No ejaculation after removal of prostate adenoma

Impotence after prostate adenoma

Prostate adenoma, or, in medical terms, benign prostatic hyperplasia (abbreviated as BPH), occurs in 50% of men over 50 years old, and after 70 years, the figure reaches 75%. Often, surgery is indicated for the disease. Most men are concerned about the question of whether impotence occurs after prostate adenoma, cured surgically. The types of surgical treatment, its possible consequences, as well as the prerequisites for the development of the disease will be discussed in the article.

What is the operation to remove prostate adenoma

If drug therapy does not help, you have to do an operation to remove the tumor, as it interferes with the outflow of urine.

The most benign and safe methods of dealing with BPH are laser removal and TUR - transurethral resection of prostatic hyperplasia.

Laser surgery is a surgical manipulation when a doctor removes an overgrown tumor with a laser beam through the urethra. After treatment, the quality of life of the operated man changes for the better. He has cramps during urination, nervous tension disappears, sexual life normalizes. However, there are also complications. The most common of them are damage to closely spaced vessels and organs, as well as infection of the urethra due to wearing a postoperative catheter: the urine remaining in it is a breeding ground for bacteria.

Retrograde ejaculation, that is, the ejection of sperm not outward, but into the bladder, is another consequence of prostate surgery. This happens because the muscle that separates the urethra and bladder is removed to access the gland. It is difficult for a man to get used to the absence of visible ejaculation, but the release of semen into the bladder does not pose a danger to the health or quality of sex.

Transurethral resection (TUR) is another way to remove Prostate adenoma. A cystoscope is inserted into the ureter - a lighting device to monitor the progress of the operation. Affected gland tissues are removed with a special cutting device.

Complications after TUR - burning sensation in the urethra when going to the toilet, leakage of urine during sudden movements and the appearance of blood in it. Normally, these phenomena disappear 10 days after the operation, and if not, you need to see a doctor. As with laser removal of hyperplasia, there is a high probability of Retrograde ejaculation.

Impotence after prostate adenoma: medical data

In India, a medical study was conducted, the purpose of which was to find out how high the risk of developing impotence after removal of BPH. The trials were conducted on 109 TUR patients, 54 of whom were in a stable sexual relationship. Among these 54 men, 10 noted a significant increase in sexual function, in 26 men nothing changed in their sexual life, in 4 of these 26 ejaculation did not change. The remaining 18 complained about the loss of libido and erection problems that appeared after the operation.

Doctors say that most often after the rehabilitation period, men notice positive changes in their sexual life. This is due to the improvement of well-being and healing of the prostate. However, if a medical error is made, erectile dysfunction may develop, and this danger also threatens men with diseases of the cardiovascular system or a history of sexual weakness.

After a radical prostatectomy, problems with potency are more common than as a result of the sparing operations described, since there is a high risk of damaging the nerves lying next to the gland that respond to an erection. Today, doctors are less and less likely to prescribe a complete removal of the prostate, replacing it with resection of only the damaged part of this organ.

To protect yourself from impotence, it is recommended to take tests for sex hormones: prolactin, estradiol, dihydrotestosterone, testosterone and PSA, and get advice from an endocrinologist. If erection and libido are greatly reduced, it is useful to use special medications and devices. One of the most effective medical devices for potency is a vibration stimulator: the device restores nerve conduction, which is important after radical prostatectomy.

A healthy lifestyle will also help stabilize an erection: proper nutrition with enough protein and fiber, feasible physical activity. Faster recovery will allow dietary supplements with ginseng or other stimulants designed specifically for men.

Modern surgeries preserve sexual function, but much also depends on the person being operated on. Compliance with the doctor's recommendations, supportive therapy (dietary supplements, vibration stimulation), a positive relationship with a partner will make it possible to avoid impotence after prostate adenoma.

Indications for removal of the prostate

Removal of the prostate is performed in cases where conservative therapy is powerless.In most cases, this is an oncological process. Sometimes a prostatectomy is performed for benign prostatic hyperplasia. An increase in the organ due to inflammation is not a reason for surgery. The following indications for removal of the prostate are distinguished:

Cancer is considered the main indication for organ removal. Prostatectomy is performed only at stages 1 and 2 of the disease. In these cases, the oncological process is limited to prostate tissue. If the prostate is not removed in a timely manner, the cancer can spread throughout the body. The operation is performed on men under 70 years of age, since somatic pathologies are contraindications to its implementation.

Prostate adenoma leads to an increase in the organ. As a result of this disease, sexual weakness and impaired urination are noted. With the progression of benign hyperplasia and the lack of effectiveness of therapeutic methods of treatment, a prostatectomy is performed.

Methods of surgical intervention

There are several ways to remove the prostate. The choice of method depends on the prevalence of pathology. Removal of an organ can be complete or partial. Surgical options include:

Currently, less traumatic surgical procedures are preferred. These include laser removal of adenoma, transurethral resection. However, it is not possible in some cases to replace an open operation with other methods.

