Erectile Dysfunction and the Prostate

ERECTILE DYSFUNCTION AND THE PROSTATE

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ERECTILE DYSFUNCTION AND THE PROSTATE

"It seems that most of the men I know are having problems with their prostate. A few even have cancer and the rest are worried about what's in store for them. What's going on?"

It's true that prostate problems are very common after age 50. And the older men get, the more likely they are to have such problems. Most prostate problems are not cancer. Still, prostate cancer does affect a lot of men.

ERECTILE DYSFUNCTION AND THE PROSTATE : WHAT IS THE PROSTATE?

The prostate is a gland. It makes fluid that becomes part of semen, the white fluid that contains sperm. The prostate lies low in the body - in front of the rectum and below the bladder (where urine is stored). It surrounds the tube that carries urine away from the bladder (urethra).

When you're a young man, your prostate is about the size of a walnut. It slowly grows as you get older. If the prostate gets too large, it can cause urinary problems. Infection or cancer in the prostate can also cause urinary and other problems. Often, men notice symptoms themselves, and sometimes their doctor finds something during a routine checkup.

There are several different kinds of prostate problems. Only a doctor can tell one from another. That's why you need to see your doctor if something doesn't seem right to you.

ERECTILE DYSFUNCTION AND THE PROSTATE : WHAT ARE PROSTATE PROBLEMS?

For men under 50, the most common prostate problem is prostatis.

For men over 50, the most common prostate problem is prostate enlargement. This condition is also called benign prostatic hyperplasia or BPH. Older men are at risk for prostate cancer as well, but this disease is much less common than BPH.

ACUTE PROSTATIS is an infection of the prostate caused by bacteria. It usually starts all of a sudden. It can cause fever, chills, or pain in the lower back and between the legs. It can cause pain when you urinate. If you have these symptoms see your doctor. Antibiotic drugs can kill the bacteria and help you feel better.

CHRONIC PROSTATIS is an infection of the prostate that keeps coming back time after time. This problem can be hard to treat. Sometimes, taking antibiotics for a long time may work. Talk with your doctor about other things you can do to feel better.

ERECTILE DYSFUNCTION AND THE PROSTATE : WHAT IS PROSTATE ENLARGEMENT, OR BPH?

If you're a man over 50 and have started having problems urinating, the reason could be an enlarged prostate, or BPH. As men get older, their prostate keeps growing. As it grows, it squeezes the urethra.

Since urine travels from the bladder through the urethra, the pressure from the enlarged prostate may affect bladder control.

If you have BPH, you may have one or more of these problems:

* A frequent and urgent need to urinate. You may get up several times a night to go to the bathroom.

* Trouble starting a urine stream. Even though you feel you have to rush to get to the bathroom, you find it hard to start urinating.

* A weak stream of urine.

* A small amount of urine each time you go.

* The feeling that you still have to go, even when you have just finished urinating.

* Leaking or dribbling.

* Small amounts of blood in your urine.

You may barely notice that you have one or two of these symptoms, or you may feel as though urination problems have taken over your life.

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ERECTILE DYSFUNCTION AND THE PROSTATE :IS BPH A SIGN OF CANCER?

No. It's true that some men with prostate cancer also have BPH, but that doesn't mean the two conditions are always linked. Most men with BPH don't develop prostate cancer.

However, because the early symptoms are the same for both conditions, you should see a doctor to evaluate these symptoms.

ERECTILE DYSFUNCTION AND THE PROSTATE :IS BPH A SERIOUS DISEASE?

By itself, BPH is not a serious condition, unless the symptoms are so bothersome that you can't enjoy life. But BPH can lead to serious problems. One problem is urinary tract infections.

If you can't urinate at all, you should get medical help right away. Sometimes this happens suddenly to men after they take an over the counter cold or allergy medicine.

In rare cases, BPH and its constant urination problems can lead to kidney damage.

ERECTILE DYSFUNCTION AND THE PROSTATE :TREATMENTS FOR BPH

Treatments for BPH include:

* Watchful waiting. If your symptoms are not too bad, your doctor may suggest that you wait before starting any treatment. You will need regular checkups. Treatment can start later on if your symptoms get worse.

* Alpha-Blockers. These medicines can ease your symptoms. Side effects may include headaches, dizziness, or feeling lightheaded or tired.

* Finasteride (Proscar) This medicine lowers the amount of male hormone (testosterone) in the body. The result is that the prostate shrinks and urinary problems get better. Side effects can include less interest in sex and problems with erection or ejaculation.

* Surgery. An operation can improve the flow of urine but it can also cause other problems. Usually, men have surgery only if medicine hasn't worked. Surgery does not protect against prostate cancer. Regular checkups are important after BPH surgery. Talk with your doctor about this treatment choice.

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There are three kinds of surgery. All are done with anesthesia:

* Transurethral resection of the prostate (TURP) is the most common type of surgery. The doctor takes out a part of the prostate through the urethra.

* Transurethral incision of the prostate (TUIP) may be used when the prostate is not too large. The doctor makes a few small cuts in the prostate near the opening of the bladder.

* Open surgery is used only when the prostate is very large. The doctor removes the prostate through a cut in the belly or behind the scrotum.

* Other treatments. Other ways to relieve the symptoms of BPH use radiowaves, microwaves, or electrical current.

ERECTILE DYSFUNCTION AND THE PROSTATE : SEXUAL FUNCTION AFTER SURGERY

Many men worry about whether surgery for BPH will affect their ability to enjoy sex. Some sources state that sexual function is rarely affected, while others claim that it can cause problems in up to 30 percent of all cases.

However, most doctors say that even though it takes a while for sexual function to return fully, with time, most men are able to enjoy sex again.

Complete recovery of erectile dysfunction and the prostate may take up to one year, lagging behind a person's general recovery. The exact length of time depends on how long after the syptoms appeared that BPH surgery was done and on the type of surgery.

Following is a summary of how surgery is likely to affect the following aspects of sexual function.

ERECTILE DYSFUNCTION AND THE PROSTATE : ERECTIONS

Most doctors agree that if you were potent (able to maintain an erection) shortly before surgery, you will probably be able to have erections afterward. Surgery rarely causes a loss of potency. However, surgery cannot usually restore potency that was lost before the operation.

ERECTILE DYSFUNCTION AND THE PROSTATE : EJACULATION

Although most men are able to continue having erections after surgery, a prostatectomy frequently makes them sterile (unable to father children) by causing a condition called "retrograde ejaculation" or "dry climax."

During sexual activity, sperm from the testes enters the urethra near the opening of the bladder. Normally, a muscle blocks off the entrance to the bladder, and the semen is expelled through the penis. However, the coring action of prostate surgery cuts this muscle as it widens the neck of the bladder.

Following surgery, the semen takes the path of least resistence and enters the wider opening to the bladder rather than being expelled through the penis. Later it is harmlessly flushed out with urine.

A doctor who specializes in fertility problems may be able to help if this backwards ejaculation causes a problem for a couple trying to get pregnant.

ERECTILE DYSFUNCTION AND THE PROSTATE : ORGASM

Most men find little or no difference in the sensation of orgasm, or sexual climax, before or after surgery. Although it may take some time to get used to retrograde ejaculation, you should eventually find sex as pleasurable after surgery as before.

Many people with health issues regarding erectile dysfunction and the prostate have found that concerns about sexual function can interfere with sex as much as the operation itself. Understanding the surgical procedure and talking over any worries with the doctor before surgery often help men regain sexual function earlier. Many men also find it helpful to talk to a counselor during the adjustment period after surgery.

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