According to Prostate Cancer UK, approximately 1 in 8 men will be diagnosed with prostate cancer in their lifetime.
Fortunately, prostate cancer is very treatable, especially if caught early. According to the NHS, different treatments for prostate cancer include:
- Hormone therapy
- High-intensity focused ultrasound (HIFU)
These treatments are essential for saving lives, but can also cause major side effects. One common side effect is erectile dysfunction.
Why Does Prostate Surgery Cause Erectile Dysfunction?
An erection is caused by the brain sending sexual arousal signals to nerves in the penis which stimulate muscles to relax. This allows blood to flow to tissue in the penis, which causes it to become erect.
Erectile dysfunction refers to a condition that occurs when a man can’t achieve an erection or maintain an erection for sexual intercourse. Many factors can contribute to erectile dysfunction including problems with the nervous system, blood vessels and hormones.
Prostate cancer is commonly a slow-growing cancer. Doctors will recommend surgery if they believe that the cancer is contained in the prostate gland and hasn't invaded the surrounding areas. One surgery used to remove the prostate gland is called a radical prostatectomy. Your surgeon will remove your prostate gland, the surrounding tissues and the tubes that carry semen.
There are two small clusters of nerves which control erections that are located on both sides of the prostate. These nerves may become injured during the operation. Your surgeon may also purposefully remove these nerves if there's a chance that the cancer has invaded them. If these set of nerves are removed, then you won’t be able to become erect without being assisted by medical devices.
There is also a type of prostate surgery called nerve sparing prostatectomy, where both bundle of nerves around the prostate are avoided. However, not everyone is suitable for this surgery, and eligibility also depends on the size and location of the cancer.
How Long Does Erectile Dysfunction Last After Surgery?
According to Cancer Research UK, after prostate surgery you may experience erectile dysfunction from anything between three months to three years. This is because prostate surgery may injure the nerves, muscles or blood vessels required for an erection. Some men may also experience erectile dysfunction for the rest of their lives and require treatment to achieve an erection.
Having a radical prostatectomy will also leave you with a higher chance of getting erectile dysfunction than having a nerve sparing prostatectomy. According to the NHS, before treatment, 67% of men who had prostate cancer said that they could get erections firm enough for intercourse. After getting a radical prostatectomy, they were asked again after 6 months, and this decreased to 12%. In contrast, according to the Prostate Cancer Foundation, approximately 50% of men who receive a nerve sparing prostatectomy who could have erections before surgery will maintain this ability long term.
What Treatments Are Available?
Fortunately, there are many treatments available for men with erectile dysfunction. Some treatments outlined by Cancer Research UK include:
- ED tablets
- Vacuum pumps
- Penile injections
- Penile implant surgery
If you'd like to learn more about these treatments or have any questions about erectile dysfunction, you should schedule an appointment with your GP.