The second type of prostate operation is done when a man has cancer of the prostate. Called a radical prostatectomy, this procedure involves the removal of the entire prostate and the seminal vesicles, always through an incision in the body. It’s much more common for crucial nerves to be injured during this type of procedure. Because surgeons have now identified the exact location of these nerves, however, new methods have been developed to save them, and the odds that potency will be maintained are much better. Using these new techniques, popularized by Patrick C. Walsh, M.D., Chairman of the Department of Urology at Johns Hopkins University, the surgeon can preserve the nerves next to the prostate that control erection. The results are striking: One year after having their prostates removed, 86 percent of men who were potent before surgery retained their ability to get an erection. Previously, the vast majority of men who had such surgery were physically incapable of getting an erection. It does take some time to regain potency following prostate surgery; less than a third of the men were potent after just three months, but after nine months about 60 percent had regained potency. Younger patients were faster to recover their erectile abilities, and the smaller the cancer, the better the odds for preserving the nerves and the ability to get an erection. The nerve-sparing technique is now widely known, and any man contemplating prostate surgery should discuss the methods to be used with his doctor.


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