Many men with prostate cancer fear becoming impotent after being treated with the da Vinci robot procedure.
“Any treatment for prostate cancer, including radiation or robotic surgery, can affect sexual function,” says Michael Herman, MD, Director of Urologic Oncology at South Nassau Communities Hospital in Oceanside, NY.
It’s Not Just the Da Vinci
“Whether or not a man develops erectile dysfunction is dependent on many factors, including the man’s pre-treatment sexual function, their age, whether or not they have other medical problems such as diabetes, and the aggressiveness of the cancer,” says Dr. Herman.
When a procedure such as the da Vinci robotic system or radiation leads to erectile dysfunction, just how does this happen in the first place?
Dr. Herman explains, “The nerves that control erectile function run very close to the prostate, and are very delicate.
“Therefore, any treatment for the prostate can potentially affect these nerves, including the changes that happen after radiation or the manipulation that occurs during surgery.”
So it should be easy to understand why there is nothing particular about the da Vinci robotic device that causes any more impotence than any other treatment for prostate cancer such as brachytherapy (implantation of radioactive “seeds”).
“If a man has aggressive prostate cancer, they may also be given medication to lower the testosterone levels, which can affect sexual function as well.”
Can Impotence from Da Vinci or Other Procedures Be Prevented?
“Meticulous surgical technique to spare the nerves during surgery is the best way to preserve sexual function,” says Dr. Herman.
“When they are diagnosed, patients should also be counseled at length about how their prostate cancer treatment will affect their sexual function.
“If someone does develop erectile dysfunction after treatment, there are many treatment options, including oral medications such as Viagra or Cialis.
“Finally, concern about sexual function is one of the main reasons that some men with non-aggressive prostate cancer opt for active surveillance.
“This allows patients and their doctors to monitor their cancer to make sure it doesn’t become aggressive while at the same time preserving their quality of life.”
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Do not disqualify the da Vinci robotic technique due to fear of becoming impotent.
There is nothing inherent about this technology, relative to other treatment options for prostate cancer, that leads to ED.
Dr. Herman’s interests include reducing the over-diagnosis and over-treatment of prostate cancer by utilizing the latest biomarkers and imaging techniques. He is at the forefront of treatment and research of urologic cancers.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.
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