NYU prostate specialist, Dr. Herbert Lepor just published questionnaire findings in the Journal of Urology about the incidence of post-prostatectomy men leaking urine during sex or climax. This side effect of prostate removal is coined “climacturia.” While this may not be a topic you’re too anxious to discuss, I want to help clarify the findings and share my feelings about the results.
The survey found this: 1 in 8 men are experiencing urinary incontinence during sex and 36% of those polled said the problem persisted two years after surgery. This issue is completely separate from sexual potency, and in some cases isn’t even linked to normal daytime urinary incontinence.
The questionnaire was given only to patients of Dr. Lepor’s. It included just over 1,400 men and encompassed those who underwent radical prostatectomy surgery at NYU between 2000 and 2007. The most critical part of the study I want you to keep in mind is the fact that all men had traditional open prostatectomy surgery. What this means is that no laparoscopic or robotic tools were used during the procedures.
In my experience, traditional open prostatectomy surgery has significant limitations. For the patient it means greater blood less, a longer hospital stay, a more painful recovery and increased sexual and urinary issues after surgery. For the surgeon it means reduced visibility and therefore, the chance for less precision during surgery.
It is estimated that roughly 90,000 men in the U.S. will undergo radical prostatectomy surgery this year. I fully endorse the removal of a cancerous prostate. I believe a man’s best chance for survival and a happy, healthy life is to completely remove the prostate once cancer presents itself. I caution you, however, to do your research. Think about the time you spend choosing what new car to buy or where to vacation next year. Surely life-saving surgery is worth at least that level of research, thought and discussion.
Robotic prostatectomy provides significant advantages. From my perspective, the technology significantly enhances my traditional surgical capabilities. There’s less blood in the operating field and the robot provides 3D sight with up to 10x magnification. Both factors give me a significant advantage over traditional, open surgery as I can rely on sight rather than touch. The less I touch, the less risk of trauma there is to the sphincter and areas under the pubic bone. Further, the dexterity of the robot in my hands offers unmatched precision. Being able to really see the cancer, the prostate and everything around it lets me work even more carefully at sparing the precious nerve bundles around the prostate. With my SMART (Samadi Modified Advanced Robotic Technology) surgical technique there are two key advantages I want you to understand:
1) Sex Life – I don’t open the endopelvic fascia during surgery. This tissue surrounding the prostate contains precious nerve bundles that control your sexual function. I do my best to create as little trauma to this area as possible. 87% of my patients regain sexual potency within 12 to 24 months.
2) Incontinence – I don’t suture the dorsal vein complex at the beginning of surgery. This lets me control the length of urethra left behind; the more urethra, the less risk of urinary incontinence and leaking after surgery. 97% of my patients regain urinary control within two to three months.
Successful robotic prostate surgery requires the marrying of a skilled surgeon with a foundation in traditional surgical methods with the enhanced technology of robotic equipment. Further, that union must exist for a long period of time to achieve quality results. It’s estimated that a surgeon must perform more than 1,600 robotic-assisted laparoscopic prostatectomy surgeries to achieve “acceptable” outcomes. I have performed more than 3,500 successful robotic prostatectomy procedures.
Reading these new polls is part of gathering information about prostate surgery. The point I make is simply to know what you’re reading. Find out the origin of prostate surgery statistics, talk to and research multiple surgeons and fully understand your options so that you and your family can make the treatment decisions that are right for you.