My Penis Stuff

What is rye grass pollen extract?

Rye grass pollen extract comes from the pollen of rye grass (Secale cereale).

Rye grass pollen extract may affect the male hormone testosterone, relax the muscles of the tube through which urine flows (urethra), and improve how well the bladder can force urine out. All of these may reduce symptoms of an enlarged prostate, such as dribbling after urinating or having to get up several times at night to urinate.

What is rye grass pollen extract used for?

People use rye grass pollen extract to relieve the symptoms of noncancerous enlarged prostate (benign prostatic hyperplasia, or BPH). Some research reports that men who use rye grass pollen extracts say their symptoms have improved and that they get up fewer times at night to urinate. But there is very little research on this.

Is rye grass pollen extract safe?

Researchers have not evaluated rye grass pollen extract for long-term effectiveness, safety, or its ability to prevent complications of BPH.

Men who have problems urinating should see a doctor to rule out prostate cancer. Prostate cancer is treatable, but treatment may be more successful when you find and treat the cancer as early as possible.

The U.S. Food and Drug Administration (FDA) does not regulate dietary supplements in the same way it regulates medication. A dietary supplement can be sold with limited or no research on how well it works.

Always tell your doctor if you are using a dietary supplement or if you are thinking about combining a dietary supplement with your conventional medical treatment. It may not be safe to forgo your conventional medical treatment and rely only on a dietary supplement. This is especially important for women who are pregnant or breast-feeding.

When using dietary supplements, keep in mind the following:

• Like conventional medicines, dietary supplements may cause side effects, trigger allergic reactions, or interact with prescription and nonprescription medicines or other supplements you might be taking. A side effect or interaction with another medicine or supplement may make other health conditions worse.
• Dietary supplements may not be standardized in their manufacturing. This means that how well they work or any side effects they cause may differ among brands or even within different lots of the same brand. The form you buy in health food or grocery stores may not be the same as the form used in research.
• The long-term effects of most dietary supplements, other than vitamins and minerals, are not known. Many dietary supplements are not used long-term.

A radical prostatectomy is an operation to remove the prostate gland and some of the tissue around it. It is done to remove prostate cancer. This operation may be done by open surgery or by laparoscopic surgery through small incisions.

Laparoscopic surgery is most often done by hand. A few doctors now do it by guiding robotic arms that hold the surgery tools. This is called robot-assisted prostatectomy.

Open surgery

In open surgery, the surgeon uses an incision to reach the prostate gland. Depending on the case, the incision is made either in the lower belly or in the groin between the anus and the penis.

When the incision is made in the lower belly, it is called the retropubic approach. A radical prostatectomy using the retropubic approach is the most common treatment for prostate cancer. In this procedure, the surgeon may also remove lymph nodes in the area so that they can be tested for cancer.

When the incision is made in the groin, it is called the perineal approach. The recovery time after this surgery may be shorter than with the retropubic approach. If the surgeon wants to remove lymph nodes for testing, he or she must make a separate incision. If the lymph nodes are believed to be free of cancer based on the grade of the cancer and results of the PSA test, the surgeon may skip the lymph node removal.

Laparoscopic surgery

For laparoscopic surgery, the surgeon makes several small incisions in the belly. A lighted viewing instrument called a laparoscope is inserted into one of the incisions. The surgeon uses special instruments to reach and remove the prostate through the other incisions.

Men who have laparoscopic surgery tend to lose less blood during the operation and to recover faster than men who have open surgery. Laparoscopic prostatectomy is not yet widely available, and because it is a relatively new technique, no results from long-term follow-up after treatment are available.

The main goal of either type of surgery is to remove all the cancer. Sometimes that means removing the prostate as well as the tissues around it, including a set of nerves to the penis that affect the man’s ability to have an erection. Some tumors can be removed using a nerve-sparing technique, which means carefully cutting around those nerves to leave them intact. Nerve-sparing surgery sometimes preserves the man’s ability to have an erection.

