Managing Erectile Dysfunction after Prostate Cancer

Managing Erectile Dysfunction after Prostate Cancer

Cure rates for prostate cancer are high with early detection and treatment. Individual results vary, but the American Cancer Society reports a 10-year survival rate of 98% for prostate cancer that hasn’t spread (metastasized).

Unfortunately, erectile dysfunction (ED) is a frequent side effect of many prostate cancer treatments. ED may not be “life-threatening” compared to cancer, but it can significantly affect your overall well-being.

Mike Hsieh, MD, is a board-certified urologist and men’s health specialist with an established practice in La Jolla, California. He’s happy to answer questions about the remedies available for ED and the importance of seeking help to manage this frustrating but sometimes temporary consequence of prostate cancer.

How common is ED following prostate cancer treatment?

Technically speaking, ED refers to your inability to achieve and maintain an erection that leads to a satisfying sexual encounter. Most men can expect to experience some level of ED following prostate cancer treatment, but several factors influence its severity and persistence.

For instance, you may experience an erection but have difficulty sustaining it. Other men report erections that are less firm than before. Some men cannot achieve an erection following cancer treatment or they lack the desire for sex.

What increases your risk of ED following prostate cancer treatment?

Your overall health before prostate cancer is often a factor in post-treatment ED. For example, if you have diabetes, heart disease, or another condition that affects your vascular (circulatory) health, you may experience more problems with ED.

The type of treatment you get also matters. If, for instance, your surgeon can perform a nerve-sparing prostatectomy, about half of men experience a return to pretreatment function within several months to a year. Unfortunately, it’s not always possible to protect nerve function during prostatectomy because of tumor size or type.

ED after radiation therapy tends to worsen over time, but more precise types such as brachytherapy pose less risk. Hormone therapy, typically used to treat advanced prostate cancer, nearly always causes ED and reduces sexual desire.

Fortunately, many effective treatments are available for ED related to prostate cancer.

How do you manage ED after prostate cancer treatment?

Dr. Hsieh develops customized treatment strategies for ED that may include oral medications such as Viagra®, Cialis®, or Levitra®. These prescription drugs prompt increased blood flow to the penis, which is necessary for a successful erection.

You may also benefit from penile injections of prostaglandin-E. Administered painlessly at the base of the penis by you or your partner with a tiny needle, this medication causes the penis to become firm within minutes and remain erect long enough for a satisfying encounter.

Should these conservative treatments fail, Dr. Hsieh may recommend penile implant surgery. During this outpatient procedure, he inserts a small medical device (prosthesis) under the skin of your penis and scrotum that helps you achieve and maintain a satisfying erection.

Your treatment strategy may also include guidance regarding improved nutrition, increased exercise, and counseling to address the psychological and relationship effects of ED. 

In addition, better control of diabetes, hypertension, and other vascular problems can improve your overall health and may enhance your response to ED treatment.

For effective management of ED, call Dr. Hsieh’s office today to schedule an appointment.

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