatectomies are also performed which is the least invasive type of removal.
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Recovering From Prostate Surgery
To treat prostate cancer, doctors perform tens of thousands of surgeries each year. In recent years, one procedure — called a radical prostatectomy — has become a fine art, says J. Brantley Thrasher, MD, a professor of urologic surgery at the University of Kansas Medical Center in Kansas City. While side effects like incontinence and impotence are still major concerns, most patients respond well to the surgery, Thrasher says.
In fact, many men respond almost too well. “They feel so good after the surgery that they start to push themselves too hard,” he says. One of his recent patients went on a two-mile jog — while still wearing a catheter. “I told him he needed to slow down and rest for a while.”
If you have a radical prostatectomy in your future, you’ll want to know what to expect. Here’s a closer look at this procedure. As you’ll see, your life won’t necessarily take a turn for the worse after prostate surgery. In fact, it just might get better.
Why do surgeons perform radical prostatectomies?
According to the Food and Drug Administration, radical prostatectomy is considered to be the most definitive treatment for many men with prostate cancer, a disease that kills about 30,000 American men each year. Depending on their age and the stage of their cancer, however, some men do well with a less invasive treatment.
How should I prepare for surgery?
What happens during a radical prostatectomy?
What will happen during recovery in the hospital?
References
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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What Is Prostate Cancer
Cancer can start any place in the body. Prostate cancer starts in the prostate gland. It starts when cells in the prostate grow out of control.
Cancer cells can spread to other parts of the body. Cancer cells in the prostate can sometimes travel to the bones or other organs and grow there. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the prostate.
Cancer is always named for the place where it starts. So when prostate cancer spreads to the bones , its still called prostate cancer. Its not called bone cancer unless it starts from cells in the bone.
Ask your doctor to use this picture to show you where your cancer is.
The prostate
The prostate is a gland found only in men, so only men can get prostate cancer.
The prostate is just below the bladder and in front of the rectum . The tube that carries pee goes through the prostate. The prostate makes some of the fluid that helps keep the sperm alive and healthy.
There are a few types of prostate cancer. Some are very rare. Most prostate cancers are a type called adenocarcinoma. This cancer starts from gland cells. Your doctor can tell you more about the type you have.
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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