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That Changes Life: The Prostate Option That Men Need to Know About

Come and see how our prostate option 'that changes life' can help you with your problem. If you are looking for a prostate option that can change your life, come and see how our option can help you. With our prostate option, you can solve your problem and have a better life.

Prostate cancer is the most common cancer in men. It is a serious disease, but most men with prostate cancer do not die from it. In fact, more than 3 million men in the United States live with prostate cancer.

There are many different treatment options for prostate cancer. The treatment you have will depend on the stage of your cancer, your age, your overall health, and your preferences.


Surgery is an option for men with early-stage prostate cancer. The two types of surgery are radical prostatectomy and laparoscopic prostatectomy.

Radical prostatectomy is the most common type of surgery. The surgeon removes the prostate gland and some of the tissue around it. This surgery can be done with or without robotic assistance.

Laparoscopic prostatectomy is a less common type of surgery. The surgeon makes several small cuts in the belly and inserts thin, long instruments through the cuts. One of these instruments is a camera. The surgeon uses the camera to see inside the belly and remove the prostate gland.

Radiation therapy

Radiation therapy uses high-energy beams, such as X-rays, to kill cancer cells. There are two types of radiation therapy:

  • External beam radiation therapy: The radiation comes from a machine outside the body.
  • Internal beam radiation therapy: The radiation comes from radioactive seeds that are placed in the prostate gland.

Radiation therapy can be given alone or with hormone therapy.

Hormone therapy

Hormone therapy is also called androgen deprivation therapy. It lowers the levels of male hormones in the body. Male hormones can make prostate cancer grow.

Hormone therapy can be given alone or with radiation therapy.


Chemotherapy uses drugs to kill cancer cells. It can be given intravenously (through an IV) or in pill form. Chemotherapy is usually given with hormone therapy.

Targeted therapy

Targeted therapy is a newer type of treatment. It uses drugs or other substances to target cancer cells and kill them. Targeted therapy is usually given with hormone therapy.

Active surveillance

Active surveillance is an option for men with early-stage prostate cancer that is not growing or causing symptoms. With active surveillance, you have regular PSA tests and prostate exams. You also have MRI or biopsy of the prostate every year or two. If your cancer starts to grow, you will start treatment.

Active surveillance is a good option for men who are older or who have other health problems. It can also be an option for men who do not want treatment right away.

Watchful waiting

Watchful waiting is an option for men with early-stage prostate cancer that is not causing symptoms. With watchful waiting, you have regular PSA tests and prostate exams. You do not have treatment unless your cancer starts to grow or cause symptoms.

Watchful waiting is a good option for men who are older or who have other health problems. It can also be an option

Professor Nathan Lawrendschuk Innovative Treatment for Prostate Cancer has helped 100 men in Victoria. Epworth Freemason is the first

#Milestone #lifechanging #prostateoption #milestonestudy

Treatment that violates prostate cancer has helped 100 men in Victoria.

Epworth Freemason is the first hospital in the state to introduce minimal invasive treatment, called focus therapy, in 2019.

Using nanocnife technology, it only treats the cancer part of the prostate, leaving the remaining prostate tissue that is not disturbed, minimizing side effects.

Expert Professor Epworth Nathan Lawrendschuk said nanocnife is an alternative for radical surgery or radiation for prostate cancer patients.

“Unfortunately, radical prostate or radiation cancer surgery brings side effects to some men including erectile dysfunction and changing bladder control,” he said.

“Cancer cells using nanocnife do not affect the surrounding structure, such as nerves and bladder and that change men’s lives.”

This process uses irreversible electroporage, where a surgeon instills several small electrodes called nanocnife around the cancer tumor.

Plus electricity is used to pierce a nanometer -sized hole in the tumor, causing cancer cells to die.

Treatment using nanocnife is a day procedure. The patient is then monitored from time to time to ensure a new tumor does not appear.

Melbourne man George Alexander was diagnosed with low prostate cancer in 2016.

Since then, he has a biopsy and scanning of surveillance regularly, and was told in the late 2021 that prostate cancer has grown.

Alexander said Prof. Lawrendschuk gave him three options: full prostate transfer; Wait for six more months and ask for the scanning of MRI and PET; Or, among the extreme, has nanocnife surge operations.

“I spoke with a general practitioner from a male health clinic in Epworth Freemason and had talked with men in prostate cancer support groups about their past experiences,” he said.

