Prostate is a male reproductory gland located anterior to the rectum and inferior to the bladder surrounding the urethra. It is involved in the secretion of prostate fluid that forms an important constituent of semen. It also works in the propulsion of seminal fluid into the urethra and also blocks the connection between the urethra and the bladder by contracting at the time of ejaculation. The prostatic fluid constitutes about one third of the total seminal fluid containing various enzymes of which PSA (Prostate Specific Antigen) is of specific importance, not only in thinning of the seminal fluid and helping proper motility of the sperm, but also in the testing procedure for prostate related diseases, such as BPH (Benign Prostatic Hyperplasia).
The location of prostate is such that, if the patient experiences BPH then it might lead to urethral compression causing difficulty in urination and leading to LUTS (lower urinary tract symptoms). Unfortunately, BPH is a common problem in adult men and the chances of BPH drastically increases after the age of 60 years. A growth in size of prostate is also a sign of prostatic cancer.
What Happens To A Man When He Has His Prostate Removed?
Prostate removal can have serious implications for men, either on their sexual life or in general. The side-effects that men can face include urinary incontinence, such as urinary leakage, trouble with urination, increased frequency or urge to urinate; erectile dysfunction; loss of fertility; changes in orgasm or dry orgasm; changes in penis size; increased chances of inguinal hernia and lymphedema. If a patient suffers any of the following side-effects, some of them may only be temporary; however, some side-effects may be permanent.
Urinary Incontinence: This is a temporary side-effect of prostate removal that can last up to a year post surgery. It is defined as the inability to control the passage of urine leading to leakage/dribbling while coughing, sneezing, laughing etc. Patients can also experience trouble completely emptying their bladder having weak urinary stream or have increased urge/frequency to urinate. The patients can wear pads for stress incontinence. If the symptoms persist after a year of prostate removal, then surgery is recommended.
Erectile Dysfunction: It is the inability to get or maintain an erection during sexual intercourse. The chances of erectile dysfunction depend on the ability to have erections prior to surgery, age of the patient or nerve damage during prostate removal. Newer surgical approaches help in removing the prostate without resecting the nerves; however, there may be cases where cancer spread necessitates nerve resection. In cases, where nerve is not damaged, erectile dysfunction improves with time. There are various treatment options available for erectile dysfunction including medications, penile injections, pumps and implants.
Dry Orgasm: Prostate removal can lead to changes in orgasm such as dry orgasm due to lack of ejaculation of semen secondary to removal of prostate and seminal vesicles. Patients may also experience change in the intensity of orgasms.
Other Side-Effects: Other side-effects include infertility secondary to resection of vas deferens. Men considering children in future can think about sperm banking to preserve their sperms. Prostate surgery can also lead to decrease in the length of penis secondary to resecting a small portion of urethra during prostatectomy. Inguinal hernia may manifest as a complication of prostate removal. There may also be greater chances of lymphedema if a lot of lymph nodes were removed at the time of prostate surgery; however, this complication is quite rare.
What Necessitates Prostate Removal?
Prostate cancer and sometimes benign prostatic hyperplasia can necessitate the removal of prostate gland. However, the most common cause is prostatic cancer as BPH can nowadays be managed with other treatment options. The prostate gland removal surgery is known as prostatectomy. The risks, benefits and side-effects of prostatectomy should be discussed with the patient, before making the decision to get prostate gland removed.
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