BPH and prostate cancer tutorial

Question 1

Radical prostatectomy erectile dysfunction - why can this complication occur

Answer 1

Damage to the cavernousal nerves

Question 2

Radical prostatectomy urinary incontinence - why can this complication occur

Answer 2

Prostate contains the proximal sphincteric unit, which controls some degree of urinary continence. Prostatectomy removes the proximal urethral sphincter and there is a risk of inadvertent damage to the cavernous nerve to the prostate (which provides neural innervation to the bladder and urethra) resulting in bladder function being affected.
Urethral length changes which can also affect continence.

Question 3

Management of post-op urinary incontinence

Answer 3

Building the pelvic floor muscles through exercises but should this fail there is an option for an artificial urinary sphincter device

Question 4

Post-op ED treatment

Answer 4

PDE5 inhibitors, prostaglandin E1 injections and penile prosthesis devices.