When men receive treatment for prostate cancer, there is always a strong possibility of becoming impotent(erectile dysfunction). Erectile dysfunction (ED) can be either temporary or sometimes permanent depending on the course of treatment. ED is a common condition among men especially those who are not dealing with prostate cancer. ED experienced by males who have not been diagnosed with prostate issues are defined by three areas: blood flow decreased by an arterial blockage, increased blood output to the penis and conditions affecting the nerve endings to the penis.
During a radical prostatectomy, nerves that are adjacent to the prostate may be cut due to cancer present in the area or if the nerves impaired the surgeon’s ability to remove the prostate.
After a prostatectomy, 60% to 80% of males may experience temporary erectile dysfunction where it is difficult to maintain an erection to sustain during intercourse. This has been reported to only last a few months. Erectile issues may begin to disappear up to 3 years after surgery. For men with this type of dysfunction, medical treatments have been successful to help the function return in a shorter amount of time. Daily dose of Viagra or Alprostadil has shown remarkable results for erectile dysfunction. Alprostadil is a hormone treatment placed in the penis or the urethra.
If the patient underwent radiation therapy, it has been reported that 30% to 60% percent will experience erectile dysfunction. The type of radiation therapy used will dictate the severity of the ED. Brachytherapy which involves using seeds or wires inserted near the tumor has caused lowest rate of erectile dysfunction.
A common way to treat prostate issues is the transurethral resection of the prostate(TURP). The TURP surgery can cause temporary ED and incontinence.
Hormone therapy to combat prostate cancer by interfering with testosterone can cause erectile dysfunction. Cryosurgery can cause erectile dysfunction because when the nerves in and surrounding the prostate are exposed to the cold temperatures, it can cause a loss in erectile function.
There are many options for men to explore about helping restore erectile function. Treatments include: medications, mechanical, surgical and psychological.
Medications like Viagra or Cialis have been successful in helping men achieve an erection but males who have an existing cardiac condition are not recommended to use these medications. These drugs help increase blood flow to the vessels of the penis. Other medications used to treat erectile dysfunction are testosterone and prostaglandins.
Mechanical aids to help restore erectile function include: penile implants and injection of pellets into the penis.
For men who have decided that maybe surgery would help with erectile dysfunction,they may turn to doctors who will perform nerve grafts. During a radical prostatectomy, sural nerve grafting is done to prevent impotence. The surgeon takes part of the sural nerve from the leg and grafts the end of the nerve past where the prostate was before. One side effect to this treatment is patients have reported numbness in the foot from the leg where the nerve was. Several hospitals like the University of Tennessee Medical Center, Memorial Sloan-Kettering in New York, the University of Texas M.D. Anderson Cancer Center and other medical facilities are performing this treatment.
Men who experience erectile dysfunction may be treated for psychological reasons. Anxiety over the ability to engage in sexual activity, poor self-image and guilt over not being able to meet their partner’s sexual needs are contributors to erectile dysfunction in men getting treatment for prostate cancer. Men with this condition can benefit form engaging with a therapist trained in working with erectile dysfunction.