this erectile dysfunction or ED. Many factors can prevent normal sexual
who had frequent sexual activity before their diagnosis and treatment
function. It is the treatment that causes
> Other methods are injection therapy
decisions and discussions with your doctor.
There are four parts to normal sexual function in men – sex drive (also called libido), erection, ejaculation
your sexual function can be affected. This information describes what may
development of male sex organs and sexual behaviour. When testosterone
Figure 2 - Male Reproductive System
Radical Surgery to remove the prostate (as indicated by dotted line)
Prostate
Lifestyle factors can af ect your sexual
avoiding excessive alcohol intake, eating a healthy diet and exercising
when a man is sexual y stimulated. This happens when nerves in the penis
(the arteries) to relax. This causes the
in. The penis elongates, shutting of the
veins so that less blood leaves the penis
than enters it. This continues until a full
propel ed into the urethra (urine tube). During ejaculation, pressure builds up in
the prostate region, a muscular valve at
outflow of urine. Semen is propel ed out
than enters it and the erection subsides.
of the penis as the pelvic floor muscles
vessels are important for erections. The nerves necessary for erections
causing a loss of libido (sexual desire)
If it is considered safe to do so, nerve
by treatment to the prostate It is helpful to use oral medications gland?
(taken by mouth) such as Viagra, Cialis or Levitra and/or penile
unassisted erections. Some men are advised to take these tablets in low
important to erectile function lie close to
the prostate and can be damaged when the prostate cancer is treated. A series of
‘give it time’. After surgery your body
an erection, lie in bundles just next to the
blood vessels expand in order to deliver
the one you’ll have years later. Many
After a radical prostatectomy, the stimuli that caused an erection in
and seminal vesicles. Initially the focus
partial erection, go ahead and attempt intercourse – vaginal stimulation
may encourage further and better quality erections. Continue with sexual
not occur. Don’t wait for the time when
months), there is usually some return of erection strength.
to medium term. Several years after radiotherapy, erectile function typical y
declines gradual y. This is thought to be
prostate that are important for erections.
fluid. This is cal ed a ‘dry ejaculation’. It
control prostate cancer has a lower risk
during an ejaculation sensation, but it is
healthy tissues adjacent to the prostate.
Table : PDE5* inhibitors (medications that assist erections)
in its flaccid (floppy) state. This can be
Ejaculation fluid is often maintained after
progresses, the penis wil usual y start to
look more as it did before the operation. Nevertheless, it is general y accepted that in the erect state, the penis is about
penis appears ‘retracted’ into the body.
sex drive will be diminished for most men. However, continuation of
and concern between you and your partner can be very important in the
attacks are more likely to occur during exercise than otherwise.
of these side effects (e.g. the antibiotic
these drugs. If the medication doesn’t
PDE5 drugs, but often their sexual desire is low.
erections after a radical prostatectomy.
A drug is injected each time an erection
return of erectile function. In addition,
any direct sexual stimulation – it is a
(alprostadil) is the most commonly available. As with PDE5 inhibitors, it is
the risk of one of the uncommon side ef ects – a painful prolonged
erection, cal ed priapism. Any erection lasting more than 4 hours with this
Some doctors prescribe a tablet to help deflate the erection should it last
for hours or more, or be painful (e.g.
pseudoephedrine 60–0 mg oral y).
activity is a form of exercise and heart
penis; injection therapy can fail if this is
sexual intimacy – there may be new discoveries to be made!
Caverject Impulse is in a powder form that can be stored or transported at
the cancer or from any potential urinary
picture. There is far more to a fulfilling
fulfilling relationship and to be rid of a
with these devices is very helpful. Most companies make available
health. This includes benign prostate disease and urinary symptoms
penis to create a mechanical erection. Such an operation is normally not
of the cost of inserting these devices is
men. You can find a practitioner with an
Has the PHIP series, support groups, an online email helpline, treatment
Intimacy with impotence: The couple’s guide to better sex
This book provides information on relationships, commercial therapies
constantly being updated. We have made every effort to ensure that
surrounding family breakdown or separation. ph: 00 8 99 8,
This information has been developed by the Urology Unit at the Repatriation
General Hospital, in consultation with men who live with prostate
and community agencies have contributed to their production. We
2. Interpreting the PSA test for prostate
are grateful to all of these individuals
3. After a diagnosis of prostate cancer:
Individualized therapy for hypertension ( a shorter version of this was published in J. David Spence M.D., FRCPC, FAHA Stroke Prevention & Atherosclerosis Research Centre 1400 Western Rd., London, ON, Canada N6G 2V2 Phone: 519-663-3113; Fax 519-663-3018; email dspence@robarts.ca The recent publication of the Blood Pressure management of resistant hypertension7, 8. As Lowering Arm
INTERNATIONAL JOURNAL OF PSYCHOTHERAPHY, VOL. 5, NO. 2, 2000 An inspired resurrection of Freudian drive theory: but does Nick Totton’s Reichian `bodymind’ concept supersede Cartesian dualism? Review article on Nick Totton’s The Water in the Glass: body and mind in psychoanalysis , London: Rebus Press, 1998, 266 pp., ISBN: L 900877 L2 0 Minster Centre/Scarborough Psychotherapy Training