Removal of prostate adenoma: consequences of surgical treatment

Removal of the prostate gland is a radical treatment that comes with a number of health risks. These include complications of the early and late postoperative period. Among them - a violation of the process of urination and ejaculation. After removing prostate adenoma with a laser and transurethral resection, the risk of these complications is reduced compared to open surgery.

This operation is stressful for the whole organism. Therefore, after it, there are violations of the functioning of the genitourinary system. Normally, they gradually disappear. In 2-10% of cases, violations remain. The negative consequences of prostatectomy include:

To prevent these complications from developing, the patient's condition is monitored in the first days after prostate removal. When discharged, you should follow the recommendations of the urologist. This will help reduce the risk of late complications.

Early postoperative period

During the first days after prostatectomy, the patient's condition is severe. This is due to blood loss and changes in the functioning of the urinary organs. At this time, there is a risk of developing the following complications:

Diagnosis of early complications is carried out by medical staff in a hospital. In case of acute conditions, the help of a surgeon is required.

Recovery period after prostatectomy

The early postoperative period is several days (5-7 days). During this time, the patient's condition is normalized, there is an independent urination. However, full recovery after removal of prostate cancer or adenoma may occur only after a few months. It depends on the age of the patient, the characteristics of his body and the technique of the operation. To speed up rehabilitation and reduce the risk of late complications, the following guidelines must be observed:

After a prostatectomy, heavy objects weighing more than 3 kg should not be lifted. It is also not recommended to engage in sedentary work and drive a car. Nutrition should be fractional, with a predominance of easily digestible carbohydrates and proteins.

Restoration of urination after prostatectomy

Removal of the prostate often leads to a violation of the process of urination. In the first days after surgery, a catheter is inserted into the urethra. It is necessary for the evacuation of fluid from the bladder. The catheter is removed after a few days or weeks. Due to the weakness of the pelvic floor muscles, urination is difficult to control. But gradually the process is getting better. To speed up rehabilitation, you need to do gymnastics, spa treatment is useful.

Intimate life after prostate surgery

After 3 months after prostatectomy, the patient can start sexual activity. By this time, the pelvic muscles should recover. In some cases, patients experience retrograde ejaculation. Seminal fluid is released, but it enters the lumen of the bladder. This phenomenon is not dangerous, but it prevents conception. To get rid of this symptom, vibromassage and vacuum erectors are used. With erectile dysfunction, drugs containing sildenafil are prescribed. These include medicines "Cialis", "Viagra".

Is it possible to have a sexual life after an operation to remove prostate adenoma?

Is it possible to have sex after surgery to remove prostate adenoma is a natural question for operated patients. It must be asked to the doctor before and after the procedure, because the answer depends on its results. It is authentically known: if before the operation the sexual life (erection and ejaculation) was disturbed, recovery will not occur. The probability of complications after hyperplasia is from 1 to 10%.

Transurethral resection (TUR)

Transurethral resection - excision, scraping of damaged tissues using a resectoscope, which is inserted through the urethra into the bladder to the tumor.

After TUR, sexual activity can begin only after a month. At the same time, the rehabilitation period often takes 6-12 months, the timing depends on the patient's immunity.

The likelihood of erectile dysfunction after the intervention is minimal. But infertility may occur due to the fact that during the operation the lumen of the urethra and bladder neck expands. Sometimes after this ejaculation does not occur - the sperm enters the bladder, then is removed with urine.

The side effect is called retrograde ejaculation or "dry orgasm", but can be treated with medication. With ineffective treatment, artificial insemination with one's own sperm is possible by extracting spermatozoa by puncture or from the bladder.

Open prostatectomy

It is carried out extremely rarely, because. considered the most traumatic procedure. Excision of hyperplasia occurs through an incision in the lower abdomen or perineum - between the scrotum and anus. After prostatectomy, various complications are possible, both general and specific:

• heart attack, cerebrovascular accident;
• pulmonary embolism, thrombosis;
• the patient may have an orgasm, but very little or no sperm;
• partial or complete loss of erectile function is typical for some men;
• reverse reflux of sperm into the seminal vesicles.

With a favorable course of the rehabilitation period, sex is possible after 4-6 weeks.

Laser removal of hyperplasia

The main methods of laser surgery:

Laser resection is performed with a Holmin laser. Recommended for large neoplasms. Main steps of the procedure:

• Cut.
• Reducing the volume of the gland.
• Restoration of urination functions.
• Removal of pieces of tissue from the body.

The main advantages of the method are minimal trauma due to the absence of tissue incisions, and quick recovery after regional anesthesia.

Rehabilitation

Regardless of the chosen method, in the postoperative period it is necessary to follow the recommendations of the doctor:

• Exclusion of physical and sports activities.
• Following the diet prescribed by the doctor.
• Refusal to have sex in the first 1-1.5 months after treatment.
• Light exercise in the morning to restore normal urination.

Strict adherence to the rules will speed up the rehabilitation period and the resumption of sexual life.