Ask the experts… life after prostate surgery
Even though just under half of the population have prostates, many men feel uncomfortable opening up about how problems with the gland can affect their lives. Because of the prostate’s delicate position in the body, prostate surgery can lead to difficulties including erectile dysfunction or urinary incontinence. These issues can affect a person’s relationship, quality of life and mindset.
Last month, the Urology Foundation offered our community the chance to ask questions about what to expect from life post prostate surgery. We were joined by two experts, consultant urologist Arun Sahai and Lorraine Grover, a psychosexual nurse specialist. Both believe that men should be given support to live a normal life, rather than just living with the effects of prostate surgery.
If you missed the clinic, don’t worry! Here’s a round-up of the best advice:
How long do you leak urine after having prostate surgery? How can I manage it?
AS: After a radical prostatectomy, many people experience leaking when coughing, laughing, sneezing, walking, moving or bending. We usually expect people to recover from this over a 12-18 month period if they are doing pelvic floor exercises regularly. If he is still bothered by incontinence after this time, people should seek expert advice and try to understand the root cause of the problem.
LG: Communication is important as it makes the team caring for a patient aware of the impacts that incontinence has on them and their partner. It may be helpful to speak to a Continence Nurse Specialist or Pelvic Floor Physiotherapist as they can provide assessment, support and a management plan. Once this is implemented, it’s very useful to make sure the strategies are being carried out properly. Sometimes a slight tweak can make all the difference!
My partner’s mental health has rapidly declined after his prostate cancer diagnosis and surgery, what can I do to help?
LG: Following a cancer diagnosis many people experience a variety of emotions that ebb and flow. Initially, things can feel quite structured because it’s easier to get help for ‘physical’ problems. Clinical psychologists are important for cancer care as they provide a confidential and safe environment for patients and their families to talk about their emotions and help with coping strategies. Remind your partner that many men experience psychological challenges and talking about them is paramount. His GP, urologist or clinical nurse specialist will be able to direct him to the right person.
I am experiencing ED for the first time after having surgery. Shall I speak to my consultant or just take Viagra?
LG: You should definitely speak to your consultant or clinical nurse. They will know your medical history and know whether there is a reason that you might not be able to take Viagra (also known as sildenafil).
Generally, if you have had a radical prostatectomy, it’s advised to start taking daily 5mg tadalafil (Cialis) early after surgery and under medical supervision. If this is not effective an additional 20 mg tadalafil can be added before sexual activity.
Self-pleasure is as important as intercourse and medications for sexual stimulation can be used for this too. If tablets are not effective, you could try Vitaros cream, MUSE pellets and injections such as Viridal Duo, Caverject Dual Chamber and Invicorp. As prostate cancer is on the list of illnesses that allow men to get these treatments on the NHS your GP might able to prescribe them. Remember, combining drug treatments with sex therapy is the best thing to do. This will increase your confidence and help you adjust to change.
I had surgery six months ago and I am finding it hard to exercise due to tiredness, what can I do?
LG: Recovery from surgery and general anaesthetic can take time, so go slow and build up. It's great you are making the effort to exercise, small steps to your recovery is better than nothing at all!
There is lots of evidence that exercise and a good diet are beneficial for cancer care. To find out more, read 'Powering Prostate Cancer Recovery Through Exercise' on the Urology Foundation website. Also, Prostate Cancer UK have a fact sheet called 'Diet and physical activity for men with prostate cancer' and a free Fatigue support helpline where you can talk to a specialist nurse trained in fatigue management.
Are there alternative treatments to Viagra that produce fewer side effects?
LG: Yes there are three other tablets. Tadalafil (Cialis), vardenafil (Levitra) and avanafil (Spedra). All of their side effects vary between individuals. Higher doses of tadalafil can be taken 'on demand', 30-60 minutes before sexual activity, or you can take a 2.5 or 5 mg daily dose. The daily dose should be taken at the same time every day as it takes five days to reach a steady level in your bloodstream. Having this daily dose can help with spontaneity as you don't need to worry about the best time to take it before sexual activity.
If you, or someone you know, is living with problems caused by prostate surgery, we have loads of advice on our talkmenshealth hub!
Information contained in this Articles page has been written by talkhealth based on available medical evidence. The content however should never be considered a substitute for medical advice. You should always seek medical advice before changing your treatment routine. talkhealth does not endorse any specific products, brands or treatments.
Information written by the talkhealth team
Last revised: 14 July 2021
Next review: 14 July 2024
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