“My decision to accept nanocnife procedures is based on practicality and lifestyle choices.”

Mr. Alexander said he was aware of the side effects of radical prostatectomy, and even the unlikely to be dissatisfied at the age of 67 “did not match” with him.

“Postponing things for six months is also not an option. Cancer is there, it can only be worse, and I don’t want to take risks, “he said.

“Nanocnife options make sense because it will treat direct cancer problems and still allow for other types of treatment on the track if needed.”

Thilakavathi Chengodu, Research Program Manager at Epworth Healthcare’s E.J. Whittate Prostate Cancer Resear

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Video transcription:

Good evening, everyone

thank you for joining us this evening for our men’s health, webinar

my name is kara I’ll, be hosting

tonight’s event, we’ll get started with a couple housekeeping items: and

then I’ll, introduce tonight’s speaker. First and foremost, I just want to

remind you that your participation, is

completely anonymous to all other attendees

no one, can see your face or your name

and. Any questions that you ask can only be seen

by myself and dr thompson

we love collaborative presentations. So, if you’d like to ask a question: please

type it in the chat box at the lower

part of your screen and we’ll save time at the end of the

presentation to answer as many as we can

so, please, we encourage you, ask questions, put them in the chat box. We’d love, to

answer them at the end

the presentation, should last about 45 minutes and will be presented by dr

katie thompson

dr thompson’s been in practice for more than a decade in the sacramento area

thank. You dr thompson, for giving up your evening

to offer this education to us. I know you

have a lot of great content to cover, so I’m gonna

hand it over to you to further introduce

yourself to everyone in attendance. Well, thank you kara and I’m grateful to

see. So many of you come out tonight to

hear a little bit more about sexual and urinary recovery for many patients. Who

Are struggling with these concerns so we’re going to talk a little bit. About

Erectile dysfunction and stress incontinence

I am a sexual and urinary health

specialist and I practice in downtown sacramento I trained in missouri and in

texas and spent some time as an active

duty urologist at travis air force base, in

fairfield california, I was recruited to

the sacramento area for my expertise in sexual and urinary health and I’ve had

the pleasure of pioneering our prostate

cancer survivorship care group, and what we strive to do is to promote longevity

and wellness to support patients after cancer therapies so that they can

experience sexual and urinary recovery. So many of our patients are struggling

with prostate cancer or have struggled

with prostate cancer and are pursuing treatments for those conditions

but. Many of you may not be many of you

may, be struggling with erectile dysfunction or urinary incontinence. And

Have not had a prostate cancer diagnosis

so. We trust this will be helpful information for you and, if you’d like to

hear a little bit more about my practice

I, would refer you to my website at restorative, you’ll find quite a bit of

information about men’s health. Conditions

And here are a few of my radio shows we

have a radio show called called men’s health with dr katie on kfbk sundays, at

1, 30 pm and some of our past shows are on the website. You can reach us at this

phone number if you’d like to discuss

your personal situation and find a tailored plan of care for you

so, let’s go on and and pursue our topics tonight before we get too far. I want to

just point out two helpful websites, from

boston scientific You can use your smartphone

to pull up that

website if you can do so here in this location

and then


both of these websites give you more information about treatment, options, for

these conditions and I think they’re

unique, because they do allow you to take a quiz to assess the severity of your

condition and that may be helpful to

each of you as you’re, navigating choices for treatment

so. Why do we talk about erectile

dysfunction? Well, we’re really striving to enhance care for men and men are

reticent to pursue health care. We know that because some of these

conditions are associated with some

shame and embarrassment, but erectile dysfunction is so common for many men in


and as a sexual health specialist. We know that sexual health is important not

just, because it’s it brings pleasure but

because. It helps to keep couples close and it helps to prevent depression for

men. So we certainly want to be

at the forefront of discussing sexual health conditions

well. What is it? It is the inability, to

achieve or maintain an erection- that’s firm enough to have sexual intercourse

and, it’s quite common one in five

american, men, 20 years or older experience, ed in their lifetime and and

many men after the age of 40 notice, a change in erection, health, both the

strength the quality and the frequency

erections. This is even seen in animal species and is often related to a

decrease in blood supply as men age, and so we know that a lot of men, struggle

with ed some are very successfully

treated and others are frustrated with a long history of failed treatments, so we

