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A triple lumen catheter is inserted through the urethra to irrigate and drain the bladder after the surgical procedure is complete. The outcome is considered excellent for 80–90% of BPH patients. The procedure carries minimal risk for erectile dysfunction, moderate risk for bleeding, and a large risk for retrograde ejaculation. [2]
Prostate laser surgery is used to relieve moderate to severe urinary symptoms caused by prostate enlargement. The surgeon inserts a scope through the penis tip into the urethra. A laser passed through the scope delivers energy to shrink or remove excess tissue that is preventing urine flow. [7] Different types of prostate laser surgery include:
[78] [80] Side effects include decreased libido and ejaculatory or erectile dysfunction. [ 81 ] [ 82 ] The 5α-reductase inhibitors are contraindicated in pregnant women because of their teratogenicity due to interference with fetal testosterone metabolism, and as a precaution, pregnant women should not handle crushed or broken tablets.
Very few surgeons will claim that patients return to the erectile experience they had prior to surgery. The rates of erectile recovery that surgeons often cite are qualified by the addition of sildenafil to the recovery regimen. [26] Remedies to the problem of post-operative sexual dysfunction include: [27] Medications; Intraurethral suppositories
Surgery rarely is the first option for retrograde ejaculation and the results have proven to be inconsistent. [11] Medications do not help retrograde ejaculation if there has been permanent damage to the prostate or the testes from radiation. Medications also do not help if prostate surgery has resulted in damage to the muscles or nerves.
Erectile dysfunction (difficulty getting and/or keeping an erection; impotence) is another side-effect associated with some surgical and non surgical treatments of prostate cancer. The problem ranges from 25 to 50% of men who receive prostate brachytherapy, which is less than that observed in men receiving standard external beam radiation. [19]