Erectile dysfunction and loss of bladder control are potential, but often temporary, side effects of prostate cancer therapy. At City of Hope, 70 percent of patients regain or maintained bladder control following prostate removal surgery, and most men regain sexual potency from a week to 18 months after surgery. For cases of persistent impotence or incontinence, there are many treatments available.
City of Hope offers the Urinary Incontinence Program
through our Rehabilitation Services department. This program includes one-on-one sessions with a team of physical therapists to help prostate cancer patients retrain their pelvic muscles and build bladder control using a combination of biofeedback and pelvic floor exercises.
The return of continence may be immediate and usually occurs within the first few months after surgery but may take as long as one year. If, after one year, a patient is still having issues with urinary incontinence, patients are thoroughly evaluated to determine the cause. If they are determined to have stress urinary incontinence (leakage of urine with cough and sneeze), they may be a candidate for additional treatments including transurethral collagen injections, a bone-anchored perineal urethral sling or an artificial urinary sphincter to help restore bladder control.
Following prostate cancer treatment, the return of erectile function may take anywhere from one day to two years. It is thought that although the neurovascular bundles are spared, the nerves that facilitate erections may be affected during treatment, leading to a temporary loss of nerve function. During this time, oral medications for erectile dysfunction may be unsuccessful because they require intact nerve function. However, there are a number of second-line therapies we offer at City of Hope that act independent of nerve function, that can serve as a temporary or sometimes permanent measure to attain satisfactory erections. These treatments include intraurethral medications, penile injection therapy or a vacuum erection device.
If these treatments prove unsuccessful, we offer patients a penile prosthesis. While this does require a surgical procedure, a penile prosthesis can be an attractive option for treatment. It is associated with over a 90 percent patient and patient/partner satisfaction rate.
Prostate Cancer Survivorship Program
provides specialized follow-up care for patients who have completed surgical treatment for localized prostate cancer. Patients who participate in this program are seen every 6 to 12 months in a clinic specially designed to meet the follow-up needs of prostate cancer survivors. Care is provided by a healthcare provider with expertise in prostate cancer care and survivorship issues. Patients in this program will receive careful monitoring for possible recurrence of their cancer and will have the opportunity to discuss their cancer treatment, its impact on their health and ways to stay as healthy as possible.