Can a 65-year-old man undergo radical cystectomy?

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I have read your query and can understand your concern.

Muscle-invasive bladder cancer is an advanced form of bladder cancer that has penetrated the muscle layer of the bladder wall. The standard treatment for this condition is often radical cystectomy, which involves the complete removal of the bladder. During radical cystectomy in men, the bladder, prostate, and parts of the urethra are typically removed. This surgery can indeed affect the nerves responsible for erection. Nerve-sparing surgical techniques have been developed to better preserve sexual function.

These techniques aim to protect the nerves responsible for erection while completely removing the cancer. If erectile problems occur after surgery, various treatment options are available, like medications such as PDE-5 (phosphodiesterase-5) inhibitors (for example, Sildenafil), vacuum erection devices, penile injections, and implants. Depending on the stage and aggressiveness of cancer, other treatment approaches might be considered in certain cases, like bladder-preserving therapies combining chemotherapy and radiation, partial bladder removal for certain tumor locations, and new clinical trials and treatment protocols.

The psychological impact of this diagnosis and treatment is significant. Many couples report that open communication, psychological support, and redefining intimacy can be helpful. This is general information only. For this specific case, it is important to discuss nerve-sparing surgical techniques with the treating urologist, seek a second opinion, especially from a urologist specializing in nerve-sparing cystectomies, and speak with a psychologist or sex psychotherapist experienced in working with cancer patients.

I hope this answers your query.

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Thank you.