Problems you may be too shy to mention
AS well as potential (but usually temporary) incontinence and impotence, there are some other changes that may take a certain amount of getting used to after treatment.
‘Post operation, male patients will no longer ejaculate after orgasm because the prostate is the organ that makes the fluid and it’s been removed, but they can still have the sensation of pleasure and release,’ explains Jane Brocksom, a senior nurse specialist in urology and Vice President of the British Association of Urological Nurses.
Another littlediscussed side-effect of surgery is that some men find that their penis becomes a bit smaller temporarily.
‘It doesn’t affect all men — but a number of them do report this, although it could be that some simply notice it more than others,’ says Gordon Muir, a consultant urological surgeon at Kings College Hospital and The Lister Hospital, both in London.
‘Typically, they experience a loss of between 1 to 2cm.
‘It is a difficult subject because if you tell men they may experience some degree of penile shortening they can become more anxious about it and their perception of any shrinkage can be greater than what it actually is. So they have to be carefully counselled about it beforehand.’
Quite why it happens is unclear. One possibility is that damage to the blood vessels and nerves during the surgery causes the muscles in and around the penis to contract slightly. Or it might be that when the prostate is removed, the urethra, which carries urine out of the body, may pull inward slightly, pulling the penis in with it.
Erections may help redress this. ‘We don’t know exactly why it helps,’ says Mr Muir, adding that it may be due to increased blood flow to the area ‘with the benefits carrying over in the non-erect state’. However, some men can temporarily lose the ability to have erections spontaneously after the surgery.
For this reason, men may be encouraged to take a low dose of a drug such as Viagra.
Or, as well as tablets, they will be given a penile pump such as the SomaErect Vacuum Pump, to be used a few minutes a day. The pump, available on prescription, is placed over the penis and the handle pumped to increase negative pressure in the tube which helps pull blood into the penis.