Sex After Prostate Cancer: Penile Implants
Men who have been diagnosed with prostate cancer sometimes worry about the sexual side effects as much as the health prognosis. Many of the treatments for prostate cancer result in erectile dysfunction (inability to get an erection).
If the treatment is a radical prostatectomy, there is the possibility that the neurovascular bundle will be damaged or removed. The penis cannot fill with blood if these nerves do not function properly and the man will be unable to get or maintain an erection.
The results of impotence from radiation therapy are delayed. After radiation therapy has begun, no sexual dysfunction generally occurs until three to six months later, but as many as 50-60% of men regain erectile function with the use of PDE 5 inhibitors like Viagra and Cialis.
Hormonal treatment can cause erectile dysfunction, and they have the added problem in that they are known for reducing sexual desire. Unfortunately, studies do not show the same positive results for treatments, drugs have little or no impact on erectile dysfunction, but normal erectile function will return after the hormonal therapy is finished.
For those men whose erectile dysfunction problem can not be solved by drugs like Viagra or by injections of a vasodilator, there are two solutions that can be tried: vacuum erection devices and penile implants.
Most vacuum erection devices consist of an airtight tube, a pump, and a ring. The tube is placed over a lubricated penis, and the man squeezes a hand held pump, or triggers a battery-operated pump, to create a vacuum effect which draws blood into the penis. Then a rubber or plastic ring slides off the tube and onto the base of the penis to keep blood from flowing out and maintain the erection. To make this process more comfortable, the ring comes in different sizes. After the erection is achieved, it will generally last for thirty minutes, but then the ring must be removed to restore healthy blood flow. When used properly, vacuum erection devices are effective, safe, and can be used as often as needed. Some side effects are possible such as pinpoint-size red dots on the surface of the penis, or bruising may occur if the penis is held under pressure too long. A cold penis tip is common because the device and ring limits the circulation. These side effects are not painful or serious and can be solved by not using the pump for a while.
If the vacuum device fails to produce erections in prostate cancer patients, penile implants may be used as a last resort. Penile implants are invasive, but they allow a man to have an erection whenever he chooses. The penile implant is installed in a surgical procedure when the patient is put to sleep with HYPERLINK “http://www.prostate-cancer.com/prostate-cancer-glossary/anesthesia.html” anesthesia. This surgery can take between thirty minutes and two hours, and patients may check out of the hospital the same day, or stay overnight, depending on the procedure and its results.
There are two types of penile implants or prostheses available, and all slightly increase the size of the penis. The HYPERLINK “http://www.prostate-cancer.com/prostate-cancer-glossary/Semirigid-Implant.html” semi-rigid implant is the most simple to use and the least expensive. This is when HYPERLINK “http://www.prostate-cancer.com/prostate-cancer-glossary/malleable-implant.html” malleable (bendable) rods are implanted in the erection chambers of the penis. They can be bent to have sex and can be unbent to resume a normal position.
The other type of penile implant is the inflatable implant. The HYPERLINK “http://www.prostate-cancer.com/prostate-cancer-glossary/Self-Contained-Inflatable.html” hydraulic inflatable implant transfers fluid from a reservoir under the groin muscles to two cylinders in the penis, causing an erection. After sex, a patient presses a release valve and bends the penis to get the fluid back to its reservoir. Side effects include infection, scarring, or damage to the two chambers of the penis.
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