There are amazing benefits to robotic prostatectomy. The incisions are much smaller, so healing time is faster and length of stay is minimized. There tend to be fewer complications after the procedures and the success rate is at least as good as open/laoaroscopic surgery, if not better.

However, two more (important) claims made about the benefits of robotic prostatectomy have undergone scrutiny recently. The first is urinary function, and the second is sexual function, both major concerns by men who have had prostate surgery.

A recent study done this week that surveyed men who had prostate surgery of some kind between August 2008 and December 2008 compiled results on this very subject, to compare the results over time for those who had either robotic or open surgery.

Completed surveys were collected from 685 men who had either had robotic or open prostatectomy. The study concluded that the risks of problems with both urinary function and erectile function are high after both of the procedures.

So does this survey demonstrate that robotic prostate surgery a lot of over-marketed hype? I don’t think so. If the robotic-assisted procedure is less invasive, heals faster, and is at least as good as the other forms of radical prostatectomy at recovery for both urinary and sexual health, it seems to me it is the superior option. However, the claim of superior recovery for urinary and sexual health are claims made by the proponents of robotic prostatectomy.

As a patient, an individual needs to discuss the options with their doctor to make the decision about what would be best to them for their particular condition. And while that decision may be robotic prosatectomy, as it stands it should be made with the consideration that improvement of urinary/sexual function over more traditional surgery methods may not be all they’re said to be.

An Abstract of this Study, published online Jan 3, 2012: http://jco.ascopubs.org/content/early/2012/01/03/JCO.2011.36.8621.abstract?sid=aad92c9d-7bb3-49ed-be5f-645917c7b9fb

The study worked like this: 369 men aged 45 years and older (61 years average) were given a one day’s dose worth of saw palmetto or a placebo sugar pill that looked identical. Over the course of 17 months, the men taking the saw palmetto had an increased dosage of 320mg the first 24 weeks, 640mg the second 24 weeks, and 960mg the final 24 weeks.

At the very end of the study, the men on the extract reported an average drop in their American Urological Assn. Symptom Index (AUASI) of 2.2 points; those on the placebo? 2.99 points. On a percentage basis, 1.8% more men on the placebo saw signs of benefit.

The benefits of Saw Palmetto have been touted since ancient times as both a nutritious food and to treat urinary and reproductive problems. In the 19th century, it was believed to treat respiratory conditions like whooping cough and tubercular laryngitis. And in modern times, it is used as alternative medicine to improve urinary condition in older men with benign prostatic hyperplasia (enlarged prostate). Over two million men in the United States, and millions more in Europe, take the supplement daily to relieve a swollen prostate, and the US market alone is worth $125 million.

In 2006, a study found the supplement ineffective to reduce BPH, but its effects on urinary incontinence were still in question. Until now, the most recent study in 2009 suggested that Saw Palmetto provides mild to moderate improvement in urinary treatment, but those claims have also been brought into question again with this latest study.

Sources: Bloomberg – LA Times

Prostate cancer treatments are also often a cause of impotence, either temporarily or permanently, so naturally we have a vested interest in both the condition and its treatments. Over the years, Overcome Impotence has written numerous articles about the subject; so today, I would like to recap some of what we have covered over the years:

• New Genetic Research Increases Accuracy of Identifying Fatal Prostate Tumors
• Common Alternative Therapies for Prostate Cancer
• Prostate Cancer and the Quality of Life
• Research Shows Low-risk Prostate Cancer is Often Overblown
• Is Prostate Cancer a Thing of the Past? Treatment Boasts 100% Effectiveness
• Gene Link to Aggressive Prostate Cancer Found
• Talk with your Doctor about Prostate Health

Treatment and Tips

There are lots of ways to treat erectile dysfunction, caused by prostate cancer or otherwise. Doctors are careful to evaluate an individual’s specific health needs before making recommendations, which tend to start from least risk to most risk: lifestyle changes, drugs, injections, or surgeries. Here are a couple articles we’ve written about ED Aids:

• Tips to Prevent Erectile Dysfunction
• Penile Rehabilitation with Vacuum Therapy

As always, we encourage you to get evaluated. Early diagnosis gives both you and your doctors the most options in treating prostate cancer to live better and live longer. Many organizations recommend to start getting checked in your 50′s, some as early as your 40′s. If you’re there, make a note this month to get examined. It could be one of the best decisions you’ve ever made for yourself.

Are you on Medicare? Your Screening is Probably Covered

Did you know Medicare provides preventative screenings for prostate cancer? If you’re on Medicare and you haven’t been evaluated, here are some links to get more information:

• Prostate Cancer Awareness Month Website
• The Guide to Medicare Preventative Services (PDF) – See Chapter 12 about Prostate Screenings
• Medicare Preventative Services Quick Reference Chart (PDF)

Common, very day aspirin, categorized as an NSAID (non-steroidal anti-inflammatory drug) has been used for over a century to treat headaches, pain, prevention of heart attacks, act as a blood thinner and more.

