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If Prostate Is Removed Are You Impotent

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Habits And Lifestyle Changes

Erectile Dysfunction Treatment Options | post Prostate Removal Surgery

Your healthcare provider may recommend making certain changes to your habits and lifestyle to promote blood flow and improve your erectile health. These may include:

  • Treating any underlying health issues

  • Changing your eating habits to maintain a healthy weight

  • Exercising regularly to improve your cardiovascular health

  • If you smoke, quitting smoking and nicotine products

  • Limiting your consumption of alcohol

Weve talked more about the effects of good habits and lifestyle changes on ED in our guide to naturally protecting your erection.

Although these changes are unlikely to treat prostatectomy-related erectile dysfunction on their own, they can contribute to an increase in blood flow, better overall health and improved sexual function.

What Are The Side Effects

The most common side effects of surgery are leaking urine and problems with getting or keeping an erection .

Your risk of getting these side effects depends on your overall health and age, how far the cancer has spread in and around the prostate and how likely it is to grow, and your surgeons skill and experience.

When Is Nerve Preservation Not Done

The term nerve preservation or nerve sparing during radical prostatectomy refers to preservation of this second set of nerves . When these nerves are not preserved it is not because they have been accidentally damaged, but because either one or part of one has been removed to ensure that the cancerous cells are fully removed. This is known as cancer control.

You can see how the location of the prostate cancer on the left side of the prostate specimen below allowed full nerve preservation on this side whereas the tumour on the right side of the prostate was invading the NVB, which meant that NVB removal on this side together with all of the tissue surrounding it was necessary for good cancer control.

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Pde5 Inhibitors: Viagra Levitra And Cialis

Approved by the FDA in 1998, sildenafil revolutionized the way we think about and treat erectile dysfunction, largely because it is so easy to use and effective. Since then the FDA has approved three closely related drugs, vardenafil , avanafil and tadalafil .

All four drugs work in a similar fashion, by affecting the normal physiology of the penis. In particular, they block PDE5, an enzyme that breaks down the erection-producing chemical cyclic guanosine monophosphate. This enables the penis to fill with blood and to stay erect long enough for intercourse. Of course, its important to realize that none of these drugs is an aphrodisiac. Youve got to feel sexually stimulated in order for them to work.

The main differences between the drugs have to do with timing: how quickly they begin to work, and how long their effects last . Levitra may start working slightly faster than Viagra although the FDA says that like Viagra, it should be taken about an hour before sexual activity. Some studies suggest that Levitra may help some men who dont respond to Viagra. And while some doctors are skeptical about this claim, theres no harm in trying Levitra or Cialis if Viagra doesnt work for you.

Cialis has also been approved to treat men with both erectile dysfunction and BPH. The dose is lower, usually 5 milligrams per day.

If You’re A Gay Or Bisexual Man


To be the active partner during anal sex you normally need a strong erection, so erection problems can be a particular issue. You could try using a constriction ring around your penis together with another treatment like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex.

If you are receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. Some men who receive anal sex find that their experience of sex changes if they have their prostate removed .

If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy. Its best to wait until your symptoms have settled before trying anal play or sex. If youve had permanent seed brachytherapy there is a risk in the first few months that your partner might be exposed to some radiation during sex. Talk to your doctor or nurse for further advice.

With all sexual changes you may be able to find ways to work through this.

Watch Martin’s story below for one gay man’s experience.

Watch other men’s personal stories about sex after prostate cancer.

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Can Prostate Be Removed What Happens After Survival Rate

Since the prostate can cause so many problems in mens health, can the prostate be removed? The answer is yes. Heres what happens after and the survival rate.

If you are looking to reduce your chances of developing prostate cancer, this procedure can help you do just that!

Keep reading to learn more about how to remove your prostate.

There Are Four Main Ways That Prostate Cancer Treatment Affects Erectile Function:

  • Sex drive or libido Any treatment that decreases your testosterone level diminishes your sex drive. You can have a low libido and still obtain an erection, but it is usually more difficult for menwho have less interest in sex. Hormone therapy and surgical orchiectomy both decrease testosterone production. The former is reversible, and the latter is not.
  • Achieving a mechanical erection is controlled by the nerves and vessels that associated with the prostate and structures near the penis. Damage to these nerves and blood vessels during surgery or radiation can prevent and individual from maintaining the mechanical ability to have an erection.
  • Orgasm. Attaining an orgasm can also be more difficult after treatment when sex drive is low, or erections are not as firm. Some men will experience discomfort initially after treatment during climax, but this usually resolves.
  • Ejaculation may be minimal after treatment. The prostate gland and seminal vesicles which produce the ejaculate were removed and/or treated with radiation, so it is common to have a minimal or no ejaculate. An orgasm is different than ejaculation, men may be able to have an erection and reach an orgasm, however nothing may come out.
  • Radiation therapy however appears to have a slower delay in erectile function decline than surgery. By15 years after radiation treatment, the rates of erectile dysfunction are similar to men who underwent surgery.