want to present some treatment options

so that you can get the help that you need

the erection of the erection process is really quite complex. It depends upon

normal, nerve, signaling and normal blood supply, with arousal the nerves, around

the penis become activated, they send

signals to the brain to send blood into the

cavities of the penis, so these are the

corpus cavernosa those chambers become engorged with blood, and then the blood

is maintained in those erectile bodies

to protect and maintain an erection so that the blood cannot leave the penis so

any. One of these processes can be

affected with disease or with age and are difficult to address for many


the top three physical causes of erectile dysfunction are vascular, or

blood, supply issues, diabetes, and

medications medications, maybe can be a little more transient. In fact, many

medications, for instance, for high blood

pressure can help a man protect against higher blood pressure, which leads to

erectile dysfunction. So I tend to

recommend the patients who stay on that their anti-hypertensives

but diabetes and vascular problems, are

much more difficult to address as a cause of erectile dysfunction

and. Many men with prostate cancer

treatment struggle with ed interestingly

diabetes can also be a precursor for

future heart disease, so for younger men that I’ll see, in my practice, men in the

in, the 50s or early 60s. We actually are quite concerned about patients that

present with early erectile dysfunction

if. You can imagine that the blood supply to the genital area runs in very small

arteries. The blood supply to the heart

runs in much larger arteries, so early erectile dysfunction might present a

silent warning sign that a patient is at risk for heart disease in the future. So

We want to use this as an opportunity to

talk about minimizing heart risk, aggressive

exercise weight management, a good, healthy diet and controlling cholesterol

and high blood pressure. There are several treatment options for

men with ed, and we want to spend some

time talking about those options, but I want to comment first that erectile

dysfunction is just not a disease of men

alone. It affects the couple and many of my patients come in with or without

their spouse. Really both suffering, from

a loss of sexual intimacy and intimacy is physical closeness. It helps keep us

together our hearts connected our

emotions connected as we get older and so for couples that struggle with both

physical or relational loss as they get older

it. Is we see a lot of patients that

begin to separate and begin to become emotionally distant, because

because either a man’s fear, of

performing of not being able to perform, might prevent him from initiating sexual

intimacy and women, because they’re missing that emotional

intimacy they’re really sure how to

present themselves in a way that helps

the couple to stay close. So I find so many couples

become less emotionally attached because

of the sexual loss, and so we want to acknowledge that this is a disease of

couples many of my female patients

mourn, the loss of their husband’s sexual ability and not just because that was

pleasurable, because it has prevented

them from staying, intimate relationally as they get older. So this is another

reason to consider pursuing treatments

for sexual loss, so oral medications. Many of you are

familiar. With these oral medications

you’ve heard of viagra, stendra cialis levitra. They work by increasing blood

flow to the penis. They can be effective

in some cases, especially in mild erectile, dysfunction

the, efficacy or treatment. Success can be

affected by food and there are some common side effects. Headaches, facial

facial, flushing, nasal congestion

occasionally can present some blurry vision

we want to recommend that you would

consult a physician

before taking nitrate therapy. That’s medications used for chest, pain, if

you’re, also planning to use pde5

inhibitors, or these oral medications. These pills

and, you might take caution with an alpha

wall, gravel blockers or medications that are used to treat prostate enlargement

interestingly about half of men who try oral medications do give up on the pills

and. Those are men that tend to have more

moderate to severe erectile dysfunction. Men with diabetes, interestingly, are two

times more likely to move on to other

therapies. So I do have quite a few men with diabetes in my practice who come in

saying doc, hey viagra is not working

anymore. I need some solutions and we’ll move on to some other options

intracavernosal injection therapy is an injection. It’s a medication that’s

injected into the penile chambers, help

stimulate blood flow. The erection does take a little bit of time to develop. And