What To Expect After Surgery

Prostatectomy usually requires general anesthesia and a hospital stay of 2 to 4 days. A thin, flexible tube called a catheter usually is left in your bladder to drain your urine for 1 to 3 weeks. Your doctor will give you instructions about how to care for your catheter at home. Bladder control can be poor for a few months after the catheter is removed.

Although prostatectomy often removes all cancer cells, it is important to receive follow-up care, which may lead to early identification and treatment if your cancer comes back. Your regular follow-up program may include:

• Physical exams.
• Prostate-specific antigen (PSA) tests, to monitor PSA levels and to measure the speed of any changes in those levels.
• Digital rectal exams.
• Biopsies as needed, to examine suspicious tissue.

Why It Is Done

Radical prostatectomy is most often used if testing shows that the cancer has not spread outside the prostate (stages I and II).

Although radical prostatectomy is occasionally used to relieve urinary obstruction in men with more advanced (stage III) cancer, a different operation, called a transurethral resection of the prostate (TURP), is most often used for that purpose. Surgery usually is not considered a cure for advanced cancer, but it can help relieve symptoms.

How Well It Works

Radical prostatectomy is generally effective in treating prostate cancer that has not spread. This is called early-stage cancer. Following surgery, the stage of the cancer can be determined based on how far it has spread. PSA levels will drop almost to zero if the surgery successfully removes the cancer and the cancer has not spread. If cancer has spread, advanced cancer may develop even after the prostate has been removed.

Compared with watchful waiting for early-stage cancer, radical prostatectomy lowers the risk that the cancer will grow or spread. And it lowers the long-term risks of death from cancer. This is important to know if you expect to live 10 or more years. (If you are already in poor health or are in your later years and you have an early-stage prostate cancer, it may not grow or spread during your lifetime.)

Risks

Erection problems

Up to 80% of men experience erection problems after a prostatectomy. The nerves that control a man’s ability to have an erection lie next to the prostate gland. They often are damaged or removed during surgery. In the months and years after surgery, most men who had erection problems after prostatectomy are able to regain their ability to have erections:

• 76% of men younger than 60
• 56% of men age 60 to 65
• 47% of men older than 65

Recovery depends on:⁵

• Whether the man was able to have an erection before surgery.
• How the surgery affected the nerves that control erections.
• How old the man was at the time of surgery.

Urinary incontinence

Up to half of all men who have a radical prostatectomy develop urinary incontinence, ranging from a need to wear urinary incontinence pads to occasional dribbling. Studies show that one year later, between 15% and 50% of men report urinary problems.

The urethra—the tube that carries urine from your bladder—runs through the middle of the doughnut-shaped prostate gland. In order to remove the prostate, the surgeon must cut the urethra and later reconnect it to the bladder. Evidence shows that the greater the surgeon’s experience and skill in making this reconnection, the lower the rate of incontinence.

Some men may require treatment for incontinence after prostatectomy, if urinary leakage continues longer than 1 year.

Complications

Radical prostatectomy is major surgery, so it carries the same general risks as other major operations, including heart problems, blood clots, allergic reaction to anesthesia, blood loss, and infection of the wound.

These additional complications can be caused by radical prostatectomy:

• Erection problems
• Urinary incontinence
• Damage to the urethra
• Damage to the rectum

What To Think About

A surgeon who is new to laparoscopy can take 80 to 100 surgeries before mastering prostatectomy. Before choosing the surgeon and type of surgery you will have, look for a surgeon with the most experience and surgery success. This can help lower your risks of problems after surgery.

When considering prostatectomy, take into account your personal wishes, age, other medical conditions you may have, the stage and grade of your cancer, and your PSA level. Radiation treatment or watching and waiting may be reasonable alternatives.

Robot-assisted prostatectomy may be best suited to a younger man in good health with a small prostate and a small, lower-grade cancer. This technology is not yet widely used.

Surgery may completely remove your prostate cancer. However, it is not possible to know ahead of time whether the cancer has spread beyond the prostate and is not curable with surgery alone.

