Restoration Phase (Well After Cancer Treatment)
The restoration phase, post prostatectomy, occurs well after cancer treatment and is necessary when the rehabilitation therapies described elsewhere on this website have not fully resolved urinary and sexual dysfunction. Most importantly, do understand that this is not a time to worry and we have the opportunity to implement treatment options that can restore full continence and sexual function. We simply ask that you keep a positive attitude and work closely with us and the other clinicians involved in your care to make the most of this very important phase in your recovery.
Unfortunately, there is no linear recovery process, and every patient returns to erectile function at a different time. During the healing process, it can be especially frustrating, especially if early rehabilitation therapies are not working or are progressing slowly. If this is the case, we can begin the next phase of treatment starting with a Penile Doppler Ultrasound study. This is a diagnostic tool that helps us understand if there is any blood leaking out, known as a venous leak, requiring earlier intervention.
The Next Phase in Treatment
We start tracking your progress at your first visit, 3 months following surgery. An individualized plan is designed based on your function, recovery, and goals. We concern ourselves with two simple questions:
· Did the treatment work?
· Did the satisfaction of treatment outweigh the side effects?
When we discuss the gold standard for moderate to severe ED treatment after prostate surgery, we turn to the penile implant. Indeed, it is the only one-stop solution to ED. And it happens to be a very safe, elegant and effective solution at that.
What Is the Penile Implant?
A penile prosthesis is a minimally invasive day-surgery procedure that replaces the two natural hydraulic tubes that run along the shaft of the penis. These are what fill with blood. These tubes are replaced with an implant that can be manipulated or inflated.
Men have multiple options when it comes to these prostheses. They can opt for a semirigid rod-like implant that is simply manipulated by hand. Otherwise, men have the option of an inflatable penile prosthesis. This uses a small, implanted reservoir in the abdomen and a pump within the scrotum to discreetly deliver fluid to the tubes implanted in the shaft of the penis, thus generating a natural looking and feeling erection
What Options Do I Have to Restore My Urinary and Bladder Control?
Most men will regain urinary continence and control of their stream over the course of weeks or months after surgery. However, those who continue struggling with leakage find it frustrating and bothersome. Living with leakage and urinary pads does not have to be an option. There are two safe and effective minimally invasive surgical procedures to assist men in improving their urinary abilities.
The Male Sling
A male sling is composed of a small piece of mesh that elevates the urethra, offering the sphincter additional support to control the urine stream. The surgery is minimally invasive and performed on an outpatient basis. The access point is hidden behind the scrotum and there is no obvious outward sign of the implant. The sling is most appropriate for men who can start and stop their urinary stream but experience some urinary leakage. This is also a good option for men who leak urine during an orgasm known as climacturia. Learn more about the Male Sling
Of note, if you’ve heard legal advertisements about the recall of defective mesh, this has nothing to do with a male sling. The meshes in question were created for females and the meshes used for the male sling remain unaffected in quality and effectiveness.
The Artificial Urinary Sphincter (AUS)?
An artificial urinary sphincter or AUS works in similar fashion to your natural urinary sphincter, letting urine through the urethra, but only when you choose. A small balloon is wrapped around the urethra and inflated to keep it closed and leak free. As the bladder fills, you activate a button hidden in the scrotum, relaxing the artificial urinary sphincter and allowing urine to pass. This device is implanted in a minimally invasive, outpatient procedure. Learn more about an Artificial Urinary Sphincter (AUS).