prostate cancer
Research
Source: European Urology
Self-healing? Improvements in erectile and urinary function after prostatectomy
In a nutshell
This study looked at the possibility of long-term improvements in urinary function or erectile function after prostate gland removal (radical prostatectomy).
Some background
Radical prostatectomy (RP) is the most common treatment for prostate cancer, but this treatment can cause urinary and erectile problems. A common assumption has been that if urinary function or erectile function was not regained within 12 months of RP, then the chance of recovery was very low. However, it is not clear from previous research whether or not this assumption is true.
Methods & findings
The current study examined whether erectile and urinary function improved in the long-term following RP.
The study involved 800 patients who reported urinary dysfunction 12 months following RP, and 1003 patients who reported erectile dysfunction. Each patient completed a standardized survey around 12 months after the RP, and then again around 24 months, 36 months and 48 months. The patients rated their urinary function or erectile function each time using a scoring method designed to measure quality of life.
Among patients who were incontinent (unable to control urination) at 12 months, the likelihood of achieving good urinary function at 24 months was 30%, 49% at 36 months, and 59% at 48 months. Among patients experiencing erectile problems at 12 months, the likelihood of achieving good erectile function at 24 months was 22%, 32% at 36 months, and 40% at 48 months.
The probability of recovery for both urinary function and erectile function was significantly influenced by the level of functionality at 12 months after RP.
The bottom line
This study concluded that long-term recovery from urinary or erectile dysfunction after RP is possible. This study also suggested that recovery is influenced by the patient’s urinary or erectile capability at 12 months after RP.
The fine print
This study focused on subjects from one institution only. The standard of follow-up care in institutions is likely to differ and affect outcomes.
What's next?
If you are experiencing urinary or erectile problems following RP, you should discuss this with your doctor to help make decisions on the best rehabilitation care for you.
Disclaimer:
This information should not be relied upon as a substitute for personal medical advice, diagnosis or treatment. Use the information provided by Medivizor solely at your own risk. Medivizor makes no warranties or representations as to the accuracy of information provided herein. If you have any concerns about your health, please consult a physician.
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I post this to pass my experience along and encourage those that have undergone complete removal or destruction of their prostate to not give up. As soon as the procedure has healed start experimenting. A vacuum device and a desire to succeed worked miracles for me. Some things are better than ever!
Before the procedure, I asked my doctor what it would do to my sex life, he replied that if it was him, he would have the procedure and live to be to be 80 and think about sex. I have proven him waayyye wrong of both accounts. Hang in there, you life is not over. Reply
Interesting and encouraging facts from the study .
The experience of erectile dysfunction and or continence certainly does vary enormously from patient to patient.
Are there other factors that affect a mans chance of regaining an erection and regaining continence?
Do men having robotic surgery do better than those that have open surgery?
Does the experience (number of prostatectomies carried out) of the surgeon play a part?
I have heard of the S.M.A.R.T robotic technique does it produce better results?
Is the S.M.A.R.T technique available to all surgeons?
The good news is that almost all of the men having a prostatectomy will have been 'cured' of prostate cancer, a small percentage of men will have a prostate cancer recurrence. Reply
Hi Redsock,
SMART refers to a specific robot-assisted prostatectomy technique developed and used by a specific physician in the United States.
Generally speaking, several studies have demonstrated improved outcomes with regards to urinary continence and erectile function with the use of robot-assisted laparoscopy compared to open retropubic surgery. However, there is a steep learning curve to all laparoscopic techniques, and to robotic-assisted prostate surgery in particular. Several studies have demonstrated significantly longer surgical times and an increased risk for surgical complications with robot-assisted prostatectomies, especially within inexperienced centers. Reply
It relates to my condition after surgery. As of today I am cancer free since my robotic surgery on Feb 2013. I have good control of my urinary function but still having difficulty with erections. I use meds and a vacuum device prescribed by my urologist to help with regaining erections. My doctor said it may return to normal ,but the amount trauma done to the nerves during surgery is what will effect the time required for a return to regular erections. Reply