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Surgery is the “gold standard” treatment for BPH symptoms. In 95 percent of men, it can be accomplished in a minimally invasive way— without an incision—in a procedure called transurethral resection of the prostate (TUR). The TUR is safe, effective, and has few side effects. If your prostate is very large, however, you may need [...]

Impotence has been reported in as many as 10 percent of men after a TUR, but this is the most difficult to document of all the postsurgical complications. In some older men, impotence just develops spontaneously, whether or not they’ve had surgery. And there are so many variables to consider—self-consciousness; the presence or absence of [...]

Men who are impotent after prostatectomy or radiation therapy have normal sensation, normal sex drive and can achieve a normal orgasm. Their only trouble may be in achieving or maintaining an erection—that’s the bad news. The good news is that this is a problem that can always be treated. Why does impotence occur? There are [...]

If adrenal androgens really were the key to fighting prostate cancer, flutamide should produce a dramatic improvement in men who were castrated, took estrogen or an LHRH agonist and then had a relapse. This just isn’t the case. Sadly, what happens for these men is that beginning total androgen blockade has very little effect—again, suggesting [...]

There are many variations, but the basic means of access is the transperineal approach, reaching the prostate through the perineum, the area between the scrotum and rectum. Before beginning interstitial brachytherapy, you should undergo an extensive physical examination and a cystoscopy to evaluate your particular anatomy and make sure the cancer is contained within the [...]