6 Questions About Sex After Prostate Cancer Treatment
Tuesday, March 28, 2017
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Expert explains what changes in man's erections and how this can be reversed.
The "blue November" encourages man to take better care of his health, focusing mainly on prostate cancer , a type of cancer that can be avoided if the patient goes urologist periodically.
Unfortunately, most men do not have this habit. And as much as prostate cancer is absolutely curable, it can cause problems in a man's sex life for a number of reasons. To talk more about this, I'll explain a little about the main doubts about this topic:
It is important to note that not every treatment for prostate cancer causes changes in the sex life of the man. Today there are resources to treat prostate diseases while preserving sexual potency. The surgery that truly brings the greatest impact in this area is radical prostatectomy. Minor surgeries such as the RTU known as "scraping" rarely bring about any change in sex life. At most they cause retrograde ejaculation, a situation in which the ejaculate goes into the bladder instead of jumping out like in the "normal" orgasm.
But in the case of radical prostatectomy, surgery to treat cancer, the impact is much greater. Surgery causes changes in orgasm, sexual potency and even libido. So the so-called "sexual rehab" should ideally begin before surgery. About 90% of men undergoing this surgery will suffer from erectile dysfunction . All will not ejaculate anything after the procedure, because in addition to the interruption of the vas deferens that led the sperm produced in the testicles, the seminal vesicles are also removed along with the prostate. There is no more production of semen. Being forewarned, therefore, preparing yourself for the steps you will face is very important.
Radical prostatectomy can be performed with traditional, laparoscopic or robot cutting. So far, no comparative study of good quality has shown that one technique is superior to another. That is, no one can claim, based on robust scientific evidence, that operating with the help of the robot reduces the risk of sexual impotence and even urinary incontinence.
The parameters that make the difference in knowing the risk of being impotent because of the surgery are of two types: related to the cardiovascular health of the individual and relative to the surgery itself. In the first group we highlight: age, presence of comorbidities such as diabetes , hypertension , obesity and smoking , previous existence of active sexual life and most important, the situation of erection before surgery. In other words, anyone who already has some degree of erectile dysfunction before surgery has a greater chance of worsening with surgery to treat prostate cancer.
In the other group of factors they count the experience of the surgeon, the location of the tumor and the individual anatomy of each patient. These are factors that influence the possibility of preserving or damaging the so-called erecting nerves, which pass close to the gland and in some cases may be injured during surgery. When nerve damage occurs on both sides, sexual impotence is certain and recovery more complex. In bilateral nerve preservation, sexual dysfunction is usually transient and on average, after the first year the erectile function is recovered. The surgeon always tries to preserve these structures, but in some cases, to remove any tissue affected by cancer he needs to sever the nerve.
Early sexual rehab is the answer. It means going back gradually to stimulate the penis in order to preserve the quality of the erectile tissue and increase the chance of regaining its erectile capacity. Return to wiggle the penis, stretch it in the bath and masturbate. These simple manipulations of the genitalia should be stimulated.
Of course, to return to practicing sexual intercourse requires a longer time, it is fundamental to contemplate the psychological part as well. But the concern here in stimulating early is to preserve the structure of the penis. The studies also show that if nothing is done after radical prostatectomy, sexual inactivity and the absence of physiological erections cause penile atrophy. It shortens and becomes more fibrous.
Studies of patients undergoing prostate cancer treatment through surgery have shown that recovery of the ability to stand erect is greater in those who initiate sexual rehab early. And they used strategies that would allow an erection that was rigid enough for penetration. The interior of the penis has special structures that provide the ability to stand erect: the corpora cavernosa. They are like an accordion that stretches and shrinks. Without periodic erections, the sanfones atrophy and lose the ability to stretch and shrink. Hence the importance of periodic erections, even before there is a will to have intercourse. If the doctor is waiting for the return of the sexual appetite to begin rehabilitation, precious time has been lost. The results in terms of sexual satisfaction in the future will be worse.
Rehabilitation focuses on getting erections to preserve the quality of the erectile tissue while the rest (integrity of the erected nerves, libido, joy, disposition among other aspects) is recovering over time. We can not neglect the psychological impact of cancer diagnosis and surgery itself.
In rehabilitation we often use the combination of oral medication, injectable medication and penile pump. Depending on the clinical response and individual adaptation, the doctor will manage different treatment modalities to achieve the ultimate goal of regaining full sex life. Combination therapy may include injection and use of the penile pump, oral medication together with injectable medication and others. Here the experience of each professional is worth a lot and the multidisciplinary teamwork must certainly include the accompaniment of a trained psychologist.
When all other alternatives have proved ineffective or the patient does not get a good adaptation, we can talk about penile (prosthesis) implants. But it is always important to emphasize that the implant of the penile prosthesis will not return physiological erections and will not produce an increase in the size of the penis. The prosthesis will replace that erectile tissue, the accordion, with a synthetic material.
I conclude by recalling that the adoption of healthy living habits is the basis of everything. As stated, penile erection depends on good blood circulation and effective communication between the brain and the penis and health care in a broader way is paramount. Understanding that sexual activity is not limited to erection is a fundamental part of rehabilitation and experiencing the exchange of pleasure using the whole body and all feelings facilitate rehabilitation after the impact of having received the diagnosis of a disease that frightens. Moreover, dating and nurturing the relationship has always meant a decisive step to the success of any rehabilitation protocol, as well as having the help and support of the partner or partner makes a lot of difference. So the final message is: there is always a viable alternative to resuming full sexual life when that is man's will!
Source:
Dr. Valter Javaroni
http://minhavida.com.br/
The "blue November" encourages man to take better care of his health, focusing mainly on prostate cancer , a type of cancer that can be avoided if the patient goes urologist periodically.
