Prostate cancer does not always cause erectile dysfunction. However, many prostate cancer treatments can lead to impotence.
Interventional Therapies for Prostate Cancer
Treatments for prostate cancer may include:
- Surgical removal of the prostate (radical prostatectomy)
- Robotic prostatectomy
- Cryosurgery (destroying abnormal tissue by freezing cancerous cells)
- Radiation therapy
- Hormone therapy
Surgery for Prostate Cancer
There are three types of prostate cancer surgery:
- Radical prostatectomy (removal of the entire prostate)
- Robotic prostatectomy (robot-assisted prostate removal)
- Cryosurgery (freezing the tumor)
ED and Prostate Removal Surgery
Most men will at least temporarily experience erectile dysfunction after surgery to remove the prostate. Whether or not you will be able to regain your ability to obtain and maintain an erection will depend, somewhat, on the skill of your surgeon. Other factors that will determine whether or not your erectile dysfunction will be temporary or permanent include:
- The type of surgery performed (nerve-sparing vs. non- nerve-sparing)
- The stage of your cancer
- Your age
- Whether or not you had erectile dysfunction prior to surgery
If you are a good candidate for nerve-sparing surgery, it’s more likely that you will be able to regain your ability to get an erection after your surgery, particularly if the cancer is confined to the prostate and you showed no signs of impotence prior to surgery.
ED and Robotic Prostatectomy
In a recent study that was published in the Journal of EndoUrology, patients who underwent robotic prostatectomy were more likely to regain erectile function within 12 months after surgery than those who had traditional surgery for prostate removal.
ED and Cryosurgery
Cryosurgery can damage the nerves to the penis, resulting in erectile dysfunction. Impotence from cryosurgery will most likely be permanent.
Radiation Treatment and ED
Radiation therapy for prostate cancer can damage the blood vessels and nerves to the penis, which often causes erectile dysfunction. ED after radiation therapy doesn’t usually happen right away; it occurs gradually over about six months. Some types of radiation therapy, such as brachytherapy, are less likely to result in impotence than external beam radiation therapy.
Hormone Therapy and ED
Hormone therapy for prostate cancer causes a decrease in testosterone, which can lead to erectile dysfunction and decreased sexual desire.
Treatments for ED in Prostate Cancer Patients
The most common treatments for erectile dysfunction after prostate cancer treatment include:
- Medications (e.g., Viagra, Cialis, Levitra)
- Penile injection therapy
- Penile implants
- ED pumps
- Intraurethral agents (suppositories inserted into the penis)
For more information on ED caused by prostate cancer, contact Dr. Leroy Jones, urologist, of San Antonio.