It can be successful in many men

especially men with moderate to severe ed. So this is something I often explore

with, that is the possibility of

utilizing this treatment. Some men just have an aversion to injection therapy

and, that’s understandable, other men, have

some side effects like penile pain or prolonged direction. That’s a little

less common but can be concerning this is where me and

my. As a sexual health specialist. I want

to better understand what your goals are, what you as a couple, your couple’s goals

are, because if you plan to have just

occasional intercourse every month or every couple of months, then injection


might make sense because you’re not

using it quite as often, but if you’re, a younger man who desires more regular


sexual activity, it may be wise to pursue other options, because injection therapy

can create some scarring in the penis if

it’s used over time, and we’ve also seen some risk of peyronie’s disease with

disease, which is a bend to the erect

penis and that can be that can develop after patients have been using erectile

aids, like injection therapy for quite

some time. So a lot of couples tend to avoid this

therapy. Even if it’s successful they

tend to fall off the therapy and choose not to use it any longer. I think some of

the reason for that is it can be a

little bit cumbersome. You have to prepare the medication, it often stays in

the freezer. It has to be thawed, and

prepared and then injected into the genital area into the penis

and. It takes some of the fun away. From

The playfulness of the experience and

and takes away some of the spontaneity

as well, so a large number of studies

have demonstrated that withdrawal rates are quite high, meaning a lot of patients

do ultimately choose to come off this

therapy, so the vacu erection pump is a

cylinder an empty cylinder that is

placed at the base of the penis to create a vacu to enhance blood flow so

this is a treatment that can often be

used for mild to moderate ed. I think it works really

in, a similar way or with similar

efficacy to the pills it does require an elastic ring to be

placed at the base of the penis to keep

the erection. To maintain it so the satisfaction rate can vary fairly, widely

depends a little bit on patient goals. Common side effects include some

bruising at the base of the penis and

the erection is cool to touch, so it may feel a little bit different than a

natural erection

if patients fail. The vacu pump they’re, often moving to a different issue. To

Different treatment excuse me

in one study, 80 86 of prostatectomy patients. Those are patients that have

their prostate removed for cancer they

decided to move on to other sexual aids. So you can see that for prostatectomy

patients the vacu pump is often

ineffective. Let’s talk a little bit about urethral

suppositories the urethral suppository

is, actually a similar medication to the injection therapy. The injection therapy

but it’s not injected. It’s instilled in the tip of the urethra and so with an

applicator. The medication is placed into

the urethra and the erection develops in the next 10 minutes

how effective. Is it well? It varies

widely men with prostate cancer, actually respond poorly to this treatment, that

might, be because the nerve signaling

signaling is often damaged after prostatectomy, and so the success rate

suffers there is

some risk of urethral discomfort and that could be transmitted to your

partner. So something to be aware. Of

And. The reason for just continuation, for

this treatment is often just you know

insufficient erections, or that urethral discomfort

let’s talk a little bit about the products. Faucet scientific provides for

penile implants. If you haven’t heard

about a penile implanted penile implant actually has the highest satisfaction

rate for patients with moderate to

severe erectile dysfunction. It’s placed in an outpatient surgery and allows

patients to have reliable spontaneous

erections at any time. So you can see how this would be attractive to many couples

that are struggling with sexual loss

we’re, going to spend most of our time talking about the ams, 700 and the

three-piece inflatable implant, but there are a couple of other devices that can

be discussed at a later date. So how does it work? Well, the implant

works, through a mechanism that allows

you to control an erection, so there’s a pump that sits in the scrot that is

under your control as you pump the

device fluid moves between a reservoir in the belly

into, the chambers or cylinders of the


and. These are all placed in an outpatient. Surgery

It looks completely concealed in the

body, so when it’s, when it’s been placed, no one can tell that you have an implant

it’s entirely concealed and it feels and

looks natural during intercourse. Interestingly, 98 of patients report

erections that are excellent or

satisfactory, it’s really hard to find treatment, options that have such a high

satisfaction rate. I’ve certainly found

that in my practice as a sexual health. Specialist

There are some post-operative side

effects that we’ll talk about in a few

minutes, but at seven years 94 of patients find that their device is still

working, and actually we see it lasting

much longer than that. For the majority of patients

so this, the particular device we’re

talking about the ams 700, has a proven track record for treatment of erectile

dysfunction. There have been 500 000 men

that have received this particular implant and are quite pleased with the

device. The device also has is it has an antibiotic coating, so infection rates

are very low for placement of this implant

and. It does mimic a natural erection

both patients and their partners relay very high levels of satisfaction, with

the implant, once it’s in place it looks natural when it’s deflated or not pumped

and, so that can be attractive to many

men, who want to be subtle in this treatment

I want to show you a depiction, a video of how this particular implant

works, so that you can understand the dynamics of the implant. When it’s in

place you’ll see here that it looks entirely

concealed, it doesn’t appear to be

unnatural. The pump is in between the testicles, as

the patient pumps, the device fluid moves

into, the chambers of the penis, to become fully erect. So the erection gains length

