Sex After Prostate Surgery And New Techniques To Improve It
Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center knows the wide range of emotions and fears that men with prostate cancer face. As a robotic prostatectomy and prostate cancer treatment expert, Dr. Samadi cares for the total patient, helping them deal with all aspects of treatment, recovery and cure. Robotic prostatectomy procedures, performed to remove the prostate gland and all surrounding cancer, can provide very good cancer cure results, though many men fear the potential side effects of the surgery. Top on their list of concerns: will they be able to have and enjoy sex after prostate cancer treatment?
Dr. Samadi understands this concern. "For most men, sexual function is every bit as important as eliminating prostate cancer. But many of their fears about sex after surgery are carry-overs from what they know of older open and laparoscopic prostatectomy techniques. Thanks to robotic surgery, these fears can be greatly reduced." Historically, the prostate gland was removed through invasive abdominal surgery during which surgeons had a very difficult time sparing the tiny nerve bundles responsible for erectile and sexual function. Often, a man’s ability to have sex after surgery was negatively impacted. Today, with the advent of robotic surgery techniques, experienced surgeons like Dr. Samadi have an enhanced view of the prostate gland, allowing increased precision and dexterity. As a result, the risk of damage to the nerves vital to sexual function is significantly diminished.
When treating his prostate cancer patients, Dr. Samadi employs a start-to-finish approach, including an individualized evaluation of sexual function prior to surgery and on-going, post-surgical assessments of options to aid in the return of sexual function. "I consider robotic surgery successful when the cancer is cured and the patient has full continence and potency. All three criteria must be met for me to consider the surgery a success." Dr. Samadi dubs this whole-patient approach, "The Treatment Trifecta."
Dr. Samadi customizes robotic surgery with his own SMART (Samadi Modified Advanced Robotic Technique) method. Using the da Vinci Surgical System, the commonly recommended treatment for localized prostate cancer, Dr. Samadi is able to perform highly precise movements at the surgical site: cancerous tissue is cleanly removed and critical nerves are spared. By not opening the surrounding fascia around the prostate and not suturing the dorsal vein complex, Dr. Samadi has improved the quality of men’s post operative sex life. Ultimately, this leads to faster recovery and an improved outlook for regaining sexual function and urinary continence.
"Men want to know they can return to a normal life when this is all over. They want the cancer gone and they want to move on and enjoy sex the way they always have," says Dr. Samadi. While the resumption of sexual potency can take up to 12 months or more, Dr. Samadi assures patients that this is within the normal course of recovery. His comprehensive approach to prostate cancer treatment and sexual wellbeing continues beyond surgery. "It’s not uncommon for men to experience some ED immediately following prostatectomy procedures, but this is not an indication of their long-term sexual potency. I continue to work with patients to achieve the complete results they desire."
