Tuesday, May 17, 2022

What Happens When You Remove The Prostate

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Where Can I Find Prostate Cancer Support Groups

Prostate Surgery: Prostatectomy

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:

  • https://www.cancerforums.net/forums/14-Prostate-Cancer-Forum
  • http://community.prostatecanceruk.org/
  • http://www.topix.com/forum/health/prostate-cancer

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.

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.

Urinary Problems After Surgery

Leaking urine

Most men cant control their bladder properly when their catheter is first removed. This is because surgery can damage the muscles and nerves that control when you urinate.You might just leak a few drops if you exercise, cough or sneeze . Or you might leak more and need to wear absorbent pads, especially in the weeks after your surgery.Leaking urine usually improves with time. Most men start to see an improvement one to six months after surgery. Some men leak urine for a year or more and others never fully recover, but there are things that can help and ways you can manage it.

Difficulty urinating

A few men may find it difficult to urinate after surgery . This can be caused by scarring around the opening of the bladder or the urethra .Some men find they suddenly and painfully cant urinate. This is called acute urine retention and it needs treating quickly to prevent further problems. If this happens, call your doctor or nurse, or go to your nearest accident and emergency department.

Watch Paul’s story for one man’s experience of managing urinary problems after surgery below.

Sexual problems after surgery

Erection problems

Change in penis size and shape

Changes to orgasm

The seminal vesicles, which make some of the fluid in semen, are removed during surgery. This means you wont ejaculate any more. You may have a dry orgasm instead where you feel the sensation of orgasm but dont ejaculate. This may feel different to the orgasms youre used to.

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Surgery For Prostate Cancer

Surgery is a common choice to try to cure prostate cancer if it is not thought to have spread outside the prostate gland.

The main type of surgery for prostate cancer is a radical prostatectomy. In this operation, the surgeon removes the entire prostate gland plus some of the tissue around it, including the seminal vesicles.

What Changes Do I Need To Make To My Diet

Gay and Bisexual Men

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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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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External Beam Radiation Therapy

In this type of therapy, a machine outside the body is used to focus the beams of radiation on the prostate gland. It is used to treat early stages of cancer and helps to relieve you from symptoms such as pain.

Before the procedure, you will undergo simulation, which is a planning session. During this session, the radiation team takes measurements to find the correct angles for aiming the beams and the proper dosage.There are various types of EBRT namely:

  • Intensity-modulated radiation therapy
  • Proton beam radiation therapy

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Open Radical Prostatectomy Vs Minimally Invasive Radical Prostatectomy

In 2003, only 9.2% of radical prostatectomies were done using a minimally invasive procedure. By 2007, that number had jumped to 43.2%. In 2009, researchers in Boston reported on a study that compared outcomes, benefits, and complications of open surgery vs. minimally invasive surgery:

  • No difference was found in deaths or in the need for additional cancer therapy between the two approaches.
  • The median hospital stay was two days for minimally invasive surgery and three days for open surgery.
  • 2.7% of men having laparoscopic surgery required a blood transfusion compared with 20.8% of men having open surgery.
  • There was more anastomotic stricture narrowing of the suture where internal body parts are rejoined for open surgery than for minimally invasive surgery .
  • There were fewer respiratory complications with minimally invasive surgery than with open surgery .
  • There were lower rates of incontinence and erectile dysfunction with open surgery. The overall rate was 4.7% for laparoscopic surgery and 2.1% for open surgery.

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Three Common Prostate Problems

Prostate Surgery: Transurethral Resection of the Prostate (TURP)

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.

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What Happens After Urethral Sling Surgery

Patients usually recover from this surgery quickly. It’s best to limit demanding activities for approximately six weeks after surgery to avoid having the sling loosen before healing is complete.

After surgery, there may be swelling that makes it difficult to urinate. You’ll have a catheter coming out of the urethra for two to three days. After this, the catheter is removed and just about everyone is able to void on their own. In rare cases, the catheter may have to be reinserted for a few days or up to a week if you cannot urinate.

After the swelling goes down, youll gradually be able to urinate on your own and empty your bladder. However, your normal urination pattern may not return for a few weeks.

The majority of men who’ve had this procedure have been cured of their urinary incontinence and no longer use pads. The others usually improve to the point where they don’t use as many pads as they were before.

What To Expect After Radical Prostatectomy

Most men stay in the hospital for one to three days after radical prostatectomy. A urinary catheter is inserted during the surgery, and some men may need to wear the catheter home for a few days to a few weeks. Another catheter inserted through the skin also may need to stay in place for a few days after returning home.

Pain after radical prostatectomy can generally be controlled with prescription pain medicines. It can take weeks or months for urinary and sexual function to return to their maximum levels.

After radical prostatectomy, regular follow-up is essential to make sure prostate cancer does not return.