and girth

and is maintained as long as the patient desires, so that can be attractive, for

timing with spouse. There’s a separate

button here that allows you to deflate or to become flaccid or soft again, because I perform so many of these


we. We do this in a very brief 45 minute procedure. It’s done under anesthesia in

an outpatient setting patients go home

the same day and return the next day to have their dressing removed, there’s a

small incision in the scrot or above the pubic bone. Typically, I would

place it right below the penis in an

area that hides nicely, and everything is placed through that small incision

men return the normal activity within a couple of days, but I would typically

recommend no aggressive exercise for

about four weeks, so many couples will be able to use the implant four weeks, after

the procedure, the insurance coverage for ed treatment

really varies widely, and maybe many of

you have probably struggled to navigate that challenge

but. Interestingly, both incontinence

treatment and ed, the penile implant is often covered by medicare and private

insurers. Medicare has a consistent

coverage for the penile implant. Private insurers

many of private insurers cover the

implant, but if you have any concerns about costs, we can certainly get you in

contact with some resources that will be

helpful to you. I have so many patients that do pursue this option, as young as

35 had several patients with significant diabetes in their 30s, who pursue the

penile implant and men in their 80s who

still pursues who are interested in remaining sexually intimate with their

spouse and will still pursue penile

implants as a treatment. So the age is not a rate. Limiting step

what are the benefits of the implants. I think for my patients I see the primary

benefits is this offers a reliable

spontaneous erection looks and feels natural, and there are treatments that

provide that, with the exception of the

implant, so many of you have struggled with erectile dysfunction for such a

long time that you’re frustrated with

all the available treatment options and there’s something to be said for a

treatment. That is so reliable so

spontaneous that you forget that you had sexual concerns

that’s. That’s that’s a big win for so

many men and for many many erectile dysfunction, isn’t just about sex it’s

also about feeling confident whole and

masculine, and I think this the implant also provides restores some of that

sense of confidence to many men, even if

you’re, not pursuing sexual activity every other day, as some would


talked about how long lasting this is. Most patients are still using the

implant 10 years after the procedure, so

I typically quote: 10 to 12 10 to 15 year longevity. So if you’re, young and you’re

going to be pursuing sexual intimacy for

a long time, you may find that you’re looking for an upgrade in about 10-15


and, then. Finally, we did talk a little bit about spontaneity. I think this

allows you to have sex when the mood

strikes, because when you’re pumping the device it takes very little time to

cycle so less than a minute for most

patients, when they’re comfortable with the pump

there are some risks involved with any surgery. Not all patients are candidates

for penile implant. This is where you

want to come, see a sexual health provider. Somebody who’s had a lot of

expertise treating sexual health


because. We want to tailor our approach to your needs. Your situation

there are some risks to the implant

there’s, a small risk of infection. That’s quite rare

because. The device is coated in

antibiotics and because I perform many implants have over a high volume. Implant

Office. Our infection rates are very low and so

I’m glad to report that that’s the case

there may be a mechanical failure that the implant won’t work appropriately

that’s. Also quite rare

typically. There is some pain associated with the healing process. In the first

few days, it tends to improve very

quickly in the first two weeks. Men with diabetes, spinal cord injuries

some of these things might have a little

increased risk of infection. We want to address that in your consultation

and, so we talked a little bit about

there about the risk of infection. In conclusion, with this topic eating is

a common problem, it might be associated

with other conditions. There are quite a few treatment options that we want to

discuss and tailor to your situation. And

Penile implants could offer a more long-lasting and satisfying

excuse-making solution to this. To this concern and so

learn more about this condition, and

these treatments at or please take a look at my website

restorative and right now we have the pleasure of

meeting with a couple that I’ve treated with erectile dysfunction, richard

thornton and his lovely wife christine

are joining us tonight. We’re going to be asking them just a couple questions

about their experience with sexual loss

how. They came to a conclusion of how they arrived at a decision on how to

pursue therapy and what they thought

about the treatment that they elected to pursue. So richard and

christine, if you’ll go ahead and come on we’d love to hear from you. Hopefully your video screen and your

