What is Post Prostatectomy Erectile Dysfunction?
Post prostatectomy erectile dysfunction is a postoperative complication that is defined as the inability to attain and maintain a sufficient erection for satisfactory sexual intercourse post removal of a partial or complete prostate gland to treat prostate cancer.
Why does Erectile Dysfunction Occur Following Prostatectomy?
The prostate is a gland that rests around the urethra. The urethra is a tube that transports semen and urine to the outside of the body. The prostate gland is surrounded by blood vessels, nerves, and muscles required to achieve an erection and control the bladder. During a prostatectomy, these blood vessels, nerves, and muscles may be damaged or weakened leading to erectile dysfunction. As a result, post prostatectomy, many men are unable to have an erection for a period of time ranging from less than a month to longer than a month or even a year or more in a worst-case scenario. The ability to achieve an erection post prostatectomy depends on how close the prostate cancer was to the nerves that control the erections.
What are the Factors that Determine Adequate Erectile Function Post Prostatectomy?
The ability to have adequate erections post prostatectomy will depend upon:
- Medical conditions you may have like diabetes or high blood pressure
- How your erections were prior to prostatectomy
- Types of medicines you may be taking such as antidepressants or high blood pressure meds
- Lifestyle habits such as smoking or drinking
- Your age
Treatment for Erectile Dysfunction Post Prostatectomy
The types of treatment used for erectile dysfunction post prostatectomy include:
- Injection therapy: A small needle is used to inject prescription drugs into the side of the penis. The injected drugs work by relaxing the smooth muscle tissue allowing more blood flow to the penis. This causes erection within 10 minutes and lasts anywhere from 30 to 60 minutes. In this method, you do not have to be in a sexually stimulated state to achieve erection.
- Oral medicines: The most common oral medications prescribed are Viagra, Cialis, and Levitra. These meds function by enabling more blood flow to your penis. It takes about 30 min to 1 hour to achieve erection with these meds, however, you would need to be in a sexually excited state to have an erection with this method.
- Vacuum device: In this technique, the penis is lubricated and placed into an airtight plastic cylinder fastened to a hand-held pump. A vacuum is created by pumping air out of the cylinder that increases blood flow to the penis thereby causing an erection. An elastic band located at the base of the penis aids in maintaining the erection.
- MUSE: This is a tiny pellet of medicine, as small as a grain of rice, that is positioned in your urethra with a disposable plastic applicator. The medicine allows blood flow to your penis and you will achieve an erection in 5 to 10 minutes lasting for 30 to 60 minutes. This method does not require you to be sexually excited in order to achieve an erection.
- Penile implants: This method is employed when medicines and external medical devices have failed to yield good results. A penile implant is a medical device that is placed in your penis through an operation. The implant assists you to have a mechanical erection (ability to achieve an erection by placement of a medical device in the penis). It has been regarded as a very effective treatment for erectile dysfunction with remarkable efficacy and satisfaction rates.
Lifestyle Changes to Improve Erectile Dysfunction Post Prostatectomy
Changes that you make in your life post prostatectomy may help with erectile dysfunction. Some changes you should consider include:
- Consuming a healthy diet
- Exercising on a regular basis
- Drinking alcohol responsibly as long-term heavy drinking can decrease your ability to achieve an erection
- Trying to reduce fatigue and stress levels as it can cause low sex drive
- Refraining from smoking as smoking has been linked to erectile dysfunction
- Practicing Kegel exercises to strengthen your pelvic floor muscles as these muscles are known to help with erections