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    Nerve Damage From Surgery

    The most common way surgery affects erections is by removing or causing injury to the nerves that help cause an erection. All of the operations listed above can damage these nerves. The nerves surround the back and sides of the prostate gland between the prostate and the rectum, and fan out like a cobweb around the prostate, which makes it easy to damage them during an operation.

    When possible, nerve-sparing methods are used in radical prostatectomy, radical cystectomy, AP resection, or TME. In nerve-sparing surgery, doctors carefully try to avoid these nerves. When the size and location of a tumor allow for nerve-sparing surgery, more men recover erections than with other techniques. But even if the surgeon is able to spare these nerves, they might still be injured during the operation and need time to heal.

    Even when the nerves are spared, research has shown that the healing process takes up to 2 years for most men. We dont know all the reasons some men regain full erections and others do not. We do know that men are more likely to recover erections when nerves on both the left and right sides of the prostate are spared.

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    What Have I Learned By Reading This

    New Treatment for Enlarged Prostate Restores Normal Urination

    You learned about:

    • Why prostate cancer treatment can cause erectile dysfunction
    • What can be done about erectile dysfunction
    • How erectile dysfunction may affect your sex life
    • What your partner can expect

    If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.

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    How To Maintain Your Sex Life After Prostate Surgery

    Although prostate surgery can affect your sexual experience and performance, getting surgery to remove part or all of your prostate doesnt mean that you can no longer have sex or enjoy a satisfying sexual life.

    However, it does mean that you may need to make some changes to how you and your partner have sex. These may include using ED medications, erection-promoting devices or engaging in penile rehabilitation exercises to keep your penis stimulated and healthy.

    If youve recently had prostate surgery, its important to talk to your healthcare provider before you make any changes to your health habits. Theyll be able to inform you about what you can do to restore and improve your sexual function after surgery.

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    What Is Prostate Massage Therapy

    So what is prostate massage and how does it relate to erectile dysfunction?

    Prostate massage therapy is not currently a mainstream form of treatment for ED and is often used in conjunction with other types of treatment. The goal is to cause the prostate to contract, which will often lead to the release of prostatic fluid and semen.

    During prostate massage therapy, a lubricated fingeralways with gloves onor a specialized tool is used to carefully stimulate the prostate. Tissues in and around the prostate are massaged with gentle pressure.

    For erectile dysfunction treatment, prostate massage therapy may take place two or three times a week over a period of one to two months. Depending on your current health condition and level of ED, the initial release of prostatic fluids during massage may cause some pain or discomfort.

    For most men, prostate massage therapy will also produce pleasurable relief.

    Because the prostate gland is extremely sensitive, massaging it can lead to an elevated orgasm without ejaculation. Got a partner? Even better. Having someone massage your prostate can be surprisingly hot.

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    Help For Ed After Prostate Surgery: The Basics

    Whats the secret to having a good sex life after prostate cancer? Its very simple, says Johns Hopkins urologist Trinity Bivalacqua, M.D., Ph.D. You use prescription erection pills. If they dont work, you move to injectable medications. If they dont work, you get a penile prosthesis. Also, having a loving and understanding partner always helps. Theres also the vacuum erection device . It is not a first-line treatment for ED because theres a high drop-out rate, Bivalacqua says. However, the VED can play a very important role in another aspect of surgical recovery: penile rehabilitation .

    First, the pills: When one of my patients leaves the hospital after a radical prostatectomy, he takes home a prescription for Viagra, says Bivalacqua. Does he take it every day, like a vitamin? No. Although some doctors prescribe the pills this way, its not what physicians call an evidence-based practice that is, the medical literature doesnt back it up conclusively. Instead, Bivalacqua tells his patients to take it as needed. It is very difficult for me to tell a man that he should spend $600 a month to take a daily erection drug, because the evidence of a quicker return of erections is just not there. However, he adds, taking a pill daily may provide a benefit, and a lot of prostate cancer patients want to take a proactive approach. If thats the case, then I encourage them to go ahead.

    How To Cope With Ed After Prostate Surgery

    South Nassau Presents Truth in Medicine

    Even when you know that erectile problems are temporary after surgery, it is not easy to experience such a change.

    It can turn into a significant burden for your relationship and yourself.

    Thus, knowing how to cope with erectile dysfunction is useful, even if you dont experience a complete lack of erections.