mute button will it’ll work for you well I

was dying

good, to see you. Thank you so much for joining us today, we’ve known each other

now for several years. Have we not yes


I met richard

several years ago? Absolutely he had just had prostatectomy

surgery for prostate cancer. A more aggressive form of prostate cancer right



and he he and his wife were really honest about their desire to remain

sexually intimate. I just want to ask you a couple questions about what that

journey was like for you

I know. You were wrestling with lots of different emotions. Christine when

richard was exploring cancer treatment. Tell me what you were thinking or they

anticipating that he would be unable to

have erections after the treatment. I was thinking that I loved him and it

it really didn’t matter, but I’m so

thankful that there was a way because I knew


would be harder for him

because. Then he wouldn’t feel like a man and he

didn’t want to have the cancer treatment

because he didn’t want to not have erections

and as his wife. I love him for who he is

and everything, but I’m I’m

extremely thankful for the penal implant. It’s like a game changer


I’m glad to hear that. So you came to quit pretty quickly after the

prostate cancer treatment. I think you

understood that, because the cancer was aggressive, the nerves had to be removed

at the time of the cancer therapy and

richard. You would struggle with some erectile dysfunction before prostate

cancer surgery, so you knew, or you were educated, that the pills like viagra

weren’t going to work any longer right. No, I think your surgeon referred you to

me to discuss some possibilities. Is that right? Yes, yes, he did yes

tell me what your thoughts were when we

had that discussion with you or with the doctor with me

with you

uh. Well I mean it was that was the only

option really was to get the implant I

mean, because the the surgeon he he laid it

right on the line that

more than likely. I would never get an erection


getting seeing you and getting the

implant, so I mean that was

it was the only thing to do. I mean it

was obvious. I mean I was a little nervous, especially when I found out you

were a woman. That’s fair! You got over that quickly. I see


but the way you’re, so professional, and I I just we

just love you. I mean you’re, just you’re the best. Thank you. I appreciate

that tell me what your experience with

the implant has been richard great

great. I mean

you’re pumping that’s ready, and

forever, how long you want it, and you were wrong on that. It doesn’t take a

minute, it takes me like 10, seconds

yeah, you’ve always been really quick with that

once. You learn to pump it. It’s it’s it’s

so, easy and deflated. It’s so easy too. I mean

so you’re, ready anytime. You want to be

right right right and you’re ready for hours if you want to be

yes. So that’s true, so the implant stays

erect, as long as you wish it to stay erect, which is really nice for timing

with. Your spouse, your partner right absolutely. And how do you feel about

sensation orgasm are those things

preserved? Are they? Are they normal for you

yeah, they’re, they’re, pretty much normal

I mean

you know I mean it’s a little different, but it’s it’s there. It’s all there the

feelings there he says but

but there, there’s no ejaculate that comes out once you have the penal

implant, which is nice because and it’s actually the prostate cancer

surgery that prevents you from

ejaculating with the orgasm

typically is preserved and so what

happens is. The implant is designed to treat the erectile dysfunction, but it

really makes no impact on sensation of the head of the penis or orgasm so we’re

careful about not promising certain things, but the implant allows you to be

fully erect and most men when they

regain erections do return to orgasm and sensation

that’s, that’s unchanged after the

implant. I would highly recommend it to any man

I mean

it’s. It’s a game. Changer I mean it

is, it really is

and. It’s like nobody. Nobody knows it’s not like anything. Where

Your. Your partner can see all everything that you’re doing it looks totally

normal feels totally normal

and like he can put it up and down, and I don’t even know

he’s subtle [Laughter]

there was a learning curve. People sure she’ll, give you a little


she’ll. Give you a little thing that has the mechanism, that’s in

there the little pump

and you can feel it, and when we went to the appointment dr katie thompson, put


pumped it up for him and then told him to practice and his first time he

got it up

and. He couldn’t figure out how to get it down. So I’m like okay, well, she did this

and. I showed him and

after that he was good. You got the hang of it fairly quickly. I

Would saw yeah. Yes, I did

well. I appreciate you coming on because it’s one thing for me to say: hey this is

a nice option for many folks, but to hear

a personal testimony, a couple that are willing to be frank and and

and real about this situation. That’s invaluable to us! So thank you so much

for, coming on, if you’re free to stay for questions at the end, that would be

really, lovely

okay sure, hey, you can go ahead and stop your video there and mute

and I’ll continue with the remaining

portion of the top okay

so. Let’s move on to talking a little bit

about stress, incontinence. Male stress, urinary incontinence is leakage of urine

