These comments are made for the purpose of discussion and should NOT be used as recommendations for or against therapies or other treatments. An individual patient is always advised to consult their own physician.
Prostate Cancer
Question: Doctor, why is it that you have to wait from six months to a year before you’re able to have sex after a radical prostatectomy. I feel great and have the desire but nothing happens. I also had the nerve-sparing surgery and it went fine.
Answer: Six months. One year is longer than most urologists recommend. Usually 3 is the
average. Although the nerve sparing surgery preserves a higher frequency of potency, it is
not 100%. Usually patients will have at least nocturnal erections if the function is adequate.
Also, there is often delayed healing. When there is pressure there are minor amounts of swelling and damage, in spite of the “nerve sparing”. This takes a while to heal, sometimes a year.
Prostate – Fluid Retention
Question: Could Tylenol PM cause fluid retention in a 77 year old male
having the usual nocturia 3-4 times until recently, now 0-1?
Answer: Tylenol will have no effect on the prostate, but the PM part will. The PM part is an
antihistamine to promote sleepiness. However, it has the effect of interfering with the outlet
muscle of the bladder (bladder sphincter). Any antihistamine will have this effect and it
should clear within 1-2 days of stopping the medication.
BPH – Saw Palmetto
Question: Do you have any recent reliable information on use of Saw Palmetto/pygeum in treatment of BPH? It seems to be better than Hytrin.
Answer: Several of my patients have tried this and swear by it. I can’t find any research done comparing the effectiveness of this with any prescription medication. However, I also can’t find any particular toxicity. My current feeling is to try it, and if it works, keep with it. It’s not like medicine has particularly good alternatives.
Prostate Infection
Question:I have had prostate infections in the past and believe I may have a current infection. I am experiencing the feeling that I have to urinate very frequently. No pain or discharge. Has been going on for several days now. Should I wait and see if this goes away or see a doctor soon?
Answer: Prostate infections in men are very common and somewhat difficult to clear up. The bacteria which causes the infection usually comes from the colon and is a “gram negative”. The prostate is very cavernous with many places for bacteria to “hide”. This usually takes antihiotics-sometimes for a protracted course. Some people have recommended oral zinc replacement for recurrent infections. Controlled studies have not shown this to be very helpful; but, I do have some patients who think it helps recurrent infections.
