Men's Health Friday April 22, 2016

Erectile Dysfunction Resulting From Prostate Surgery

For men who are told they have prostate cancer, their immediate reaction may well be to ask about surgical options. We are accustomed to most forms of cancer - breast, testicular or lung for example - being treated in part through physical removal of the tumour where possible. It's true that, in the case of prostate cancer, surgery is often possible as even the entire prostate can be removed without a serious risk to life.

Potentially Serious Side Effects

However, prostate surgery (prostatectomy) can have side effects that may adversely affect quality of life. These include urinary incontinence, infertility and erectile dysfunction. It is for this reason that doctors often advise other treatments instead of surgery for prostate cancer. These can include hormone treatments, chemotherapy, radiotherapy and steroids, all of which can prevent the cancer spreading or even kill the cancerous cells. If the cancer is not yet causing any symptoms, a doctor may even advise a period of 'watchful waiting' to see how quickly it develops before taking any action. In fact, many who opt for watchful waiting never need any treatment for prostate cancer.

Is Treatment Always Necessary?

This type of cancer is most common among older men, and can be very slow to develop. This means that men with prostate cancer may actually die from other natural causes before the cancer has developed to a late stage. Looking at the numbers of men who survive for many years after diagnosis, the outlook is fairly positive. More than 80 out of every 100 men will survive for ten years or more after being diagnosed with prostate cancer. This discounts any men who die of other causes, but it does show that a diagnosis of this kind is not a death sentence.

How Much Do Prostate Cancer Patients Know?

A new study carried out in the US looked at the understanding prostate cancer patients have regarding the side effects of surgery. The men involved in the study had come into a clinic because they were experiencing sexual dysfunction following a prostatectomy due to cancer. Researchers asked the men about the information they had received before the surgery regarding the effect of the procedure on their sexual function and found that they had 'largely unrealistic expectations' about how the surgery would affect their ability to achieve erections and other physical ramifications.

The men, whose average age was 64, had nearly all been able to have sex before the procedure. Just 38% knew whether they'd had the type of surgery that attempts to preserve sexual function, and only 10% of them realised that their penis length might decrease following the procedure. Very few recalled being told that they might experience changes or pain during orgasms.

The researchers didn't record what patients were advised on before the procedure, however, so it is possible that some of the men had been told and forgotten this information.

Can sexual function be restored?

Multiple sources have stated that sexual should be restored in the months following prostate surgery and that erectile dysfunction shouldn't be a permanent side effect. The NYU Langone Medical Center has claimed that it can take most men up to a year after prostate surgery before they can experience an erection. The timetable for this normally states that sexual function will be restored between three and twelve months after prostate surgery. In rare cases some men may see no improvement up to two years after surgery. However, this doesn't mean restoration isn't possible.

"Most men will continue to see erectile-potency improvements up to two years after surgery, so we would expect to see even better outcomes by then" Dr. Jim Hu, director of minimally invasive surgery in the department of urology at the David Geffen School of Medicine at UCLA

Certain studies have found that sexual function will continue to improve over time post-surgery. A study in the Journal of Urology has found 60% of men were able to successfully perform sex up to two years after prostate surgery. This was the case without any of the men needing to take ED medications during this time.

Treatment Options

The results concerning the effects of prostate surgery on sexual function don't mean to say all men with prostate cancer should avoid surgery, as this can be a good option. But it does suggest that patients should not rush into any decision regarding treatment.

In some cases, depending on how much damage occurs to the nerves during the procedure, erectile dysfunction as a result of prostate surgery can be treated with oral prescription medications such as Viagra or Cialis. To find out more about how these treatments work, and whether they are right for you, visit our ED treatment information page.

On top of being able to effectively treat erectile dysfunction caused by prostate surgery, there is strong evidence to suggest that Viagra can be used as a part of the treatment process when treating prostate cancer itself!

The drug Doxorubicin has been used for years as an anti-cancer drug for prostate cancer among other forms of the disease. Although Doxorubicin is effective, it has been associated with irreversible heart damage, which generally occurs several years after treatment stops. Researchers have worked hard to find a medication that protects the heart without limiting the effect of the chemotherapy. Now it seems that the erectile dysfunction treatment Viagra may be the answer.

Experts at Virginia Commonwealth University School of Medicine gave Viagra to test rats while simultaneously treating them with Doxorubicin. Not only did the combination of the two drugs reduce tumour size, but it also alleviated damage to the heart.

Lead investigator Dr Rakesh C. Kukreja said: "We believe sildenafil could be an excellent candidate for incorporation into cancer treatment protocols with the potential of enhancing the anti-tumour efficacy, while protecting the heart against both short-term and long-term damage."

The research team are now hoping to proceed to the next stage of the trial - testing the combination of drugs on cancer patients. Their findings so far are published in the latest edition of the journal Proceedings of the National Academy of Sciences.

A versatile drug

Viagra is a versatile drug. It was originally designed to treat arthrosclerosis, but showed the unexpected side effect of causing erections during tests. Following this it was designed as, and has since been used as, a drug to treat erectile dysfunction. But many more uses have been found for Viagra. Viagra has been used to treat patients with heart and lung problems, by opening up blood vessels. Viagra has also been used to help with pregnancy and newborn children. With relatively few side effects Viagra has been hailed as a highly effective impotence drug that can also help with many other conditions.

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