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Addressing Sexual Recovery after Prostate Surgery

by Victor Hola, RN

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Most men undergoing surgery to remove their prostate will experience difficulty getting an erection for varying lengths of time after surgery. In order to restore sexual vitality, two main areas need to be addressed. The first is largely physical (but can be influenced by psychologi­cal factors) – regaining the ability to have and maintain an erection. The second can have both physical and psychological factors – recovering the desire for sexual activity, or sexual libido. The road to sexual recovery is not always an easy one, but with time, effort, and a little bit of patience, success is possible.

The Meds A man’s erections may not return for up to three years after prostatectomy, and in some cases, they may never return to their previous level of function­ing. However, this does not mean that erec­tions can’t be helped along. Oral medications such as Viagra, Levitra, Staxyn, and Cialis can be used to produce an erection or to enhance pleasure during sexual activity. Similarly, medications such as Edex and Caverject can be injected into the shaft of the penis with a tiny needle in order to facilitate an erection. Another option is a small suppository – about the size of a ball­point pen tip – that is placed into the penile urethra, which, like the injec­tion, can produce an erection within 15 minutes.

You may benefit from meeting with a sexual therapist or counselor to determine whether psychological reasons are causing erectile dysfunction and low libido.

Author of Article photo

Victor Hola

If you and your doctor decide that any of these medicines is appropriate for you, you will need to experiment in order to determine the right dosage. If the dosage isn’t strong enough, you may not achieve a full erection. On the other hand, if the dosage is too strong, you may experience side effects, such as low blood pressure, fainting, and painful erections.

The Pump If you have a history of cardiac conditions and are unable to try erectile medications, a vacuum erection pump is an option you can explore. The pump is a plastic tube that fits over the flaccid penis and creates a vacuum that brings blood into the penis, causing it to swell and become erect. Once erect, a rubber ring is placed at the base of the penis, acting as a dam to keep the penis full of blood and erect. This ring may be worn for up to 30 minutes, and can be left on during intercourse.

The Sex Drive No two men are alike in their level of libido. A man’s libido can be affected by both psycho­logical and physical factors. If you’re experiencing loss of sexual desire after prostatectomy, help first comes in the form of a comprehensive physi­cal by your doctor. Blood tests and physical assessments can reveal whether there is a physical cause to your low desire. Then, you may want to consider meeting with a sexual therapist or counselor to determine whether psychological factors are causing erectile dysfunction and low libido.

The best thing you can do to recover sexually after having a prostatectomy is to be open to trying new things. Eventually you will find what works best for you and your partner. After all, human sexuality is a beautiful part of life – a part of life that prostate can­cer survivors and their partners deserve to experience.

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Victor Hola is a registered nurse in the Department of Urology at the University of Michigan Cancer Center in Ann Arbor, MI. In addition, he is an AASECT-certified sexual counselor, as well as a certified sexual educator.

You can find a certified sexual counselor or therapist in your area at AASECT.org.

This article was published in Coping® with Cancer magazine, January/February 2014.