Contributed by Dr. Cordell Nwokeji (Pronouced “Wo-Kage”)
As previously discussed, life after prostate cancer can be a confusing time where men must relearn their bodies and capabilities, not only in relation to everyday actions and exercises, but also sexual activities.
The first part of this rediscovery involves determining what physical changes the body has undergone. Prostate cancer treatment is associated with a few possible side effects including dry ejaculation, penile shrinkage, and erectile dysfunction, among others. One study shows 78 percent of men contend with erectile dysfunction two years after a prostatectomy with that number only decreasing to 72 percent after five years. The likelihood of developing these side effects after treatment depends on a number of things like the type of treatment, the location of the cancerous tumor, the stage of prostate cancer when it is eradicated, and the man’s age. Invasive procedures combined with older patients are more likely to come with more severe side effects.
That is why testing and catching prostate cancer early can make a big impact on the effectiveness of the treatment and the post-treatment results. A lot of men specifically explore HIFU for prostate cancer so that they can reduce their risk of having to worry about erectile dysfunction after treatment.
With many men grappling with erectile dysfunction after prostate cancer treatment, it’s no wonder men question their ability to have satisfying intercourse post-treatment. Although erectile dysfunction is common, this effect does not erase a man’s ability to have and enjoy sex. Because orgasms are controlled by a different set of nerves than erections, pleasurable intercourse is still possible without achieving an erection. However, it can take time for couples to adapt to sex with a soft penis.
For some, talking with a sex therapist or joining a support group with others undergoing these changes can be helpful. At first it may be uncomfortable to discuss these intimacies issues, but it is important for men to regain function and control over their lives. When it comes to relationships and intercourse, research has shown that women can orgasm with a flaccid penis. Those in the relationship must become comfortable with this new fact of life.
There are a few options to combat erectile dysfunction. Of these options, prescription medicines are most common for their ease of use and unobtrusive nature. Men should take these pills a few hours before they plan on intercourse to achieve the full effect. In addition to pills, other men utilize a vacuum constriction device. Though this device works well, the learning curve and inconvenience can deter some men. There are other alternatives ranging from injections to implants. For a comprehensive list of options, men should consult with their doctor.
Open communication between men and their partners can go a long way to recovering their daily activities and rekindling their romance. Erectile dysfunction and other side effects related to prostate cancer do not end sexual intercourse or pleasure. Being flexible and having an understanding partner can help men regain their intimacy.
About the Author
Dr. Nwokeji specializes in general urology with an emphasis in minimally invasive prostate cancer therapy such as high intensity focused ultrasound (HIFU) and cryoablation therapy.
Dr. Nwokeji was the first physician in Texas to be credentialed in the HIFU procedure having trained in 2007. He was also one of three urologists who gave a testimonial to the FDA panel about his experience with Sonablate HIFU prior to approval. Dr. Nwokeji has been involved with more than 200 HIFU patients and is currently one of a few urologist trained to offer the procedure in Texas. Outside of prostate cancer, Dr. Nwokeji also manages kidney stones, prostate disease, female voiding dysfunction and oncology.