“Can I get an erection after prostate removal?” is a frequent question. And here is the good news – yes, you can, if you are proactive and keep a positive mindset regarding your sexual activity and changes in it.
Prostate removal surgery (Prostatectomy)
It is a BPH (benign prostate dysplasia) or prostate cancer treatment method. During the surgery, the doctor removes the whole gland or a part of it.
Radical prostatectomy
RP includes the elimination of the prostate gland, seminal vesicles, and, in some cases, nearby lymph nodes.
Laparoscopic prostatectomy
Laparoscopic surgery means that the surgeon will make minor cuts in the abdomen and place long catheters with a laparoscope (a camera) and surgical tools there.
Robotic-assisted laparoscopic prostatectomy
The operation is done similarly to ordinary LPR but the surgeon operates a robotic arm. The technology provides more precision in the process.
Impact of prostate removal on erections
It is important to remember that erections and orgasms are still possible. The things that change are ejaculations (prostate and vesicles produce semen fluid—without them, there will be no semen to ejaculate) and sensitivity. The latter depends on whether the nerves were spared.
Nerve-sparing vs. non-nerve-sparing procedures
As the name suggests, the difference lies in nerve preservation. With NS, neurovascular bundles stay unaffected by the operation. Whether the surgery is NS or NNS, depends on the surgeon’s training and the location of cancerous formations.
Affecting Factors
Future sexual life and erectile function do not depend exclusively on the kind of surgery itself: there are other significant factors:
- Age, general health, and lifestyle before surgery will affect the speed and success of recovery.
- The post-operative sexual life will depend on what erections the patient had prior.
- Surgeon’s skills and experience determine if it is NS or NNS surgery, potential damage to blood flow, and other complications.
Erectile dysfunction statistics after prostatectomy
Getting an erection after prostate removal can be complicated: after an RP, 85% of males reported ED issues. The chances of recovery depend on the patient’s approach and rate of nerves-sparing during the procedure. After NNS prostatectomy, getting rid of erectile dysfunction is much more complicated.
However, the rate of the men who returned to their pre-surgery erections looks promising: 40%–50% in the first year, and 30%–60% in the second year.
Recovery and treatment options
Right after you were discharged from the hospital, you will require much rest and healing. Then, you can make the first steps back to sexual activity.
Timeline
In general, the patient can try masturbating or penetrative sex in 3–4 weeks after the surgery. The exact term may vary depending on individual conditions. The meaningful changes will likely come in 9 to 12 months, and the full-scale recovery can take 2 years or more.
Therapeutic interventions
We stress again that prostate removal and erection are not mutually exclusive. For a good erection, a man needs two things: transmission of a neural signal about arousal from the brain and uninterrupted blood flow to corpora cavernosa. And there are many ways to improve the latter.
Oral medications
The inhibitors of phosphodiesterase 5 are the gold standard of ED treatment. These drugs are vasodilators: they expand the walls of blood vessels so blood flows freely. The most well-known PDE5Is:
- Sildenafil (Viagra)
- Tadalafil (Cialis)
- Vardenafil (Levitra)
Penile injections
Penile injections are the option when PDE5 inhibitors are insufficient. They are a mix of prostaglandin E-1, papaverine, and phentolamine (the exact proportion is determined individually for each patient). The medication is injected into the penis with a hypodermic syringe which takes 5 to 20 minutes and can be easily done by the patient themselves. The mix relaxes the smooth muscles and dilates blood vessels providing enhanced blood flow.
Vacuum erection devices
This method implies that the patient literally pumps blood to the penis using a vacuum pump. After that, they slide a rubber ring on the base to prevent outflow. Many patients complain that the penis quickly gets cold and is not hard enough for penetration but it is still a good way to provide oxygenation and nutrition for the penile tissues to prevent ischemia and shrinking.
Penile implants
If nothing works, another surgery may be indicated: implantation of a flexible or inflatable rod into the penis.
Tips for maintaining sexual health
Good sexual life is not limited to wet orgasms. Sexual stimulation, the sense of intimacy, experiments and, most importantly, trust will allow the man to fully enjoy intimacy.
Communication with your partner
Open communication, honesty, and willingness to cooperate are key to returning the action to your bedroom. Do not be ashamed to seek the help of a sex therapist or a family consult – these specialists have practical methods to help two partners overcome post-surgery complications.
Alternative methods
Keep in mind that sex is not necessarily about penile stimulation, penetration, or ejaculation. Giving some attention to other erogenous zones that you neglected before can make your sex life just as exciting as before.
Focusing on overall health
Do not forget to care about your mental and physical health in general. It will assist your recovery and will give a necessary vector away from self-deprecation.
Summary
Whether can a man get an erection after prostate surgery, is determined by the operation itself and the patient’s recovery strategy. However, it is possible. The ability to have and maintain an erection will take some time to recover and there are therapeutic methods to assist the rehabilitation.
FAQ
It depends. The first try can be done in 3 to 4 weeks, visible changes can come in 9 to 12 months, and full recovery – in 2 years or more.
You can honestly communicate about the situation and develop together new ways to try and achieve sexual pleasure. Medical specialists and consultants can help you do that.
Yes. Post-prostatectomy orgasms are called “dry orgasms” because there will be no semen to be ejaculated.