Prostate cancer often spreads to the nerves that surround the prostate. These nerves control a man’s ability to have an erection. When the nerves are removed along with the cancer, the man will most likely have erection problems. A nerve graft sometimes may be done to reduce this chance. For this, the surgeon removes part of a nerve that goes down the back of the leg and attaches it to the nerves where the prostate gland was. This surgery seems to be helpful for some men, but not for all. More research is needed to see how well this surgery works to preserve the man’s ability to have an erection.

Orchiectomy is the removal of one or both testicles (testes). The testicles are the male sex organs that produce sperm and the male hormone, testosterone.

An orchiectomy is a common treatment for testicular cancer. It may also be done to treat other conditions such as prostate cancer or in the event of severe trauma to one or both testes.

During the procedure, a small incision is made in the lower abdomen just below the belt line. The testicle is then pushed up from the scrotum through the incision and removed. The procedure is usually finished in less than an hour.

What To Expect After Surgery

Orchiectomy can be done as an outpatient procedure or with a short hospital stay. Regular activities are usually resumed within 1 to 2 weeks, and a full recovery can be expected within 2 to 4 weeks.

Why It Is Done

Orchiectomy is always performed when testicular cancer is suspected. This is because testicular lumps are often cancerous and must be removed as part of treatment. Also, performing a biopsy on a testicle before it is surgically removed can cause cancer cells to spread, making successful treatment more difficult.

Sometimes bilateral orchiectomy (removal of both testes) is necessary, though this is rare.

How Well It Works

Orchiectomy is the most effective way to remove cancerous tumors of the testicles. In some cases, orchiectomy is followed by additional surgery to remove cancer that has spread or by adjuvant therapies such as chemotherapy or radiation therapy.

In some cases of early-stage testicular cancer, orchiectomy is the only treatment necessary and is followed only with a watchful waiting program. Watchful waiting, or surveillance, is a period of time during which you and your health professional observe your symptoms or condition without using medical treatment.

Testicular cancer is a very curable form of cancer, especially if it is diagnosed and treated at an early stage. Orchiectomy is important to the successful treatment of this disease and offers the best chance for cure.

Risks

Orchiectomy surgery is relatively low-risk, and complications are uncommon. However, orchiectomy carries all the risks of any major surgery, including:

• Reactions to anesthesia or medications.
• Infection.
• Bleeding.

Bilateral orchiectomy (removal of both testes) is rarely done and carries the possibility of side effects. They are related to the loss of testosterone following the removal of both testes. These include:

• Infertility.
• Loss of sexual interest.
• Erection problems.
• Hot flashes.
• Breast enlargement (gynecomastia).
• Weight gain.
• Loss of muscle mass.
• Osteoporosis.

What To Think About

In the majority of cases, orchiectomy does not result in long-term sexual side effects or infertility, though it may increase these problems if they were present before the surgery. If a man has one healthy testicle, he should not notice any negative change in his quality of life. Men who do not have one normally functioning testicle after orchiectomy will need to take hormone therapy to fulfill the body’s need for testosterone.

Some men choose to have a prosthetic testicle(s). After an orchiectomy, the surgeon places the artificial testicle(s) in the scrotum to maintain the natural appearance of the genitals.

If you have any questions or concerns about this surgery, talk to your doctor.

Radiation therapy uses high doses of radiation, such as X-rays, to destroy cancer cells. The radiation damages the genetic material of the cells so that they can’t grow. Although radiation damages normal cells as well as cancer cells, the normal cells can repair themselves and function, while the cancer cells cannot.

Radiation therapy may be used alone or combined with hormonal treatment to treat prostate cancer. It is most effective in treating cancers that have not spread outside the prostate. But it also may be used if the cancer has spread to nearby tissues. Radiation is sometimes used after surgery to destroy any remaining cancer cells and to relieve pain from metastatic cancer.

Radiation is delivered in one of two ways.

