Sexual Health Following a Prostatectomy
Some patients with prostate cancer require a radical prostatectomy, which often takes a toll on a man's sexual health. Erectile dysfunction and other conditions might result from the procedure, and while some patients see benefits from medication or devices, others never experience a full recovery.
How does a prostatectomy affect different patients?
Each patient brings unique circumstances to a prostatectomy—medical or lifestyle conditions, as well as the unique nature and outcome of the surgical procedure. All of these factors can affect what will happen to a patient’s sexual health during recovery and remission. For example, according to The James Buchanan Brady Urological Institute at Johns Hopkins School of Medicine,1 procedures that use smaller incisions and precise extractions of cancerous tissues from the prostate may help preserve the body’s connective nerves and tissues that aid in potency and sexual health.
How much can your sexual health recover after a prostatectomy?
Radical prostatectomy is a procedure with an evolving combination of assessment, surgical procedures, and approaches to recovery. But even with the best possible health results following surgery, there is no set timetable for a return to healthy sexual activity. Recovery can take weeks, months, even years. And in some cases, extenuating circumstances like age, health, the nature of the prostatectomy, and chronic medical conditions may complicate sexual health recovery.
General guidelines for recovery times may vary, but according to published research from Johns Hopkins School of Medicine, “...physical capacity is fully recovered in most patients within several weeks, return of urinary continence is achieved by more than 95% of patients within a few months, and erection recovery with ability to engage in sexual intercourse is regained by most patients with or without oral phosphodiesterase 5 (PDE5) inhibitors within 2 years.”2
What are some common treatments to regain sexual health after a prostatectomy?
A number of treatment options are available.3,4 Options to help with sexual health recovery include:
- Oral medications — Medication that increases blood flow to the penis to increase the likelihood of an erection with sexual stimulation
- Penile injections — Medicine injected into the base of the penis when an erection is desired
- Penile suppositories — Medication in a small pellet that is inserted into the urethra with a plastic applicator to generate an erection
- Penile rings and vacuum pumps — External medical devices used to increase blood flow to the penis and maintain the resulting erection
- Penile implants — If the other above options are ineffective, you may discuss a penile implant with your doctor. A medical device will be surgically inserted into the penis during an operation to mechanically assist with erections.3
Talking to your doctor can help clarify your situation. Your urologist can help determine key recovery factors following a prostatectomy including:
- Are you healthy enough to resume sexual activity?
- Are you going to be healthy enough to resume sexual activity at some point, and if so, which treatment is the right fit for you?
Advances in minimally invasive surgery, nerve-sparing surgical techniques, and recovery treatments have made sexual health an attainable goal for many patients who have undergone a radical prostatectomy. Patients who have gone through this procedure, and are interested in finding the right treatment to recover and maintain sexual health, should consult their urologist. For more information on how you can improve your sexual health after and during cancer treatment, visit the American Cancer Society.
1. Erection rehabilitation after radical prostatectomy. The James Buchanan Brady Urological Institute at Johns Hopkins School of Medicine. http://urology.jhu.edu/erectileDysfunction/erectile_dysfunctions_Rehab.php. Accessed May 1, 2020.
2. Erectile dysfunction following radical prostatectomy. The James Buchanan Brady Urological Institute at Johns Hopkins University. http://urology.jhu.edu/erectileDysfunction/erectile_dysfunctions_RP.php. Accessed May 1, 2020.
3. Dealing with erectile dysfunction: for you and your partner. UCLA Health. https://www.uclahealth.org/urology/prostate-cancer/dealing-with-erectile-dysfunction. Accessed May 1, 2020.
4. Erectile Dysfunction After Prostate Cancer. Johns Hopkins University. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/erectile-dysfunction-after-prostate-cancer. Accessed May 1, 2020.
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