NCCN Guidelines for Patients® | Prostate Cancer - page 30

30
NCCN Guidelines for Patients
®
: Prostate Cancer
Version 1.2014
Part 4: Overview of cancer treatments
crying right after you wake up. From the operation,
you will have pain and swelling that often fade away
within weeks. The PLND may rarely cause swelling
(lymphedema) in the legs due to the buildup of lymph that
will resolve over several weeks.
Almost every man has urinary incontinence and erectile
dysfunction after a radical prostatectomy. These two
side effects may be short lived, but for some men they
are lifelong issues. You’re at higher risk for erectile
dysfunction if 1) you’re older; 2) you have erectile
problems before the operation; or 3) your cavernous
nerves are damaged or removed during the operation.
If your cavernous nerves are removed, there is no good
proof that nerve grafts will help restore your ability to
have erections. Aids are still needed.
Removing your prostate and seminal vesicles will cause
you to have dry orgasms. You will no longer be able
to father children through sex—your prostatectomy
essentially includes a vasectomy. Although not as
common as erectile dysfunction, other sexual changes
may include pain during orgasm (dysorgasmia), inability
to have an orgasm (inorgasmia), curving of your penis
(penile curvature), and a smaller penis (penile shrinkage).
Bladder control often returns within months after the
operation, but you may not have full control. Leaking
a small amount of urine when coughing, laughing,
sneezing, or exercising is called stress incontinence. It
is caused by damage to the muscle at the base of the
Figure 9. Graph showing how many men will receive
a PLND and how many men with cancer in their
lymph nodes will be found using a ≥2% risk cutoff
1...,20,21,22,23,24,25,26,27,28,29 31,32,33,34,35,36,37,38,39,40,...92
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