EP293: The factor of prostatic neurovascular bundle | PUTTING DR G ON THE SPOT - video Dailymotion

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Consultant urologist Dr George Lee Eng Geap, or a.k.a Dr G, explains how crucial is the prostatic neurovascular bundle in determining whether one will experience erectile dysfunction when undergoing treatment for prostate cancer.  WATCH MORE: https://thestartv.com/c/news SUBSCRIBE: https://cutt.ly/TheStar LIKE: https://fb.com/TheStarOnline

Transcript

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.

EP293: The factor of prostatic neurovascular bundle | PUTTING DR G ON THE SPOT

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