The Fundamentals of Sex

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Nearly all men experience some erectile difficulty after prostate surgery, even with nerve-sparing technique.

Recovery is slow, occurring over a year or more. Not everyone returns to their baseline functioning.

Starting medication or a vacuum device soon after surgery might help preserve tissue health.

A prostate cancer diagnosis can be devastating. It brings us face-to-face with our mortality. Even knowing the high survival rates may not limit the worry and grief. While surgery can remove a tumor, it doesn’t always resolve the emotional impact of this experience. This is especially true when erectile difficulty occurs post-prostatectomy.

Please note the following case is a composite with client details anonymized to protect privacy.

Tom was 62 when a routine PSA test led to a prostate cancer diagnosis. He eventually had a nerve-sparing radical prostatectomy. By every clinical measure, the surgery was a success. However, three months later, Tom continued to experience severe post-operative erectile dysfunction (ED). His penis would not become erect with his partner or during masturbation.

He was informed of the risk to his sexual functioning before surgery. Even then, he was not fully prepared for the emotional experience of ED. The arousal that used to happen effortlessly now felt impossible. He mourned a loss of function, a loss of normalcy, and a loss of connection to his partner and his own sexuality.

This is one of the most common effects of prostate cancer treatment. It is not necessarily an indicator that something went wrong.

Why Erection Loss Happens

The nerves that control erections run alongside the prostate in bundles so fine that even the most skilled, nerve-sparing surgery can bruise,........

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