Prostate cancer and its impact on sexual function

Prostate cancer itself can reduce sexual desire and the frequency of sexual intercourse. Although it is not a direct cause of erectile dysfunction (ED), the treatments for prostate cancer can lead to ED or impotence.

Causes of erectile dysfunction (ED) in prostate cancer patients

a. Surgery to remove the prostate gland

One of the primary treatments for prostate cancer is the surgical removal of the prostate gland. This procedure can result in erectile dysfunction, as it may interfere with the nerves and blood vessels involved in achieving an erection.

b. Radiation therapy

Radiation therapy for prostate cancer can also cause ED by damaging the nerves and blood vessels responsible for erections.

c. Hormone therapy

Hormone therapy, which aims to block testosterone, can lead to ED in prostate cancer patients.

Most types of hormone therapy typically cause ED.

d. Neurovascular bundle injury and radical prostatectomy

Neurovascular bundle injuries resulting from radical prostatectomy can further increase the frequency of erectile dysfunction.

Factors affecting the likelihood of ED after prostate cancer treatment

a. Age

The risk of having ED after prostate cancer treatment depends on several factors, including age. Younger individuals are less likely to experience ED after treatment compared to older individuals.

b. Intact nerves and nerve-sparing techniques

The degree of nerve preservation during surgery is another factor that affects the likelihood of ED after prostate cancer treatment. Nearly all men with intact nerves will see a substantial improvement within one year after treatment.

Recovery from ED after prostate cancer treatment

a. Improvement within one year for men with intact nerves

While nearly all men will experience some erectile dysfunction for the first few months after prostate cancer treatment, those with intact nerves will see a significant improvement within one year after treatment. Some men may take between 3 months and 3 years to regain their ability to have erections, while others may require help for the rest of their lives.

b. Role of vacuum devices and ED drugs

The use of vacuum devices or ED drugs can improve the quality of erections and speed up the return of normal sexual function.

Treatment and management options for ED in prostate cancer patients

a. Referrals to sexual behavior consultation units

Men experiencing ED after prostate cancer treatment can seek help from sexual behavior consultation units for professional guidance and support.

b. Lifestyle changes: exercise, healthy diet, responsible drinking, stress reduction

Adopting a healthy lifestyle, including regular exercise, a balanced diet, responsible drinking, and stress reduction, can help improve erectile function after prostate cancer treatment.

c. Vacuum devices and ED drugs for improved erection quality and sexual function

Various treatments are available for ED, including oral medications such as sildenafil, vardenafil, and tadalafil, vacuum devices that help create an erection, penis injections or pellets for at-home treatment, and penile implants, which are either solid or fluid-filled tubes. These treatments can improve erection quality and sexual function, allowing men to maintain satisfying sex lives after prostate cancer treatment.