When an enlarged prostate causes symptoms of incomplete bladder emptying, the blockage must be relieved. This is usually done by surgery through the abdomen or through the penis (transurethral resection, or TURP). Even very elderly men can usually withstand prostate surgery that is done through the penis. Your age should not deter you from having TURP surgery. It is not a difficult procedure, and it is usually successful in relieving symptoms. In very frail individuals, it can be done with a spinal anesthetic. Sometimes a complete removal of the prostate is necessary. This is a major operation, but if required it should be done.
Rarely do problems arise after a transurethral resection. You may temporarily lose some control of your urine, but this is usually not permanent unless a neurological problem was present before surgery. There is usually no significant interference with sexual abilities. Your sexual capabilities may improve, because the excess pressure in the bladder and kidneys may have interfered with normal sexual function. Sometimes, however, sexual function may not be satisfactory after prostate surgery.
In the case of a malignant tumor, if your prostate gland is removed while the tumor is small, the malignancy may not have spread. If the tumor has already expanded, surgical removal of the testicles, which eliminates the male hormones that the tumor needs for growth, can halt its progress. Various medications, including female hormones, are often also helpful. Radiation to the prostate or to painful areas of invaded bone are sometimes useful. The malignancy may take years to progress if it is treated energetically. You can often enjoy years of comfort and health with proper medical management
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