usually with activity. This is certainly

far more common after prostate cancer surgery, but can occur with other

conditions. So we want to talk about

these option treatment options that may present some solutions for men with this


so. As we said stress, incontinence is leakage or urinary, incontinence, that

occurs, with movement laughing lifting

bending, it’s very common. Nearly one in 20 men have moderate to severe

incontinence of any kind meaning

sometimes, it’s not stress related. It might also be urge incontinence

associated with an urgency to get to the

bathroom and that’s complicated with bladder other bladder and prostate

issues we can address in consultation in the future

what. Is the job of the bladder while

it’s supposed to store urine until it’s socially convenient to empty urine exits


urethra and the sphincter muscles right. Here

These muscles help us surround the

urethra, help to control or maintain continence

that’s a muscle contraction, it’s under

your control in most cases when that sphincter muscle relaxes the urine is

able to exit. So as we

stated stress incontinence is quite

common. After prostate cancer surgery up to 50 percent of men do report leakage

immediately after surgery to remove the prostate, with cancer

up to 16 of men, have incontinence that last one year after treatment or more

than a year after treatment so

thankfully, we see a lot of men regain continence in the first year, after

treatment with pelvic floor exercises

and, sometimes with pelvic floor therapist and just time, but there are

patients that continue to struggle with

stress, incontinence a year or more after surgery. There are a few other disorders

that can lead to stress. Incontinence

Enlarged prostate surgery called a terp or a roto-rooter radiation, pelvic trauma

and, some neurologic disorders as you would. You would not be surprised

to hear the quality of life

significantly suffers with this disorder. If your social and relational challenges

occur as a result of stress incontinence, there are patients that struggle with

regaining sexual health because they’re

leaking during orgasm there are many men who are depressed because they not can’t

get back to their golf game or can’t get

back to normal exercise, because they’re leaking so much

so. There’s room for improvement in our treatment for for stress incontinence. There are approximately 70 000

prostatectomies performed each year

that’s again surgery for prostate cancer and, as you can see here during a

prostatectomy, the bladder is removed. The

Prostate is removed, separated from the bladder and the urethra

and. The urinary sphincter is right, here

towards the end to the the distal end of the prostate. So when it’s removed some

of the nerves are impact. Impaired or

impacted and the muscle that allows for continent is also

impacted that may improve upon the leakage we ask

you not to drink too much. Of course stay

hydrated, but don’t drink, don’t over drink, fluids

take time to go to the bathroom

regularly to keep the bladder as empty

as possible pelvic floor physical therapy, either at home or with a trained

therapist, has been shown to improve

continence in the first year, maybe two years, and there are some coping

mechanisms pads, diapers, catheters or penile clamps that help to control

to some degree. The leakage coping solutions can be expensive, and

become a nuisance. You can imagine. That

Some of patients suffer from a smell associated with prolonged incontinence

or, large volume, incontinence, catheters

are, uncomfortable in a penile clamp, which is just what it sounds like. It’s a

clamp that sits on the penis to try to

hold back the urine. It has to be moved often just to allow the penis to be



avoid injury. There are some long-term solutions, we

want to review for you today, the

advanced male sling and the artificial urinary sphincter are treatment. Options

That we might pursue for men who

continue to leak urine after prostate cancer. Surgery

The male sling will discuss first, it’s a

mesh hammock that sits under the urethra. It’s placed in a surgically, it’s placed

surgically in an outpace of outpatient

surgery and it’s undetectable to others. So it’s entirely concealed in the

genital area it has the highest success

for men with mild to moderate stress, incontinence and most patients are

continent immediately following the

procedure, so many men wake up and hey I’m dry doc. This is really a godsend. It

Does operate on on its own. It doesn’t require any pumping, for

men to

be continent

and, a high rate of satisfaction, 92 percent of men would undergo the

procedure. Again

This is just this

image to reveal to you how this works. It’s a mesh hammock! That’s placed under

the urethra to pull up on the urethra and reposition the urethra deeper in the

pelvis. So there is a form of compression to pull the urethra closed and up. Up


94 of men would recommend the sling procedure to a friend. This works best

again for men with mild, to moderate stress, incontinence for men that are

wearing one to three pads a day. Let’s move on to discuss the artificial

urinary sphincter. This is the gold

standard treatment for treatment of larger volume. Stress incontinence, this

has been around for many decades, and

works very effectively to cure men with urinary leakage

it’s proven to be discrete and effective, it’s undetectable to others and it

mimics a healthy urethra. So it actually

stays closed. All the time until a man pumps a device, a pump in the scrot to

open up the urethra here you’ll see that the inflated cuff

this is again placed in a outpatient surgery about 45 minutes to an hour

patients go home. The same day

and, the cuff works by being filled with fluid at all times. So this stays filled