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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:

  • Penile implants. It is normal for your doctor to try and treat your erectile dysfunction with medicine or external medical devices first. If these options dont help you get an erection, you may want to talk to your doctor about the chance of getting a penile implant. A penile implant is a medical device put in your penis during an operation. The implant will help you have a mechanical erection .
  • What Is Prostate Removal

    Do You Have To Get A Prostate Exam

    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 Happens To The Prostate After Radiation

    The entire prostate gland is radiated when we treat the cancer. The prostate normally produces some of the fluid in the ejaculation. Radiation therapy has the side effect of damaging the glands in the prostate, so a lot less fluid is produced. The ejaculation may be dry or nearly dry. In addition, you will probably be sterile after radiation, but this is not 100% guaranteed and should not be relied upon as a form of birth control. You can still usually have erections because the nerves and blood vessels that go to the penis are not as damaged as the prostate gland.

    The prostate gland will end up having a lot of scar tissue. It will shrink in size to about half its original weight within a couple years after finishing radiation. The urethra passes through the canter of the prostate gland like the hole of a doughnut. Sometimes this passage can widen, other times it can shrink after radiation. In summary, the prostate gland is heavily damaged from radiation and does not work normally afterwards.

    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.

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    When Should I See My Healthcare Provider

    Talk to your healthcare provider if you have any of these symptoms after your surgery:

    • Bleeding, swelling or drainage from the incisions.
    • Inability to have a bowel movement.
    • Inability to urinate after catheter removal.
    • Increased pain around the incisions.

    A note from Cleveland Clinic

    Radical prostatectomy is a common surgery to remove the entire prostate gland. This prostate cancer surgery may be robotic surgery or open surgery. Robotic surgery has a shorter recovery time. Full recovery can take weeks, with some side effects lasting for months. Light exercise and medication can help you heal faster.

    Last reviewed by a Cleveland Clinic medical professional on 08/03/2021.

    References

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    Life After A Radical Prostatectomy: A Real

    Prostate Surgery: Vaporization

    Reposted from Greater Boston Urology.

    In October of 2013, Les Cavicchi underwent a radical prostatectomythe removal of the prostate gland. Les had been diagnosed with prostate cancer a month earlier after undergoing a TRUS biopsy.

    Less cancer was localized, meaning it was contained within the prostate gland itself. He didnt need further treatment for prostate cancer after the surgery, only regular monitoring of his PSA.

    However, Les did suffer from common side effects associated with radical prostatectomies, specifically urinary incontinence and erectile dysfunction.

    Q: So lets get right to it: You were dealing with incontinence after your radical prostatectomy?Les: The thing about any kind of prostate procedure is youve got to deal with incontinence. This was a big issue for me for a while. I had purchased padded undergarmentsa whole case of them, because I didnt know how long this was going to last.

    Men wonder why this particular side effect happens. The prostate gland is the primary organ for controlling urinary flow in normal physiology. When you are rising frequently during the night, and/or having difficulty starting urination, these are signs that the prostate is beginning to grow in size and interfere with this specific function. Every mans prostate gets larger with age it does not necessarily have anything to do with having cancer. It is a separate reality.

    Women dont have a prostate. What do they use? Kegel muscles!

    About Greater Boston Urology

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    Impotence Or Erectile Dysfunction

    This means your penis cannot get hard enough for sex.

    An erection is a way your penis gets hard. If you can have an erection before surgery, the doctor will try not to hurt it during the surgery. This is called a nerve-sparing approach. But if the cancer is too close to or growing into these nerves, they will need to be removed.

    If you have both nerves removed, then you wont be able to have spontaneous erections. If only one side is removed, you might still have erections, but it would be less likely. If neither are removed, then maybe your erections will go back to normal after surgery.

    After surgery, you will have an erection if you were able to before the operation and if the nerves were not cut. But, if you had an issue with your erection before surgery and the nerves were cut, you will probably lose this ability after surgery too.

    Doctors who do many radical prostatectomies tend to report lower impotence rates than doctors who do the surgery less often. There are many different rates of impotence in the medical literature, but every man is other, so it is best to ask your doctor about their success rates and what will happen if you have this surgery.

    If your ability to get erections returns after surgery, it often takes a while before you can do it yourself. It might take up to two years. During the first few months, you may not get an erection at all and will need help from medicines or other treatments.

    What The Research Shows About Radiation Vs Surgery

    The ProtecT trial was a 10-year, randomized clinical study designed to compare radical prostatectomy, external-beam radiotherapy and active surveillance for the treatment of localized prostate cancer.

    The results, published in 2016, showed that the rate of disease progression among men assigned to radiotherapy or radical prostatectomy was less than half the rate among men assigned to active monitoring. However, there was no significant difference in survival at the median 10-year mark for radiation therapy, surgery or active surveillance.

    If youre interested in directly comparing treatment outcomes by treatment method and risk group , the Prostate Cancer Free Foundation provides an interactive graph on its website with information from data obtained from over 100,000 prostate cancer patients over a 15-year period.

    As discussed earlier in the sections on the side effects of radiation therapy and surgery, the researchers conducting the ProtecT trial also looked at side effects and quality-of-life issues and found that the three major side effects of these two treatment options that affect quality of life after prostate cancer treatment are urinary incontinence, sexual dysfunction and bowel health.

    The trial found that urinary leakage and erectile dysfunction were more common after surgery than after radiation therapy. Gastrointestinal bowel problems were more common after radiation therapy.

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