i am going to discuss erectile dysfunctioncommonly known as impotence following prostate cancer treatments and as well as treatmentoptions available to patients. impotence is a common side effect of manyprostate cancer treatments. treatments for impotence include a wide variety from minimallyinvasive standpoint which usually starts our course with medical therapies which includeoral therapies or medications, and range from
penile pump, injection therapies, intraurethral suppositoriesand also include penile pumps as well as the last option would be a penile prosthesis andi will discuss each of these in particular detail. particularly starting with oral phosphodiesteraseinhibitors which the three most common medications include viagra, levitra and cialis have beencommonly used and many men are quite familiar
with utilizing these agents for treatmentof erectile dysfunction unrelated to prostate cancer treatments. quite often, many patientsdo come to my office requesting some form of what has been talked about as penile rehabilitationtherapy and what that entails is essentially restarting the engines, if you will in regardsfor erections itself. this includes the combination of these medications, the oral phosphodiesteraseinhibitors or what is also, if the impotence does not improve include moving on to thenext stage of treatments which do include injection therapy. this is the intracavernosalinjection therapy and needle is injected into the base of the penis itself to essentiallystimulate an erection itself. if this in fact, those two combination treatments do not tendto work in regards for the patient having
successful erection for intercourse, the otheroption is the intraurethral suppository or alprostadil, it is a pellet that is insertedinto the urethra itself to cause an erection. both the injections as well as the intraurethralsuppository, however, should be done at the discretion of the patient's urologist in theoffice due to the side effects that may be present with these which include a decreasedblood pressure in addition meticulous review of the medical history and medications todeem that any of these therapies are safe. the next option pending upon the patient'spreference and response to the prior treatments would include a penile pump which can includea device that is inserted on to the penis itself to bring in blood flow and a ring isinserted at the base of the penis.
the last option would include penile prosthesiswhich come in a variety of components which include both malleable which essentially thepatient moves the penis up and down him or herself and in addition would include a penilepump which has a three piece component or a two piece component. depending upon thepatient's preference and the counselling, this will be the last more definitive optionregards for treatment for impotence itself. there is a greater than 90% success rate withthe surgery itself, but i think the most important factor is to have the patient talk with theirurologist in regards to the most appropriate treatment for their impotence. some prostate cancers are high risk, aggressive,and more likely to spread. others are low
risk, least likely to have bad outcomes. thebiopsy says cancer, but current diagnostic tools provide limited information about howaggressive a man's individual disease is, so most men decide to treat prostate cancerimmediately. once treated, many men experience serious long-term side effects like incontinenceand sexual impotence. immediate treatment is not always needed, but right now a mancan't be sure if his cancer is the kind that is likely to require treatment or if he isokay to wait for now. what if there was a test that could determine how aggressive prostatecancer is. genomic health is developing a new test to do just that. by reviewing theunderlying biology of the tumor and using genes from multiple biologic pathways, thetest can predict the aggressiveness of prostate
cancer when diagnosed, allowing a man to makea more informed treatment decision with confidence, taking care of himself with more informationand greater peace of mind.