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Sex After Prostate Cancer: Two Men's Questions

Our experienced medical journalist Jeanie Lerche Davis took your questions about sexual issues to specialists. Here's what she found out.
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Prostate Problems & Sex

Our experienced medical journalist Jeanie Lerche Davis took your questions about prostate problems and sexual issues to specialists. Here's what she found out.

Question:

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When, if ever, is something going to be done for the unfortunates like me who suffer from impotence and incontinence after prostate surgery? If I had it to do over, you can bet your life I'd say no. Quality of life is more important than quantity.

Answer:

I agree, quality of life is absolutely important. Every treatment has potential complications, but the number of complications [with prostate surgery] is decreasing. We're seeing fewer and fewer people with these problems.

There are a number of treatments for impotence. There's a vacuum constriction device, injections of the drug alprostodil, an inflatable penile prosthesis -- available treatments that are well accepted and time-tested. There are also a number of drugs in the pipeline, which show promise -- drugs that are longer-acting and quicker-acting than Viagra.

For incontinence, we can do collagen injections; insertion of artificial urinary sphincters is also a possibility. Again, these are time-tested and well accepted treatments. -- J. Brantley Thrasher, MD, chair of urology at the University of Kansas in Kansas City.

Question:

I am a prostate cancer survivor. Based on what I now know, it appears that I did not have the nerve-sparing type of surgery. After 22 months I still don't have complete bladder control and no response to Viagra. Is it possible for those nerves to be regenerated or repaired? My internist has me taking vitamins C and E to help. Are they effective in this area?

Answer:

It's very unlikely that you will have recovery of function after 22 months. Most recoveries happen in the first year. Late regeneration of nerves is possible but remote. And there's no way to do a correction. [See the previous answer for options.] -- J. Brantley Thrasher, MD, chair of urology at the University of Kansas in Kansas City.

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