Surprising new research is suggesting a correlation between regular, low dosage aspiring use and erectile dysfunction in men aged 55 and up.

The study followed 80,000 men aged between 45 and 69 and their usage of NSAIDS. They found that men who took NSAIDS, like aspiring, three times per day were more than 2 times more likely to have erectile dysfunction compared to men who do not take it regularly.

Researchers, who recently published their findings in The Journal of Urology, were actually expecting to see an opposite result, where aspisin was protecting men with heart disease from erectile dysfunction. It is known that erectile dysfunction is often closely linked to heart disease. And aspirin has been proven many times to be useful in regular, low dosage to prevent heart disease or other conditions.

Of course, there are many benefits of taking NSAIDS, and the study is not to suggest that men stop taking them. It is not yet clear what elements are causing the increased risk of ED among these men; more observations must be done to find an exact link.

Here is an abstract of the study in the Journal of Urology.

A 92 percent accuracy rating, when combined with standard prostate tests, is a massive leap in pinpointing fatal tumors over previous diagnostics, which are at best 75 percent accurate, according to Dr. Ronald DePinho.

Prostate cancer is unique in that many prostate cancers may never become fatal for an individual. But, the potential for a life-threatening prostate cancer (the risk assessed by a doctor) must lean towards the safe side, forcing many man into serious surgical or therapy decisions that can lead to both impotence and incontinence.

The better the accuracy in testing, the better chances of saving men from getting harsh, unnecessary treatment for a cancer that may have never killed them in the first place. Dr. Depinho estimates that about 48 men must be treated for prostate cancer in order to save one life.

DePinho and his team of researchers identified a gene, known as Smad4, that slows cancer growth. Alternately, they found the genes that were key to driving growth of cancerous tumors: SPP1 and CyclinD1 – both of which work closely with Smad4.

Prostate cancer is a very common cancer among men 50+, the second most common cancer in men after lung cancer.

Source: http://www.reuters.com/article/2011/02/02/us-cancer-prostate-idUSTRE7117X520110202

The Osbon Erecaid Pump

The Osbon Erecaid pump comes in a Manual version and an Automatic version. The Manual version uses a squeezable hand grip to apply vacuum pressure. The Automatic version runs on 3 AA batteries and has a simple push-button operation. However, apart from the vacuum operation, the devices operate almost entirely identical to each other.

The design is tried-and-tested and many doctors often recommend Osbon Erecaid with a prescription to men who may have ED issues but either cannot or do not want to use drugs or other, potentially more invasive treatments. A good design coupled with a lifetime warranty on the main components (er… NOT the tension rings) makes Osbon Erecaid a reliable solution for most men.

Tension Rings

Osbon Erecaid rings are popular for their “v-notch” system, which is anatomically designed to provide the right amount of pressure to the right areas on the penis to restrict blood flow while providing the comfort needed for both partners during intercourse. The grips on either side of the ring are designed to make applying and removing the ring easier.

There are two versions of Erecaid rings, both which come in a number of sizes and tension levels. The Standard ring comes in both “Medium” and “Large” and multiple levels of tension (designated by the color of the ring). The Standard rings are beige, and the high tension rings are Pink.

Also available is the SurErec ring, which has the same V-notch hole for the penis but features a wider ring design made especially for men who may have problems with the scrotal tissue being pulled into the vacuum pump cylinder while in use.

It’s been noted as a common issue that the Osbon Erecaid rings often get weak and snap more often compared to thicker, less conformable rings. And at $17.45, they’re not a relatively cheap replacement. But, regardless, most users of the Osbon system feel it’s still worth it and many still prefer the Osbon rings over the competition.

PROS of the Osbon Erecaid Vacuum Therapy System:

• Anatomically designed tension rings in many sizes and tension levels.
• High quality design and function.
• Fits comfortably in one hand.
• Lifetime warranty on components, 90 day return policy with the manufacturer.
• Instructions are extremely easy to understand.
  • - How to use Osbon Erecaid

CONS of the Osbon Erecaid Vacuum Therapy System:

• The rings must be carefully applied to avoid snapping.
• The manual pump design can be tough on weak hands.
• For those less endowed, the scrotal tissue can get sucked into the cylinder. (This problem is often alleviated with the use of the newer, wider SurErec rings.)

While doctors will recommend surgery and/or radiation therapy for life-threatening cases, they often come with nasty urological and sexual side effects that can last for years.

But all hope is not lost! Men with prostate troubles, including the issues of post-surgery and post-radiation therapy for prostate cancer, can still take steps to improve both their sexual and urological health. Here are some options for you to research and look into:

Saw Palmetto – An herb that helps prevent production of DHT (which aids the development of prostate cancer). Saw Palmetto can help prevent enlargement and inflammation of the prostate.

Zinc – It is recommended for good prostate health to have a daily dose of zinc, which can be found in oysters, wheat germ, low fat roast beef, pumpkin seeds, chocolate, lamb, and peanuts.

