Better Sex, Easier Peeing With Partial Gland Ablation
- Partial gland ablation can address common worries about urinary and sexual function in prostate cancer treatment.
- Partial gland ablation will require more studies to determine its efficacy compared to surgery or radiation and is not currently standard of care.
- Between 10% to 20% of men undergoing radiation and up to 20% of those having surgery experience urinary issues, while up to 80% encounter erectile difficulties and ejaculation problems post-surgery or radiation.
- Because the procedure only targets cancerous prostate areas, it can help preserve surrounding areas involved in sexual and urinary functions.
- While partial gland ablation may help in some cases, it may not resolve all issues and could potentially introduce new problems, such as dry ejaculation.
They are valid concerns.
- Between 10% to 30% of men who undergo radiation for prostate cancer experience urinary irritation, frequency, urgency, or retention after treatment.
- Up to 20% of men who undergo surgery have urinary incontinence, or the involuntary leakage of urine.
- More than half – and up to 80% – of men report difficulty getting or maintaining an erection after surgery or radiation for prostate cancer.
- The majority of men who have surgery and radiation have problems with ejaculation, at least temporarily.
What is partial gland ablation?
Partial gland ablation, also known as focal therapy, targets only the cancerous part of the prostate. It leaves the rest of the gland and the surrounding areas alone.
The technique uses different types of energy to attack the cancer cells.
- Hot: Ultrasound or radiofrequency waves raise the temperature and destroy cancer cells
- Cold: Gas or liquid freezes cancer cells to eliminate them
- Laser: Electric pulses or light burns cancer cells
- Chemical: Chemicals injected into the prostate to poison and destroy cancer cells
How well does it avoid sexual and urinary side effects?
Because partial gland ablation targets the prostate so precisely, it is less likely to cause side effects like sexual dysfunction and bladder problems. The preservation of normal tissue function minimizes the impact on urinary and sexual functions compared to more aggressive treatments.
By some estimates:
- It preserves sexual function in up to 90% of patients
- Up to 98% of patients can avoid urinary continence
“The rest of the prostate that does not have cancer is preserved functionally. These men do great,” Dr. Wysock says.
“They don’t have incontinence and they have a minimal impact on their sexual erectile function, which is a drastic improvement over surgery and is also an improvement over whole gland radiation,” he adds.
That said, long-term outcomes and effectiveness of the technique are still under investigation. It will take more research to compare it with other treatments. Currently this approach is not standard of care and will require large future studies comparing this to surgery and radiation to know how well this treatment actually works.
Related: A New Organ-Sparing Treatment Option For Localized Prostate Cancer
Are sexual dysfunction and urinary problems possible with partial gland ablation?
Partial gland ablation can still lead to various short and long-term effects on sexual function and urinary health.
Short-term issues
- Temporary erectile dysfunction
- Reduced ejaculation volume
- Urinary symptoms like frequency or urgency
Long term
- Persistent erectile dysfunction
- Decreased ejaculatory function
- Ongoing urinary problems such as urinary incontinence or urinary retention
Dr. Wysock adds that, although partial gland ablation usually preserves erectile function it may create a new problem known as “dry ejaculation”.
“[The procedure] will decrease the volume of semen that a man produces and it may also impair the mechanisms that propel semen at the time of ejaculation and therefore men may notice no ejaculate and we’ll call a dry ejaculation or a dry orgasm.” he explains. “The sensation of orgasm would all be the same, but this is actually a new challenge.”
If you have any of these complications after the procedure, tell your doctor immediately.
Related: Loss of Penis Size Possible After Prostate Surgery
What can be done if there are issues?
Supportive care for sexual and urinary dysfunction after partial gland ablation may include the following:
- Medication: Some drugs may help to improve erectile function and increase blood flow to the penis. Other drugs may help to reduce urinary urgency, frequency, or leakage.
- Devices: Some devices, such as vacuum pumps, penile implants, or artificial urinary sphincters, can help to restore sexual function or urinary continence. These devices may require surgery.
- Pelvic floor exercises: Exercises, usually taught by a physical therapist, can help strengthen the muscles that support the bladder, prostate, and penis to improve erectile function and urinary control.
- Counseling: Psychological support or sex therapy can help cope with the emotional impact of sexual or urinary dysfunction.
Questions for your doctor
When considering partial gland ablation for prostate cancer, it’s important to address concerns about urinary and sexual function. Some questions you might ask:
- Am I a candidate for partial gland ablation?
- Is partial gland ablation considered a standard of care approach?
- Can partial gland ablation improve my urinary symptoms and reduce the risk of incontinence?
- How soon after partial gland ablation can I expect improvements in my sexual function?
- Are there any factors that may affect my recovery of urinary and sexual function after the procedure?
- What are the potential side effects or complications related to urinary and sexual function?
- If I have had previous treatments like surgery or radiation, can the procedure help or harm my existing urinary and sexual function?
Learn more about SurvivorNet's rigorous medical review process.
