Many men that have prostate cancer are rightfully concerned about undergoing a prostate surgery that results in erectile dysfunction (ED). Whether the treatment is radical prostatectomy (operation to remove the prostate gland), radiation therapy or medical therapy, ED often develops. If radical prostatectomy is performed, there is existing clinical evidences that vacuum erectile device (penile pump) therapy can improve ED and preserve penile size after your surgery. Prostate Surgery - Erectile Dysfunction Treatment
Even if you aren't engaging in sex, using a penile pump is very important after your prostate surgery. The negative pressure generated by the penis pump forces oxygen enriched blood into the penis and generally increase the blood flow to stave off erectile dysfunction. After your prostate surgery, erectile dysfunction may take around 2 years to be fully resolved, that's a long time to not have blood flowing sufficiently into the penis! Dormant penile function may result in fibrosis occurring in the arteries, blocking future blood flow. It can also cause a venous leak to occur, which is when blood flows out of the penis at a rate that doesn't allow a hard erection to occur. It may seem aggressive, but early and daily use of penile pumps after prostate surgery produced promising results.
A study also found that men who were consistently compliant with penile pump therapy only 3% resulted in decreased penile length of greater than 1 cm. However, for the non-compliant group, 67% had reduction in penile length of greater than 1 cm.
Prostate surgery - erectile dysfunction commonly occur together because both prostate cancer and ED are more common in older men. Phosphodiesterase inhibitors (oral ED medications), are the most convenient and effective treatment option recommended post prostate surgery to treat erectile dysfunction and are most effective following a nerve-sparing prostatectomy. However, these oral agents rely on intact and functioning cavernosal nerves to produce an erection, which were likely damaged during the prostate surgery and will take many months to regenerate. A combination therapy of both penile pumps and oral medications are typically recommended post-prostate surgery. Another option is to utilize penile injections to stimulate an erection.
Treatment options for patient who have prostate surgery - erectile dysfunction or radiation induced ED:
- Oral Medications - Pills are the treatment of choice but failure rate is as high as 80% among men who have undergone prostatectomy. Also, if you take nitrates for heart problems, consuming pills with nitrates can dangerously drop your blood pressure. Therefore, other options listed below would be more appropriate for patients taking nitrates.
- Alprostadil (Muse or Caverject) – This medications comes in injection and pellet form. This drug induces penile erection by relaxing certain muscles in the penis and widening blood vessels, which increases blood flow to the penis and helps to cause an erection.
- Mechanical devices - Vacuum constriction device, or vacuum pump. These devices stimulate erection by forcing blood into the penis and keeping it there with the use of rubber ring.
- Balloon angioplasty – This procedure identifies blockages in the pelvic arteries, and restores proper blood flow through balloon angioplasty.
- Penile Implants – This surgical treatment is the final option as it tends to be invasive. Read more about this option in our blog post: How do Penile Implants or Penile Prosthesis Work? and Are Penis Implants or Penile Prosthesis Effective?
These are some of the best options to combat the prostate surgery - erectile dysfunction linkage. Think that you might want to try one of these? Get an ED Evaluation and see which of these is the most effective option for you! Our Men's Clinic provides a unique evaluation as well as provides a trial test dosing of medication that has up to a 90% success rate. Results may not be this good in patients that have undergone prostate surgery, however other options may be available.
Or, think you have tried all the treatment options available to you? Read our free eBook on the 5 Step Erectile Dysfunction Treatment Guide to find out about other treatment options that you can consider.