with fluid around the urethra at all

times. When you pump the pump in the scrot fluid moves away from the

urethra into the reservoir or the

pressure regulating balloon to allow for urine to come out, and then the cuff

automatically reinflates. So you’ll see a little bit more about this in this video entirely, concealed in the genital area

there’s, a pump that sits on the side, of

the scrot and the cuff sits around the urethra

when, the man pumps, the device fluid

moves away from the cuff, into the pressure regulating balloon, to

open up the urethra, urine flows, out

naturally and then automatically re-inflates to close off the leakage or

close off the continents. As we discussed it is an outpatient

surgery go home. The same day, there’s two

small incisions made under the scrot for the cuff placement and in the lower

abdomen or the lower belly for the

reservoir, or the pressure regulating balloon. After a few days, patients can

return to some non-strenuous activities

but. We do want you to wait at least four to six weeks before being aggressively

active or exercising, and also we we do want it to heal correctly before we

activate it or turn it on. If you will it’s hard to beat the the success rates

for, the artificial urinary sphincter 95 of patients are satisfied with the

device and a high number of patients

recommended to others. So this is the real winner for patients that have

leaked quite a bit of urine after the

prostatectomy and are looking for a solution that allows them to be dry


insurance. Coverage does vary, but the majority of insurers do cover

treatments for stress, incontinence. And

We do have resources to help find that answer for you

in summary, I think there’s some good options available to help achieve

continence to allow you to urinate when

it’s desired, not when it’s socially inconvenient. These are all very subtle

treatments, are undetectable to others and have very high satisfaction. Rates

You. Can you can appreciate that many patients with prostate cancer feel like

cancer has stolen much of their life

we want to be able to provide a way back to normalcy

there? Are some risks involved with any surgery, not every patient’s, a candidate

for, these therapies? With regards to the

male sling? There are a few side effects that could be seen: device failure just

that it may not work, especially for men

with higher volume, incontinence, urinary retention or difficulty urinating while

that’s, not common, it can’t happen. What

We’re trying to do is pull the urethra tighter and up into the pelvic floor. So

Some men have difficulty urinating

typically, that’s short-lived, but it may last a few weeks or may need to be

addressed in a different manner

post-operative pain and irritation of the one side we don’t see

much of a foreign body response but

that’s something that’s listed here as for side effects with the artificial

urinary sphincter

device malfunction or failure can occur. We know that this device doesn’t last

forever. Many patients within the first

seven to ten years do need some sort of replacement or revision surgery. Because

Over time the cuff holds the urethra closed and can thin the urethra and just

be less effective

the. Other thing that can occur is erosion of the urethra. This is something

we, do our best to avoid by techniques

but. We rarely see the pressure of the cuff

creating a hole on there you’re in the urethra, so we want to avoid that there’s

some techniques we use to try to avoid


urinary retention would be uncommon but possible an infection of the device is

uncommon but possible. So in conclusion, stress, incontinence, is

a, known side effect of prostate cancer

treatment. There are some treatment options that are ultimately very

successful the short-term options are

limited, but they can certainly be helpful in the first year after

prostatectomy and the sling or the

artificial sphincter could offer a long-term solution. So if you want some

more information

go ahead and take a look at and we’ll move on here, a lot of our references referring to

what, we discussed tonight

and we’re complete. Thank you so much for attending our webinar tonight we look

forward to discussing more in the future

if you’d, like a personal consultation, to discuss your individual concerns

regarding sexual or urinary health. Please give us a call: here’s the number

and to hear more about my practice my

approach to patients and to hear some of our radio programs or past radio

programs. Take a look at restorative, you can also use this scan. Take your

phone and use the camera function, to

scan this qr code to pull up my website, we’re going to move on to some questions

and answers. Thank you again, for

attending and I hope you’ll save up your questions for me. Kara thank you for

supporting us tonight and I’m going to stephen

hi yeah. That was great. Thank you. So much


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