• External-beam radiation therapy uses a large machine to aim a beam of radiation at your tumor. Once the area of cancer is identified, an ink tattoo no bigger than a pencil tip is placed on your skin so that the radiation beam can be aimed at the same spot for each treatment. This helps focus the beam on your cancer to protect nearby healthy tissue from the radiation. External radiation treatments usually are done 5 days a week for 4 to 8 weeks. If cancer has spread to your bones, shorter periods of treatment may be given to specific areas to relieve pain.
• Brachytherapy, or internal radiation therapy, uses dozens of tiny seeds that contain radioactive material. It may be used to treat early-stage prostate cancer. Needles are used to insert the seeds through your skin into your prostate. As the needles are pulled out, the seeds are left in place. The surgeon uses ultrasound to locate your prostate and guide the needles. The seeds release radiation for weeks or months, after which they are no longer radioactive. The radiation in the seeds can’t be aimed as accurately as external beams, but on the other hand, they are less likely to damage normal tissue. Once the seeds have lost their radioactivity, they become harmless and can stay in place indefinitely.

Sometimes treatment involves a combination of brachytherapy and low-dose external radiation. In other cases, treatment combines surgery with external radiation.

A newer form of radiation therapy, called 3D-CRT (three-dimensional conformal radiation therapy), allows doctors to use higher doses of radiation that are more accurately aimed to avoid damaging normal tissue. Use of 3D-CRT causes less serious side effects than radiation therapy. It is preferred over ordinary radiation therapy for the treatment of prostate cancer.

Before radiation therapy is scheduled, your doctor probably will order a bone scan and CT scan to find out whether the cancer has spread to distant parts of your body. If it has, your doctor may offer you the option of a clinical trial for treatment.

What To Expect After Treatment

Side effects may last only as long as the treatment, or they may continue and become chronic. Side effects include:

• An irritated rectum and an urgent need to pass a stool. This is called proctitis.
• An inflamed bladder and urination problems. This is called cystitis.
• An inflamed intestine and diarrhea. This is called enteritis.
• Being unable to have an erection. This is called impotence.
• Being unable to control urination. This is called incontinence.
• Painful urination. This is called dysuria.
• Bleeding from the rectum or blood in the urine.

Why It Is Done

Radiation therapy is used for:

• Cancer that has not spread in generally healthy men who are younger than 70.
• Cancer that has spread to the bones, is not getting better with hormonal treatment, and is causing pain.
• Cancer that has come back in the prostate after surgery.
• Additional therapy after surgery to destroy cancer cells that may remain, especially if all the cancer cannot be removed. This is done very rarely.

How Well It Works

For curing early stage prostate cancer, the evidence seems to show that radiation works as well as surgery. (No studies have directly compared radiation with surgery.)

For treating advanced prostate cancer that has grown beyond the prostate but not into lymph nodes or bones, external-beam radiation combined with hormone drugs can work better than surgery. This treatment often results in controlling cancer growth and in many years of disease-free survival.

For stage III prostate cancer, there is evidence that combining radiation with hormone drugs improves survival rates. One study that followed men with stage III prostate cancer for 20 years after radiation therapy showed that:

• 44% had no problems with prostate cancer for the rest of their lives.
• 47% eventually died of prostate cancer.

Risks

Side effects are common. Some men develop long-term problems that may have a significant impact on their quality of life. Long-term problems that can be caused by radiation treatment include:

• An irritated rectum and an urgent need to pass a stool. This is called proctitis.
• An inflamed bladder and urination problems. This is called cystitis.
• An inflamed intestine and diarrhea. This is called enteritis.
• Being unable to have an erection. This is called impotence.
• Being unable to control urination. This is called incontinence.
• Painful urination. This is called dysuria.

What To Think About

A newer form of brachytherapy involves placing radioactive material into the prostate and then removing the material.

This technique—also called high-dose rate, or HDR, brachytherapy—uses tiny tubes that are placed through your skin into your prostate. Radioactive material is injected into the tubes, which are left in place for 5 to 15 minutes. The tubes are removed at the end of each treatment. Generally, about 3 brief treatments are given over 1 or 2 days.