What is erectile dysfunction?
Erectile dysfunction, also sometimes called impotence, is when a man cannot achieve or maintain an erection for satisfactory sex. Erectile dysfunction can limit your intimacy, affect self-esteem, and impact your relationship with your partner.
Watch Dr. Lowentritt of Chesapeake Urology discuss erectile dysfunction in the video below:
What causes erectile dysfunction?
Most men who undergo treatment for prostate cancer will experience some erectile dysfunction for the first several months after treatment, even despite nerve sparing surgery or precision radiation. This is because the blood vessels that control an erection are easily affected by any trauma to the area.
Knowing that this is a potential side effect, be sure to discuss your management strategy for erectile dysfunction with your doctor. Erectile dysfunction can be a difficult topic to discuss, but being open and honest about the problems you are having will allow your doctor to make the best treatment recommendation for you. Side effects from prostate cancer treatments are often different from one man to the next.
Can erectile dysfunction be treated?
There are several treatment and management options for erectile dysfunction. However, your ability to have an erection after prostate cancer treatment can be affected by several things:
- How good your erections were before treatment
- Other medical conditions like high blood pressure and diabetes
- Other medicines you may take
- Your lifestyle, drinking, or smoking
- The type of treatment you had
As you consider your treatment options make sure you and your doctor consider all of the options. You may want to seek out a prosthetic urologist. These physicians specialize in the treatments for erectile dysfunction and urinary incontinence. They can be an excellent source of information about the risks and benefits of each treatment. Learn more on our Treatment Options for Erectile Dysfunction page.
By working with a physical therapist, you can find out if kegel exercises may help relieve your erectile dysfunction. You can also try kegel exercises on your own. Learn more on our Physical Activity and Exercise page.
There are a number of prescription medications available that may improve blood flow to the penis. Commonly used medications are Viagra, Cialis, and Levitra. Combined with sexual stimulation, this can produce an erection. These drugs are not for everyone. They can interfere with other medications you are taking and negatively impact your health.
With injection therapy a needle is used to inject medication directly into the base or side of the penis. The medication allows blood to flow into the penis, creating an erection. See image on left, below.
Vacuum Erection Devices
A plastic cylinder is placed over the penis, and a pump (either manual or battery operated) creates a vacuum suction within the cylinder, drawing blood into the penis to create an erection. A stretchable tension band is placed at the base of the penis to help maintain the erection.
An applicator containing a small medicated pellet or suppository is inserted and released into the urethra through the opening at the tip of the penis. The pellet is about the size of a grain of rice and dissolves to increase blood flow to the penis, creating an erection.
A medical device that is implanted into the penis. Entirely contained within the body, a pump fills two cylinders and creates an erection. Once activated you can maintain an erection as long as you desire.
Penile implants require a surgical procedure by a physician, typically a urologist who has been trained and is skilled in penile prosthetics. There are three different types of penile implants: 3-piece inflatable implant, 2-piece inflatable implant, and a 1-piece bendable (malleable) implant. Because each type of implant offers unique features, the risks and benefits should be discussed with the physician to help choose the most appropriate option.
Resources for Managing Erectile Dysfunction
Men who undergo procedures not designed to spare nerves will fare worse when recovering from erectile dysfunction following treatment. Read this interesting article about Sex After Prostate Cancer from the Chicago Tribune.