What Happens During Prostate Cancer 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.
How Does The Doctor Know I Have Prostate Cancer
Prostate cancer tends to grow slowly over many years. Most men with early prostate cancer dont have changes that they notice. Signs of prostate cancer most often show up later, as the cancer grows.
Some signs of prostate cancer are trouble peeing, blood in the pee , trouble getting an erection, and pain in the back, hips, ribs, or other bones.
If signs are pointing to prostate cancer, tests will be done. Most men will not need all of them, but here are some of the tests you may need:
PSA blood test: PSA is a protein thats made by the prostate gland and can be found in the blood. Prostate cancer can make PSA levels go up. Blood tests will be done to see what your PSA level is and how it changes over time.
Transrectal ultrasound : For this test, a small wand is put into your rectum. It gives off sound waves and picks up the echoes as they bounce off the prostate gland. The echoes are made into a picture on a computer screen.
MRI: This test uses radio waves and strong magnets to make detailed pictures of the body. MRI scans can be used to look at the prostate and can show if the cancer has spread outside the prostate to nearby organs.
Prostate biopsy: For a prostate biopsy, the doctor uses a long, hollow needle to take out small pieces of the prostate where the cancer might be. This is often done while using TRUS or MRI to look at the prostate. The prostate pieces are then checked for cancer cells. Ask the doctor what kind of biopsy you need and how its done.
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.
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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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What About Other Treatments I Hear About
When you have cancer you might hear about other ways to treat the cancer or treat your symptoms. These may not always be standard medical treatments. These treatments may be vitamins, herbs, special diets, and other things. You may wonder about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to help. A few have even been found to be harmful. Talk to your doctor about anything youre thinking about using, whether its a vitamin, a diet, or anything else.
What Kind Of Treatment Will I Need
There are many ways to treat prostate cancer. The main kinds of treatment are observation, active surveillance, surgery, radiation, hormone therapy, and chemo. Sometimes more than one kind of treatment is used.
The treatment thats best for you will depend on:
- Your age
- Any other health problems you might have
- The stage and grade of the cancer
- Your feelings about the need to treat the cancer
- The chance that treatment will cure the cancer or help in some way
- Your feelings about the side effects that might come with treatment
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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:
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
- minimize pain before, during, and after surgery
What Treatment Options For Sexual Dysfunction Are Safe After Prostate Surgery
All of the treatment options come with risks, even the all-natural ones. You need to be careful about sourcing supplements, being confident in the supply.
Many US-based manufacturers were caught by the FDA selling natural Tongkat Ali which actually contained prescription ED drugs! Likewise, overtraining can lead to injury or soreness. However, theres no doubt that the natural approach is safer than the alternative.
Only purchase Tongkat Ali supplements from a reputable company that provides 3rd party lab tests to prove that it is an unadulterated and safe supplement.
If you are looking for a safe and natural testosterone boosting supplement that contains Tongkat Ali, we recommend our Testo-Booster supplement.
The side effects from the most commonly used ED pharmaceuticals include minor ones, such as headache, flushing, runny nose and pains in the stomach or back.
In some cases, dizziness and a sudden drop in your blood pressure can take place. Thats why men with heart conditions have to be evaluated by a physician before they take it, and may have to rely on a lower dose.
Around 1 out of every fifty men who take those drugs will also experience painful or persistent erections.
The highest risk group, however, is those who undergo surgery to get an implant. Thats why its always the last choice. As the surgeon needs to make an incision into the scrotum, penis and often the abdominal wall, there is a risk of infection.
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Drugs To Treat Cancer Spread To Bone
If prostate cancer spreads to other parts of the body, it almost always goes to the bones first. These areas of cancer spread can cause pain and weak bones that might break. Medicines that can help strengthen the bones and lower the chance of fracture are bisphosphonates and denosumab. Sometimes, radiation, radiopharmaceuticals, or pain medicines are given for pain control.
Side effects of bone medicines
A serious side effect of bisphosphonates and denosumab is damage to the jaw, also called osteonecrosis of the jaw . Most people will need to get approval from their dentist before starting one of these drugs.
