Cancer Survivorship

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Urology issues after prostate cancer

Prostate cancer is the most common non-skin cancer in America, affecting 1 in 9 men today. Nearly 3 million men in the U.S. count themselves as a prostate cancer survivor. Even after recovering from prostate cancer though, there are still multiple side effects that are common to prostate cancer treatment which include bladder leakage and erectile dysfunction.

Prostate Cancer Penis Problems

Prostate cancer affects 1 in 9 men today

Bladder Leakage After Prostate Cancer

After prostate cancer treatment, your bladder may leak anywhere from a few drops of urine to uncontrolled streams. Leakage typically tapers off within several weeks or months with most patients regaining bladder control within a year.

Persistent stress urinary incontinence (SUI) occurs when bladder control is not regained and urine persistently leaks out during activities such as exercise, sneezing, laughing or coughing. Severe SUI may lead to leakage during simple activities such as walking or bending over. Urinary "accidents" can range from a few drops of urine to enough to soak through your clothes.   Approximately 1 in 10 men who have recovered from prostate cancer still deal with persistent SUI.

Management options

For mild bladder leakage after prostate cancer:

  • Absorbent pads
  • Adult diapers
  • Catheter collection device
  • Penile clamp
  • Pelvic floor physical therapy
    • Kegel exercises

For moderate bladder leakage after prostate cancer:

  • Injections or bulking agents
  • Male sling
    • Intended to support the urethra
    • Intended to prevent leaks when coughing, laughing and sneezing
    • Most patients can be continent immediately following the procedure

For persistent bladder leakage after prostate cancer:

  • Artificial urinary sphincter (AUS)
    • 3 components: Urethral cuff, pressure regulating balloon and control pump in the scrotum
    • Mimics function of healthy urinary sphincter
  • Deflate cuff when you need to urinate
  • Automatically re-inflates to close off the urethra, preventing leakage
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Erectile Dysfunction (ED) After Prostate Cancer

For some men, prostate cancer treatment may affect the nerves that control erections taking as much as 2 years or longer for a man to regain sexual function.

Penile rehab following radical prostatectomy surgery may help the nerves responsible for erections recover after surgery. If the ability to have erections doesn’t recover after prostate surgery, there are treatment options to help reestablish a spontaneous, sexual relationship

Treatment options include:

  • Oral medications
    • May be offered before or after prostate cancer treatment
  • Vacuum pumps
    • May be added to increase blood flow to the penis after treatment
  • Penile injections
  • Urethral suppositories
  • Penile implants


How long does it take to achieve bladder control after prostate cancer?

SUI is usually resolved within the year following a prostatectomy, but in some cases SUI can persist past a year without improvement. One study found that at one year following a robotic prostatectomy, approximately 1 in 10 men still have persistent stress urinary incontinence (SUI).

Are penile implants covered by insurance?

Most insurers cover the diagnosis and medically necessary treatment of ED and SUI. Medicare has a national policy for penile implants–although coverage may depend on where you live. Dr. Tausch’s office will work with your insurance carrier to check coverage levels prior to receiving treatment.

Why don’t all men recover erectile function after prostate cancer treatment?

Your ability to have an erection after robot-assisted radical prostatectomy prostate treatment could be affected by pre-existing risk factors, including older age, cardiovascular disease, diabetes, cigarette smoking, physical inactivity and certain medications such as anti-hypertensive drugs or psychotropic medications. One year after prostate cancer treatment, up to 50% of men suffer from erectile dysfunction.

Don't lose hope. Dr. Tausch has helped countless patients regain control of their bladder and erectile issues. Get in touch so we can start discussing which treatment options are right for you.

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