00:00Hello there! We're approaching the end of the month. We're now talking a lot more about prostate
00:06cancer and its associations with sexual dysfunction. And on this occasion, we're
00:11going to talk about prostate cancer. Will it cause erectile dysfunction?
00:22In fact, prostate cancer itself doesn't directly cause erectile dysfunction unless
00:29the cancer itself is highly invasive and involves the neurovascular bundle. So when that neurovascular
00:38bundle which is next to the prostate supplying the penis is affected, then men who has got late
00:43stage prostate cancer will get erectile dysfunction. But just the thought of getting prostate cancer or
00:50dealing with prostate cancer treatment actually will send a lot of anxiety and depression to
00:55patient that itself might indirectly cause erectile dysfunction. But what we know is the treatment
01:02of prostate cancer definitely will impact on the actual erection. Number one is a radical prostatectomy.
01:11Radical prostatectomy means that removal of the whole prostate because of cancer such as done by
01:17Li Xianlong. When this is done, we need to preserve the nerve and also the vessels called neurovascular
01:24bundle towards the supply of the penis. However, a lot of the older generation operation cannot preserve
01:33that. So many men may have up to 80 or 90 percent risk of getting erectile dysfunction after radical
01:40prostatectomy. But mind you, the latest technology such as robotic radical prostatectomy itself actually has
01:48higher chance of preserving neurovascular bundle. For men who undergo robotic surgery, the chances of
01:56getting erectile dysfunction is significantly less. The other type of treatment is radiotherapy. Radiotherapy
02:03can come in a form of internal radiotherapy which is brachytherapy and external beam radiation. Both of them
02:11are known to destroy the actual neurovascular bundle. Although some of them might recover, but
02:19even if they recover, the degree of erection is significantly reduced. And lastly, men who has got
02:27metastatic prostate cancer tends to require hormonal treatment. That itself doesn't only suppress
02:34testosterone and libido. It also suppress erectile rigidity. So, is there a treatment? Yes, there is.
02:42The blue pill aren't also equivalent of PDE5 inhibitors such as sidenafil, tadalafil, verdanafil,
02:50eudanafil and all the danafil actually will help to perfuse the penis. Although it might take a while,
02:58but most men will have a recovery of their erectile function after treatment. For the following week,
03:05we are approaching month of October. October obviously is the pink October month. And we want to deal with
03:13various conditions that affect breasts. But on this occasion, we're going to talk about men's breasts.
03:19So, one of the things we talked about before, which is man boobs or gynecomastia. And on this occasion,
03:26we're going to talk about what are the treatments that's available in order to resolve the man boobs.
03:32Stay tuned for next week's Putting Dr. G on the Spot.
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