What Kinds Of Surgeries Treat Urinary Incontinence After Your Prostate Is Removed
There are two types of surgery for urinary incontinence: the urethral sling and the artificial urinary sphincter. Usually, the incontinence needs to last for about one year after the prostatectomy to be sure there is not going to be further improvement before your healthcare provider suggests this type of therapy.
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Sex After Prostate Surgery
Youll often hear people say that men think about sex every 12 seconds, or some other ridiculous number.
While we may know that isnt exactly the case, theres no denying that for most men its at the forefront of their mind.
So when undergoing treatment for an enlarged prostate or even prostate cancer, its inevitable that questions about your sex life will arise.
This article will look at the most common concerns for men who have undergone, are in the middle of, or are thinking about undergoing treatment.
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.
Last reviewed by a Cleveland Clinic medical professional on 10/31/2020.
References
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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.
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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Are There Things I Can Do To Help Myself If I Have Erectile Dysfunction
Yes, there are changes you can make in your life that may help with your erectile dysfunction. Remember to speak with your doctor or healthcare team before making any of these changes.
Some changes you may want to consider are:
- Try to exercise on a regular basis.
- Try to eat a healthy diet.
- Drink responsibly. Long-term, heavy drinking lowers your ability to have an erection.
- Try to lower your stress and fatigue . Being diagnosed with prostate cancer and working in all the changes it brings to your life can be stressful. Stress and the tiredness caused by your prostate cancer treatment, can make it difficult for you to get in the mood. Many men going through prostate cancer treatment feel this way. Talking with your partner might help lower your stress. You may also speak to your doctor or healthcare team about how you are feeling. They are there to help you through this time.
- Stop smoking. Research studies show that smoking can harm your ability to have sex. If you need help to stop smoking, speak with your doctor or healthcare team.
- Practice your Kegel exercises. Kegel exercises help strengthen your pelvic floor muscles, which support your bladder and bowel. These muscles also help with erections. For more information, please see the IMPACT booklet, Kegel Exercises for Men.
The Purpose Of Prostate Surgery
Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.
It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.
Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:
Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.
The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.
Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.
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Advantages And Disadvantages Of Surgery
What may be important for one person might be less important for someone else. The advantages and disadvantages of surgery may depend on your age, general health and the stage of your cancer.
Advantages
- If the cancer is completely contained inside the prostate, surgery will remove all of the cancer.
- The prostate is looked at under a microscope to give a clearer picture of how aggressive your cancer is, whether it has spread outside your prostate and if you need further treatment.
- Your health professionals can get a good idea of whether your cancer was completely removed during surgery. Your PSA level should drop so low that its not possible to detect it at six to eight weeks after surgery.
- If there are signs that your cancer has come back or wasnt all removed, you may be able to have further treatment.
- Some men find it reassuring to know that their prostate has been physically removed, although you will still need to have follow-up tests to make sure no cancer cells have spread outside the prostate.
Disadvantages
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.
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Ask Your Doctor About Solutions
Patients should not be shy about discussing intimacy issues with their doctor. He or she may be able to prescribe medications to help. Certain medicationssuch as sildenafil , tadalafil or vardenafil are typically tried first. But these drugs may not help men achieve an erection if the nerves responsible are not healthy. In fact, the medications only work for a small percentage of men in the first few months after surgery, according to a 2017 study published in the International Journal of Sexual Health.
Besides oral medications for erectile dysfunction, there are other options available to men with ED after prostate cancer treatment, says Dr. Shelfo. These include penile injection therapy, which involves injecting a small amount of medication directly into the base of the penis. That has helped many men achieve erections. Another option is an intraurethral suppository of medication, an external vacuum erection device, or surgery may be performed to implant a penile prosthesis.
While regaining erectile function is not possible for all men treated for prostate cancer, it is important to remember that an erection is just one aspect of a satisfying sex life. Intimacy is another major component, one that may become more important as sexual relationships become more difficult after cancer treatment.