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How to avoid erection problems after prostate surgery

Kathleen Blanchard's picture
The right surgeon can help men preserve erectile function after prostate surgery

Men who are faced with prostate surgery are also at risk for erectile dysfunction (ED) and urinary incontinence that are common side effects of prostate gland removal for cancer. But new research shows with the right surgeon, ED can be avoided.

Gentle surgeon lowers chances of ED from prostate surgery

A new UCLA study that focused on robotic-assisted prostate surgery suggests men should look for a knowledgeable surgeon who has performed at least 1,000 surgeries.

The reason say the study authors is that a skilled surgeon is more likely to use refined techniques that spare the nerves around the prostate gland; in turn preserving erectile function.

Dr. Jim Hu, director of minimally invasive surgery in the department of urology at the David Geffen School of Medicine at UCLA and lead author of the study explained in a press release: "Like improving a golf swing, a technique for nerve-sparing surgery has many subtleties that are influenced by training, talent, a desire to improve, and meticulous review of technique and outcomes."

The study is the first to look at how the nerves surrounding the prostate glands – if handled gently – can minimize the possibility that men will continue to be able to achieve erections after prostatectomy.

For the study, Dr. Hu asked patients if they had recovered erectile function after prostate surgery, using questionnaires.

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The finding showed when surgeon handle prostate tissue gently and have more experience, erectile function went from zero to up to 33 percent within 5 months; a year after surgery, erectile function recovery went from 15 percent to 59 percent.

Hu reviewed surgery videos also to study the nerve sparing prostatectomy technique.

There were also better outcomes for men who had good erectile function before surgery and younger.

The authors explain that the traditional approach involves peeling nerves away from the prostate much like peeling an orange. With the new approach, there is less displacement of delicate nerves that can become easily damaged, which leads to problems with erection.

One of the goals of the study said Hu is to let surgeons know about the best way to help men preserve erectile function after prostate surgery so they can improve their techniques. Prostate cancer is the second most common non-skin cancer in the U.S., according to background information from the study. The most widely used treatment option is to remove the prostate gland, which can also mean erectile dysfunction and urinary incontinence.

The study, published in the journal European Urology, shows men should seek a surgeon who is skilled in the gentler robotic- assisted technique that spares nerves around the prostate gland. With the right technique and a skilled surgeon, men could expect a lower chance of erectile dysfunction after prostate cancer surgery.

UCLA Health System
May 16, 2012

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