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« Tips for Coping with Prostate Cancer | Main | Prostate Cancer: Fight, Flight or Acceptance? »


Prostate Problems

Physically, each prostate case is different, and how the individual is affected long-term entirely depends on what is removed by whichever procedure. Given that there are two main “tubes” on either side of the prostate that supply the penis with the “wherewithal” to function properly, in most surgeries one or even both tubes may have to be removed depending on the spread of a man's cancer. Nowadays surgeons are very careful to try to save as much as possible- but it’s not always possible. If a man’s cancer is on one side of the prostate, as it usually is, it’s almost a certainty that he will lose one of the two tubes. In such a case, his capability may be affected (although not necessarily), even if prior to the procedure he had no difficulties in achieving full, firm erections etc. If on the other hand he was experiencing difficulties before one tube was removed, it is highly likely that his capabilities will be even further reduced.

I agree that every patient is different, in terms of how prostate cancer can affect them physically as well as emotionally and spiritually. However, there are plenty of common denominators such as the presence of tumors, whether early-stage or more aggressive.
When you refer to "tubes" you mean the two sets of neurovascular (or "nerve") bundles on either side of the prostate. Dr. Patrick Walsh was the first urologist to conduct nerve-sparing surgery in the early 1980's, a couple of years after a German pathologist told him the nerves were not within the prostate itself. You are right that most doctors aim to spare the prostate nerve bundles from being excised unless there's evidence that they too are impacted by a man's prostate cancer. Nerve-sparing makes it possible for most men to continue having erections after surgery, radiation or other prostate cancer treatments, often in conjunction with other erectile medicines or devices.
----Rabbi Ed

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