Erections After Prostatectomy – Do You Care?

The diagnosis of prostate cancer means making a lot of decisions. Who knew that there would be so many decisions regarding treatment? In a perfect world, you would go into your doctor’s office and they would tell you exactly the type of treatment you need, exactly how long it will take to recover, and when you can get back to your regular life.

Unfortunately, that is not the case with this type of cancer. You must first decide how to treat the disease and understand the side effects of each type of treatment. Weighing the pros and cons of each type of treatment can mean assessing the importance of certain aspects of your life that people often take for granted, including sexual function and bladder control.

What is important to you?

In my practice as physical therapist in a large urology practice, I have the privilege of helping men to proactively address “quality of life” issues before and after a prostatectomy. Being a PT, I love to put the emphasis on being proactive. This means taking an active role in your own recovery. In the case of sexual function, this can start with being honest about how important sexual function (achieving and maintaining a penile erection) is to you.

Truthfully, the answer to this question can vary greatly from one man to another. I have had men tell me that they would be fine if the ability to achieve an erection never returned, and I have had men in tears when 2 months after surgery they were unable to sustain an erection suitable for intercourse.

So, how important is this to you? If it is important, then here is my first piece of advice. Talk about it. Tell your doctor. Let your doctor know that you would like to be proactive in preserving this ability. This may play a role in the type of treatment you choose. It may play a role in how quickly penile rehabilitation begins after surgery, or in some cases before surgery.

Honest conversations with your doctor

Some men will have the wrong idea that if they talk about these quality of life issues, they may seem as if they are less focused on “beating the cancer.” Your doctor should be completely honest with you regarding how each form of treatment may impact your sexual function AND give you advice regarding your desire to preserve as much sexual function as possible. They should not sacrifice “beating the cancer” for erectile function but rather have an honest conversation with you.

If nothing else, this conversation lets your doctor know you are interested in being proactive. If you have already had treatment for your prostate cancer and have not mentioned to your doctor that you have ED and would like to be proactive in regaining as much function as possible, it is not too late to let them know. Please do not let embarrassment about this topic prevent you from speaking up!

There are many options for help regaining sexual function postoperatively, and I look forward to discussing these in future articles.