An erection is as essential as any other quality of life consideration.
The prostate is an organ located near an intricate and sensitive bundle of nerves that contributes significantly to a man's sexual function. Given this fact, a diagnosis of prostate cancer can cause many men and their partners to become rightfully concerned with how prostate cancer surgery will alter their sex life after undergoing treatment. "When will my sexual function return after prostate cancer surgery?" is an essential question that should be asked and must be answered for any man considering or preparing to undergo prostate cancer surgery because maintaining excellent sexual health is a quality-of-life consideration that should always be ranked high one’s list of lifestyle factors.
No matter the type of prostate cancer treatment a man chooses, most will experience some issues with erectile dysfunction following prostate cancer treatment. Thankfully, these problems do not typically persist indefinitely and are most often temporary. The risk of developing erectile dysfunction exists with all forms of prostate cancer therapy including prostatectomy, radiation, cryotherapy, hormone therapy, and focal therapy.
Robotic-assisted surgical approaches to prostate removal performed by experienced surgeons are highly favorable in preserving those delicate and essential nerves necessary for healthy sexual function. Robotic-assisted prostatectomy results in high cure rates for prostate cancer, as it simultaneously minimizes the side effects of traditional or open surgery. In fact, it is associated with minimal blood loss during the operation, a quick recovery, and decreased pain, with excellent chance for return of urinary continence and erections. The prostate cancer surgeon's experience and techniques are critical factors in helping to reduce the risks associated with prostate surgery and erectile dysfunction.
In many cases, men will experience restoration of their sexual function within a year of prostate cancer surgery. In other instances, that timeline may be extended, with the majority able to know their level of erectile function by two years post-treatment. Other crucial factors in evaluating how much sexual function a man will regain after surgery include his age (the more advanced age, the more prolonged erectile dysfunction problems may persist) and the overall health of his erectile function before surgery.
There are also some extra steps a man can take before undergoing prostate cancer surgery that can help to lower his sexual side effect risks. Because the penis is an organ that requires adequate blood flow to properly function, ensuring healthy lifestyle decisions are being made before surgery is essential. Smoking and conditions such as diabetes, obesity, and high blood pressure contribute to a lack of sufficient blood flow to the penis and erection problems, so making sure to have these health conditions in check before undergoing prostate cancer treatment is prudent. Starting patients on oral erectile dysfunction medications daily – prior to surgery or soon after surgery – can also aid in a successful return of erections post surgery.
Erections are important. Especially after prostate cancer surgery, it is crucial to keep the vascular supply of the penis working as it should. Men might be surprised to learn that I recommend my patients begin sexual activity as early as a week or two after surgery. I also encourage penile stimulation at least two to three times per week, whether with a partner or alone. To aid in this effort immediately after surgery, I will also typically prescribe a daily dose of an erectile dysfunction medication.
In some cases, I will also recommend a penis pump – a medical-grade vacuum device for stimulating erections. These devices can allow for manual pumping of the penis to increase blood flow and prevent atrophy. Stimulating the penis, sooner rather than later, to function as it was designed to is one crucial way to help reduce the risk and duration of erectile dysfunction after prostate cancer surgery.
If you or someone you care about is considering surgical treatment for prostate cancer, I strongly encourage an open and honest conversation with your doctor about sexual health and erectile function. These are not trivial topics. They are essential to a man's health and wellness and should never be neglected. Stay well!