Lycopene – With its antioxidant properties, studies have shown are good for the prostate and can even reverse the malignant process. Lycopene comes from tomatoes (tomatoes and tomato sauce are great foods for the male diet for this reason), and men who have tomatoes in their diet tend to have less risk of Prostate Cancer.

Pomegranate Juice – While not officially proven, pomegranate juice has been researched, and the tests show that drinking one glass a day can considerably drop PSA (prostate-specific antigen) levels nearly four times those who do not. The stabilizing of PSA levels can allow aging men to live far longer.

Chinese Herbal Medicines – Many of those who suffer from Prostate issues try Chinese herbal remedies, but beware – many of the new products found in stores for “impotency treatment” have been discovered to illegally contain pharmaceuticals like Viagra and Cialis in an attempt to falsely prove effectiveness for sexual issues.

Be sure you are purchasing authentic Chinese medicines and not falsely advertised products!

Here is a reference for more information on Chinese treatments for prostate cancer: http://www.prostatitis.org/chinesepills.html

Ayurveda Medicine - Another complementary/alternative treatment with roots in India.

Some of the popular herbs in Ayurveda prostate treatment are:

• Hog Weed – for the treatment of urinary problems caused by prostate-related issues.
• Prickly Lettuce – Effective for enlarged prostates.
• Small Caltrop – Used to aid the urinary problems caused by prostate-related issues.

Some popular dietary suggestions: Eat more zinc, eat less sour and friend foods to relieve pressure on the prostate. Also recommended are milk, butter, juniper berries, and garlic.

Also recommended: Alternate cold and hot baths for 10 minutes a day. Regular sex and regular walks also help. Avoid alcohol and cigarettes.

Bioelectric Therapy – This therapy is a safe, drug-free alternative for those experiencing pain. It works effectively by blocking messages to the brain that cause the pain with small concentrated electrical pulses using electrode pads.

3,300 men between 40 and 79 were interviewed and studied for low male hormone levels and had the symptoms of male menopause. Only 9 men out of the 3,300 interviewed were discovered to have the the lack of sex drive, lack of energy, inactivity, and sadness combined with low hormone levels as an indicator.

The low hormones and menopause like symptoms (which is determined to only affect about 2% of all men), is most commonly linked with poor health and obesity.

As a result of this study, it’s now known that testosterone treatment may only be helpful in a very few, select cases.

Finasteride, which has been proven to increase hair count and thickness, is helpful for most men, who are reporting a 30 percent increase in hair growth within the first two years. It works by blocking the enzymes that change testosterone into dihydrotestosterone, which is the hormone responsible for hair loss.

But this comes with a costly side effect for 1 in 80 men, one with recent studies showing 2% experience erectile dysfunction as a result of taking finasteride. Hair loss effects half of the men over 50. And while sexual dysfunction is uncommon from finasteride use, ceasing to take it for hair growth is a likely first step recommended by physicians to combat any resulting sexual side effects.

Sure enough, this has not deterred men from taking finasteride, even the ones with sexual dysfunction as a result. Proof of 2 percent incidence among patients is really a drop in the bucket when measuring against the consensus of users; but could there be more with an extended study of long-term affects?

Despite the new research, most dermatologists feel that finasteride is safe and extremely effective for their patients.

1. Over 60% had received radical prostatectomy or total removal of the prostate gland.
2. 17% had been treated with radioactive implants.
3. 12% had been treated with external radioactive therapy.
4. 6% received both forms of radiation treatment.
5. 5% were treated with hormone-blocking medications.

The major side effects of these treatments are urinary function and sexual dysfunction. How do these treatments size up with their common side effects?

Urinary Function
Of all men who received surgery and radioactive treatments, nearly all of them experienced urological issues like incontinence. These symptoms became worse in the first year, but improved in the second year, but never back to the level of continence before surgery.

With hormone-blocking medications, men tended to get worse over a period of four years. Researchers attribute this to the degradation of the pubic muscles that control urological function.

Sexual Function

All of the surgical and radiation treatments affect sexual function to some degree in all men during the first year after treatment. But after Year One, surgery patients generally improved within the second year, with no improvement seen in patients with other treatments. As a whole, the study group showed no real difference in sexual function.

Scope of Prostate Cancer

Prostate cancer is quite common among aging men. New research has debated the usefulness of regular prostate screenings, and most argue only men over 50 need screenings.

Many men refuse to undergo surgery or radiation therapy because of the urological and sexual side effects, or rely solely on alternative prostate cancer treatments. Those who do often use techniques such as penile rehabilitation with vacuum therapy devices such as Osbon Erecaid and Osbon rings or competitive options like Erec-Tech. (See the Overcome Impotence Erec-Tech Product Review)

While alternative treatments for prostate cancer are useful in lieu of conventional treatments, it’s important to make wise health decisions on your long-term health. Surgery or radiation therapy is indeed a life-changing event, but it can also save lives.

Find more about this in the Journal of Urology