Erectile dysfunction after a Prostate Surgery

Erectile dysfunction after a Prostate Surgery
Published : Feb 03, 2024
Last Updated : Apr 06, 2024

According to a report, Prostate cancer is the second most frequent malignancy in men globally. Fortunately, this is curable, and getting diagnosed in the initial stages is better.

A man's prostate is a small walnut-sized gland that is responsible for producing the seminal fluid that sustains and transports sperm. There is no particular reason behind prostate cancer till now. Additionally, there are no vivid symptoms to detect in the early stage.

Prostatectomy is the surgical procedure in prostate cancer treatment to remove the affected part or all of the prostate gland.

Multiple types of Prostatectomy include several delicate steps, like radical Prostatectomy and transurethral Resection of the Prostate (TURP). On the brighter side, these surgeries have a promising success rate.

However, Prostatectomy may leave some side effects on the body, including sexual dysfunction in men. It might affect erectile function and cause problems during sexual intercourse.

This dysfunction might develop over time if not treated properly. Here's how to deal with post-prostatectomy erectile dysfunction or ED.

How does Prostatectomy cause ED?

Before moving to the solutions, it's essential to know how the malignancy causes erectile dysfunction.

One of the types of Prostatectomy includes a radical Prostatectomy, which concerns the removal of the prostate gland. It is used in men who have aggressive but clinically localized prostate cancer conditions. 

As this gland is situated just below the bladder and in front of the rectum, multiple delicate nerves and tissues are available. Removal of the gland and the surrounding tissues may damage the nerves and blood vessels that play an essential role in the process of achieving an erection.

Neurovascular bundles are the two principal bundles of nerves at risk of injury during radical Prostatectomy. 

These bundles are mainly responsible for transmitting nerve signals to trigger the dilation of blood vessels in the penis.

It further allows an increased blood flow and the smooth achievement of an erection. During the surgery, these bundles may get affected, causing erectile dysfunction.

There are some points to note here. The temporary or permanent loss of erection is not entirely dependent on the surgical technique.

Other factors include the tumour's location and size and the surgeon's skill. It also depends on the patient's age and other pre-existing medical conditions.

Now, let's find out what are the ways to cure erectile dysfunction after Prostatectomy.

ED Treatment after Prostatectomy

Penile rehabilitation, also known as erectile dysfunction rehabilitation, can help regain sexual function after prostate cancer surgery. Also, doctors suggest Nerve-sparing radical Prostatectomy, a critical surgical procedure for preserving or restoring erectile function. In this process, they remove the prostate without damaging the neurovascular bundles. This results in higher postoperative potency rates than non-nerve-sparing surgery.

Other treatment includes the use of drugs or devices to support men's natural erectile function.

Most men intake medications to treat erectile dysfunction. There are different PDE5 inhibitors like Sildenafil citrate (Viagra), Tadalafil (Cialis), Vardenafil (Levitra, Staxyn), Avanafil (Stendra), etc.

They increase the blood flow to the penis by relaxing and stimulating erectile tissue. It helps the man achieve a desired erection under sexual stimulation. For them to work best, the man needs to feel sexually stimulated. 

These medicines are available in different dosages and should be taken once a day. Under the proper medical prescription, these medicines should be consumed.

Note that there are side effects (like back pain, indigestion, headaches, dizziness, etc.) associated with these medicines.

People with cardiovascular conditions, liver or kidney impairment, eye conditions, and regular nitrate consumption cannot consume PDE5 inhibitors.

There is also an alprostadil cream called Vitaros that can treat Erectile dysfunction. You need to use an applicator to put this cream onto the opening of the penis. It will start working within 5 to 30 minutes after applying, and the erection can last for 1 to 2 hours. 

Alternate Options to Treat ED

Men who can't consume the medicines or apply the cream may choose any of the following options to retain an erection. These options may also help in postoperative erectile dysfunction and help improve your sexual response. 

Vacuum Pumps

Vacuum pumps or vacuum erection devices (VEDs) fit over the penis and draw blood to form an erection. After that, you need to put a soft constriction ring around your penis for about 30 minutes. This ring keeps the erection firm. However, using it for longer can damage the tissues as the constriction ring blocks blood flow.

Injections or Pellets

Caverject or Viridal Duo is a type of infection containing alprostadil. It needs to be injected into the shaft of the penis in a specific way shown by the specialist. It helps to get an erection within 15 minutes, and the erection lasts up to 30 to 40 minutes. MUSE is a type of pellet that contains the same drug. It has the size of a grain of rice that needs to be out in the opening of the penis. Surrounding tissue will absorb the pellet and start working within 10 minutes. The erection would last for an hour.

Implants

If all of the above options aren't suitable or fail to achieve erectile function outcomes, then only implants or penile prostheses are put into the penis. There are two main types of implants: inflatable implants and malleable implants.

Lifestyle Changes

Switching to a healthier lifestyle often helps men retain sexual abilities after any primary treatment like Prostatectomy. This includes regular exercise, quitting smoking, and cutting down alcohol consumption. Consume natural foods which help in erection and improve the quality of Sex life.

Also, counseling and sex therapy help to reduce sexual difficulties. Something these dysfunctions take place from stress, anxiety, and irregular lifestyle.

Discussing them with a professional therapist might improve the citation without major medications or 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 the 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. Apart from that, other treatment options are available as well.