Erectile dysfunction after a Prostate Surgery
Yes, erectile dysfunction (ED) is a common side effect after prostate surgery, especially radical Prostatectomy for prostate cancer.
Due to surgery, nerves and blood vessels involved in erections may be affected during the procedure.
The effect may either lead to temporary or long-term Erectile dysfunction problems in some men.
While the recovery from prostatectomy-caused ED varies by individual.
In case you’ve had or are planning prostate surgery, it’s important to understand its impact on your sexual function.
In this blog, we’ll cover why ED may happen during post-surgery, how long it may last, and what treatments are available for it.
You can just read on to learn more.
How Does Prostatectomy Cause ED?
A radical prostatectomy, performed to treat aggressive prostate cancer, involves removing the prostate gland.
The prostate gland is located near delicate nerves and blood vessels critical for erections.
During surgery, it is possible to cause damage to the neurovascular bundles.
These neurovascular bundles help to transmit signals to dilate penile blood vessels to enable erectile function.
Damage to these neurovascular bundles can impair blood flow and cause erectile dysfunction or impotence.
The risk of ED depends not only on surgical technique but also on factors like tumour location, surgeon skill, patient age, and existing medical conditions.
Temporary or permanent ED can result after the procedure. Learn about temporary erectile dysfunction.
What are the risk factors for increasing the chances of getting into the ED after surgery?
Age of the patient:
Older men generally have a slower nerve recovery. Age can reduce vascular health and make ED more likely to appear after surgery.
Pre-surgery erectile function:
Men who are already dealing with weaker erections before surgery are at higher risk of severe or permanent ED afterwards. Due to pre-existing vascular or nerve problems, the condition can get worse after surgery.
Type and extent of surgery:
Patients who need more extensive surgeries, like non-nerve-sparing Prostatectomy, are at higher risk. The type and extent of surgery with a higher risk of damaging the erectile nerves are most likely to affect your sexual function.
Surgeon's expertise and technique:
Surgeons skilled in nerve-sparing and minimally invasive methods can greatly reduce the risk of impotence or erectile dysfunction after Prostatectomy. Compared to procedures done by less experienced surgeons, it can be quite risky and may lead to mistakes that may lead to situations causing ED.
Also, learn about Neurological Erectile Dysfunction, and know how it interferes with your sexual life.
Timeline: What to Expect After Surgery
In the first weeks of the surgery, most men experience complete erectile loss.
While Partial or full recovery from it may often take months to years, depending on nerve healing.
Nerves controlling erections can take up to 6 to 24 months to fully recover.
Also, healing speed may vary by age, health, and surgery type.
Most Men often report weaker, less frequent erections and reduced sexual confidence after surgery.
And they only see gradual improvements over time with treatments or therapy.
Diagnosis and Assessment of Erectile Dysfunction
After prostate surgery, diagnosing ED needs to have regular postoperative follow-ups to check your sexual health recovery.
Your doctor may use a penile Doppler ultrasound to check for blood flow and vascular health of your penile region.
A Nocturnal Penile Tumescence (NPT) test, which checks for erections during sleep, may also help differentiate between the causes of ED.
It can help differentiate between physical and psychological causes.
Additionally, questionnaires by the International Index of Erectile Function (IIEF) may help quantify the severity of erectile issues.
Also, the guide may help choose the treatment plan depending on the causes.
ED Treatment after Prostatectomy
Here are some recommended treatments that can help treat ED symptoms after Prostatectomy:
Penile Rehabilitation:
Penile rehabilitation can help restore sexual function after prostate cancer surgery.
Nerve-Sparing Surgery:
A nerve-sparing radical prostatectomy, which preserves neurovascular bundles, offers better postoperative erectile function than non-nerve-sparing surgery.
Medication and Cream Treatments:
Other treatments include drugs and devices that support natural erections. Most men use PDE5 inhibitors like Sildenafil citrate (Viagra), Tadalafil tablets (Cialis), Vardenafil (Levitra, Staxyn), and Avanafil (Stendra). These ED drugs relax and stimulate erectile tissue to enhance blood flow during sexual stimulation. However, ED pills are not suitable for people with cardiovascular issues, liver or kidney problems, eye conditions, or those taking nitrates. Another option is Alprostadil cream (Vitaros), applied directly to the penis, which works within 5 to 30 minutes and lasts 1 to 2 hours.
Vacuum Pumps:
Devices that draw blood into the penis; a constriction ring maintains the erection for up to 30 minutes, but longer use can damage tissue. Learn what a Vacuum pump is and how it helps.
Injections or Pellets:
Alprostadil injections (Caverject, Viridal Duo) are administered into the penis, producing an erection in 15 minutes lasting 30–40 minutes. MUSE pellets, inserted into the urethra, act within 10 minutes and last about an hour.
Implants:
Penile prostheses, either inflatable or malleable, are options when other treatments fail.
Lifestyle Changes:
Exercise, quitting smoking, reducing alcohol, and following a healthy diet can support sexual function. Know about food that can help with ED.
Counselling and Therapy:
Addressing stress, anxiety, and lifestyle factors with professional help can improve erectile issues without major treatments.
Conclusion
Erectile dysfunction is not a confirmed side effect of Prostatectomy.
It may or may not happen to men after the surgery.
Sometimes, people retain an erection naturally on some days.
However, after a certain age and due to some additional medical condition, ED might happen.
In such cases, consuming a PDE5 inhibitor and having a healthy lifestyle is the best choice.
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ED can last from several months to up to two years post-surgery. The recovery time may vary depending on age, nerve preservation, and overall health.
Yes, nerve damage can be permanent if the neurovascular bundles are severely injured or removed during surgery. The procedure can lead to long-term erectile function among males undergone surgery.
Yes, younger patients generally recover faster and have better chances of regaining erectile function. It happens due to stronger nerve resilience and better vascular health.
Yes, many men experience satisfying sexual lives after recovery. Most men, with the help of treatments and emotional support, can regain their intimacy and sexual satisfaction.