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    Risk Of Erection Problems After Robotic Prostatectomy Depends On:

    • age the older the patient the more likely he is to experience erectile dysfunction after surgery. This is likely related to an underlying increased risk of vascular disease that occurs as people age. Vascular disease may be subtle enough not to manifest itself in other ways.
    • diabetesmen with diabetes are at higher risk for erectile dysfunction. The stress of surgery to remove the prostate may tip the balance over and lead to the earlier manifestation of the underlying problems that predispose to ED.
    • hypertension erectile dysfunction is a known problem in men with high blood pressure. High blood pressure affects small blood vessels that carry blood to the penis. All men with high blood pressure are at risk of developing erection problems. Prostate cancer treatment tends to accentuate the problem by affecting the nerves in addition to already affected blood vessels.
    • Coronary Artery Disease heart disease affects blood vessels to the penis the same way the heart vessels are affected.
    • the baseline quality of erections
    • the use of PDE-5 inhibitors
    • type of surgical procedure

    Erectile Dysfunction After Prostate Cancer Treatment

    • Original: May 2, 2020

    Erectile dysfunction is the most common side effect after prostate cancer treatment irrespective of precision dose and delivery of radiation therapy or if the nerves were spared during surgery. Sexual dysfunction occurs because the nerves and blood vessels that control the physical aspect of an erection are incredibly delicate, and any trauma or stress to them can result in temporary or permanent damage.

    Within one year after treatment, most men with intact nerves that were not significantly damaged will see a substantial improvement in sexual function. The skill of the surgeon or radiation oncologist can have a significant impact on long term sexual function, so its important to select your treatment and team very carefully.

    When selecting treatment make sure your doctor explains the type and probability of side effect from their treatment facility. Sometimes treatment selection will depend on which side effects are most tolerable for you age and lifestyle.

    Age, obesity and the ability to spare the nerves are the major determinants of the type and severity of side effects. In general, it is more challenging to spare the nerves in men with higher risk disease because the prostate cancer may have already spread past the nerves outside the prostate capsule.

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    Sex When Youre Single

    Being sexually active and feeling attractive can be just as important if you are a single man. All the treatments described here are available to you if youre single whether you want to be able to masturbate, have sex, or want to start a new relationship.

    If you are starting a new relationship, sexual problems and other side effects like urinary or bowel problems could be a worry. Some men worry that having problems with erections will affect their chances of having a new relationship. Fear of rejection is natural, and everyone has their own worries, whether or not theyve had cancer. If youre single, you may want time to come to terms with any changes prostate cancer has caused before you start having sex or dating.

    Try talking over your worries with someone you feel comfortable with, such as a friend. Counselling or sex therapy may also help if you would prefer to talk to someone you dont know.

    Richard Tried Viagra Cialis And Other Treatments For Erectile Dysfunction He Was Relieved To

    Side Effects of Surgery Vs Radiation for Prostate Cancer

    I went back to my consultant and then they try you on Viagra, Cialis, injections, theres a whole host of things that you can try to get your erection back, because the reason you dont have an erection, because theres nerve damage when they remove your prostate that cant be avoided, they just try and minimise the nerve damage, but there will be nerve damage, and you will lose the function for a period of time but the nerves apparently, they heal very, very slowly, nerves heal very slowly, and he, sort of tried to reassure me that you know, Id probably get the erection back after maybe four years, you know, I was thinking, four years, I mean, thats like a lifetime, so in the meantime you can try different things, and yeah, that was very difficult, and very difficult for my wife, yeah, but because shes so supportive and so caring it was less difficult than it might be.

    So youve no side effects now?So it is very unusual then for, to be in the position that youre in?And do you tell men that, when youre speaking to other men?

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    Getting Treatment And Support

    Speak to your GP or doctor or nurse at the hospital.

    Your GP, hospital doctor or nurse can prescribe treatment for erection problems for free on the NHS, whether it’s for sex or masturbation. There may be a limit on how much treatment they can prescribe, but there is no age limit.

    Talking about sex

    It can be difficult talking about sex, but talking to your doctor, nurse or other health professional will mean you can get treatment and support. It can also help you feel more positive and more in control.

    You can ask about sexual problems at any stage – before, during or after your prostate cancer treatment. Talking about it before your treatment will mean you know what to expect and can help you to prepare to start treatments for sexual problems soon afterwards.

    Your team should ask you about your erections and sex life during your treatment for prostate cancer. But if they don’t then you may need to bring it up yourself.

    Not everyone is used to talking about sex. You might need to bring it up more than once, or with a different person in your team. You can also ask to be referred to an expert in sexual problems or an ED clinic – they will be used to talking about sexual problems.

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