Unfortunately, most men do not have this habit. And as much as prostate cancer is absolutely curable, it can cause problems in a man's sex life for a number of reasons. To talk more about this, I'll explain a little about the main doubts about this topic:
Why Does Prostate Surgery Affect Sex Life?
It is important to note that not every treatment for prostate cancer causes changes in the sex life of the man. Today there are resources to treat prostate diseases while preserving sexual potency. The surgery that truly brings the greatest impact in this area is radical prostatectomy. Minor surgeries such as the RTU known as "scraping" rarely bring about any change in sex life. At most they cause retrograde ejaculation, a situation in which the ejaculate goes into the bladder instead of jumping out like in the "normal" orgasm.
But in the case of radical prostatectomy, surgery to treat cancer, the impact is much greater. Surgery causes changes in orgasm, sexual potency and even libido. So the so-called "sexual rehab" should ideally begin before surgery. About 90% of men undergoing this surgery will suffer from erectile dysfunction . All will not ejaculate anything after the procedure, because in addition to the interruption of the vas deferens that led the sperm produced in the testicles, the seminal vesicles are also removed along with the prostate. There is no more production of semen. Being forewarned, therefore, preparing yourself for the steps you will face is very important.
Does robot protection prevent impotence?
Radical prostatectomy can be performed with traditional, laparoscopic or robot cutting. So far, no comparative study of good quality has shown that one technique is superior to another. That is, no one can claim, based on robust scientific evidence, that operating with the help of the robot reduces the risk of sexual impotence and even urinary incontinence.
The parameters that make the difference in knowing the risk of being impotent because of the surgery are of two types: related to the cardiovascular health of the individual and relative to the surgery itself. In the first group we highlight: age, presence of comorbidities such as diabetes , hypertension , obesity and smoking , previous existence of active sexual life and most important, the situation of erection before surgery. In other words, anyone who already has some degree of erectile dysfunction before surgery has a greater chance of worsening with surgery to treat prostate cancer.
In the other group of factors they count the experience of the surgeon, the location of the tumor and the individual anatomy of each patient. These are factors that influence the possibility of preserving or damaging the so-called erecting nerves, which pass close to the gland and in some cases may be injured during surgery. When nerve damage occurs on both sides, sexual impotence is certain and recovery more complex. In bilateral nerve preservation, sexual dysfunction is usually transient and on average, after the first year the erectile function is recovered. The surgeon always tries to preserve these structures, but in some cases, to remove any tissue affected by cancer he needs to sever the nerve.
My doctor said I'm cured of cancer, but I'm completely powerless. And now?
Early sexual rehab is the answer. It means going back gradually to stimulate the penis in order to preserve the quality of the erectile tissue and increase the chance of regaining its erectile capacity. Return to wiggle the penis, stretch it in the bath and masturbate. These simple manipulations of the genitalia should be stimulated.
Of course, to return to practicing sexual intercourse requires a longer time, it is fundamental to contemplate the psychological part as well. But the concern here in stimulating early is to preserve the structure of the penis. The studies also show that if nothing is done after radical prostatectomy, sexual inactivity and the absence of physiological erections cause penile atrophy. It shortens and becomes more fibrous.
But why are erections so important? I'm not even thinking about sex!
Studies of patients undergoing prostate cancer treatment through surgery have shown that recovery of the ability to stand erect is greater in those who initiate sexual rehab early. And they used strategies that would allow an erection that was rigid enough for penetration. The interior of the penis has special structures that provide the ability to stand erect: the corpora cavernosa. They are like an accordion that stretches and shrinks. Without periodic erections, the sanfones atrophy and lose the ability to stretch and shrink. Hence the importance of periodic erections, even before there is a will to have intercourse. If the doctor is waiting for the return of the sexual appetite to begin rehabilitation, precious time has been lost. The results in terms of sexual satisfaction in the future will be worse.
Besides rehabilitation, are there other treatments?
Rehabilitation focuses on getting erections to preserve the quality of the erectile tissue while the rest (integrity of the erected nerves, libido, joy, disposition among other aspects) is recovering over time. We can not neglect the psychological impact of cancer diagnosis and surgery itself.
In rehabilitation we often use the combination of oral medication, injectable medication and penile pump. Depending on the clinical response and individual adaptation, the doctor will manage different treatment modalities to achieve the ultimate goal of regaining full sex life. Combination therapy may include injection and use of the penile pump, oral medication together with injectable medication and others. Here the experience of each professional is worth a lot and the multidisciplinary teamwork must certainly include the accompaniment of a trained psychologist.
I tried everything and I still can not have sex. And now?
When all other alternatives have proved ineffective or the patient does not get a good adaptation, we can talk about penile (prosthesis) implants. But it is always important to emphasize that the implant of the penile prosthesis will not return physiological erections and will not produce an increase in the size of the penis. The prosthesis will replace that erectile tissue, the accordion, with a synthetic material.
I conclude by recalling that the adoption of healthy living habits is the basis of everything. As stated, penile erection depends on good blood circulation and effective communication between the brain and the penis and health care in a broader way is paramount. Understanding that sexual activity is not limited to erection is a fundamental part of rehabilitation and experiencing the exchange of pleasure using the whole body and all feelings facilitate rehabilitation after the impact of having received the diagnosis of a disease that frightens. Moreover, dating and nurturing the relationship has always meant a decisive step to the success of any rehabilitation protocol, as well as having the help and support of the partner or partner makes a lot of difference. So the final message is: there is always a viable alternative to resuming full sexual life when that is man's will!
Source:
Dr. Valter Javaroni
http://minhavida.com.br/
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