In addition, younger men regained function sooner than older men. Despite the risk of side effects, about 75 percent of those surveyed were "delighted or pleased" with their surgery, and only 4 percent were dissatisfied. A year and a half after surgery, 72 percent of the men said they would make the same treatment choice, although this varied by race 56 percent of blacks said they would choose the surgery again, as compared to 76 percent of whites and 61 percent of Hispanics.
Only 7 percent of the men reported that they would not choose radical prostatectomy again. Editor's note: For more information, to arrange an interview with Dr. The Fred Hutchinson Cancer Research Center is an independent, nonprofit research institution dedicated to the development and advancement of biomedical technology to eliminate cancer and other potentially fatal diseases. Recognized internationally for its pioneering work in bone-marrow transplantation, the Center's four scientific divisions collaborate to form a unique environment for conducting basic and applied science.
Prostate cancer is the most frequently diagnosed solid tumor in American men. An estimated , men will be diagnosed this year, and more than 70 percent of these patients will have early stage, localized disease. Treatment options for men with tumors confined to the prostate and who have at least a year life expectancy include radical prostatectomy, external-beam radiation, brachytherapy and expectant management, also known as "watchful waiting.
Each of these approaches is associated with a different spectrum of side effects that may impact quality of life in the short or long run. Radical prostatectomy -- the surgical removal of the prostate and some of the tissue around it.
Radical prostatectomy is done only if the cancer does not appear to have spread outside the prostate. There are two types of prostatectomy:. Whether one or both nerve bundles can be spared during surgery depends on the extent and location of the cancer.
The outcome and side effects also depend largely on the experience and training of the surgeon. With the advent of the nerve-sparing radical prostatectomy technique, many men can expect to recover erectile function in the current era. However, despite expert application of the nerve-sparing prostatectomy technique, early recovery of natural erectile function is not common. Increasing attention has been given to this problem in recent years with the advancement of possible new therapeutic options to enhance erection function recovery following this surgery.
Visit Dr. Burnett's Neuro-Urology Laboratory. This topic area was handled thoroughly in an article written by Dr. Arthur L. Using a question and answer format, excerpts from this article are provided below.
In considering the impact of the various treatment approaches for prostate cancer on their quality of life, many patients place paramount importance on the possibility of retaining natural erectile function. This matter is frequently important to young men who by age status are more likely to have intact erectile function than older men; however, for all men having normal preoperative erectile function irrespective of age, preservation of this function is understandably important postoperatively.
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. The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas.
Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return. A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states e.
At this time, there are several different surgical approaches to carry out the surgery, including retropubic abdominal or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation.
Much debate but no consensus exists about the advantages and disadvantages of the different approaches. We review the research. Health Conditions Discover Plan Connect. What causes impotence? Risk factors. Regaining function. The takeaway. Read this next. Medically reviewed by Daniel Murrell, M. What Are Erection Problems? Medically reviewed by Alana Biggers, M. About half of all prostate cancer patients who undergo any of these types of radiation therapy are likely to develop erectile dysfunction, according to a article published in Advances in Radiation Oncology.
With radiation, erections are usually less affected in the beginning, but over time—months or, sometimes, years—sexual dysfunction may develop. Both treatments may affect sexual function, resulting in no ejaculate or the ability to attain erections. The goal of hormone therapy is to reduce the level of male hormones in the body, or to stop them from fueling prostate cancer cells.
Hormone therapy may cause a loss of libido sex drive for some but not all patients. Some men find that they maintain their desire for sex but are unable to get an erection or are unable to reach orgasm. Hormone therapy may also reduce the amount of semen released at ejaculation. Chemotherapy drugs are used to kill cancer cells or limit their growth.
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