Prostate Cancer: Erectile Dysfunction
Erectile dysfunction, also called impotence, is the inability to develop or sustain an erection satisfactory for sexual intercourse.
All current treatments for prostate cancer can cause erectile dysfunction, though some treatments can lead to impotence sooner than others.
When Can Erectile Dysfunction Occur After Treatment?
The severity of the erectile dysfunction depends on the type of surgery, stage of cancer, and skill of the surgeon.
If the nerve-sparing technique is used, recovery from erectile dysfunction may occur within the first year following the procedure. Recovery of erectile function after a non-nerve-sparing surgery is unlikely, but possible.
One study shows erectile dysfunction rates of 66% for nerve-sparing prostatectomy versus 75% for non-nerve sparing surgery at one year after the surgery. The use of vacuum devices or drugs such as Viagra after surgery once the body has healed may improve the quality of erections and speed the return of normal sexual function (see below).
If an erection can be achieved after surgery one does not lose the ability to have an orgasm but they are "dry" orgasms in which little (if any) ejaculation comes out. This results in infertility for most men. Although this is often not a concern, since most men are older at the time of diagnosis, if desired you could talk to your doctor about "banking" sperm before the procedure.
Loss of erectile function is the most common long-term complication of radiation therapy. But its occurrence decreases when more sophisticated treatments, like radioactive seed implants (brachytherapy), intensity-modulated radiotherapy (IMRT), and 3-D conformal radiotherapy, are used.
How Is Erectile Dysfunction Treated?
Current treatment options for erectile dysfunction for men who have received treatment for prostate cancer include:
How Effective Are Oral Erectile Dysfunction Drugs?