Sex After Radical Prostatectomy

What is radical prostatectomy?

Radical prostatectomy is a surgical procedure that completely removes the prostate, including its capsule, due to cancer. The seminal vesicle and the sperm duct, also known as the ductus deferens, are also removed. When regional lymph node invasion is present or suspected, lymphadenectomy is performed simultaneously.

What is robotic radical prostatectomy?

Robotic radical prostatectomy, performed with a da Vinci robot, is the gold standard for prostate cancer surgery in modern countries.

Prostate, seminal vesicle, ductus deferens and in some patients lymph node dissection are performed by inserting robot arms through 4-5 eight mm holes.

What will change in my sex life after radical prostatectomy?

After radical prostatectomy, there will be no ejaculation anymore because the structures that produce and transport semen, the seminal vesicle and ductus deferens, are removed. Even if an orgasm occurs, it will be dry.

Advantages of robotic prostate surgery

• Faster healing
• Less blood loss
• Less pain
• Sooner erection

Is sex possible after prostate removal?

Absolutely yes. Especially when robotic prostate surgery is performed with a nerve-sparing technique, the vast majority of patients are able to achieve strong erections after a few months.

Can you get an erection without a prostate?

The prostate is not directly involved in erection. The vast majority of patients can achieve an erection. However, the neurovascular bundles on either side of the prostate are the main structures that enable erection and can be damaged during prostate cancer surgery. Consequently, approximately 40% of patients with radical prostatectomy experience erectile dysfunction. Robotic radical prostatectomy offers the advantage of nerve-sparing surgery when an erection is achieved early.

Can a man get a woman pregnant after prostate removal?

Patients who have their prostates removed due to prostate cancer will experience dry orgasms because the seminal vesicles and ductus deferens, the sperm and semen ducts, are also removed. This means they will not ejaculate. Therefore, they cannot conceive through intercourse. However, these couples can have children through assisted reproductive technologies (IVF) because sperm production continues in the testicles.

Where does sperm go after prostatectomy?

During prostate cancer surgery, part of the sperm ductus deferens (the sperm duct) is removed and the remaining portion of the ductus deferens is ligated, so sperm will no longer be released during orgasm. However, the testicles continue to produce sperm. This surgery does not negatively impact the testes' primary function: testosterone and sperm production. So, what happens to the sperm produced? Spermatozoa that fail to travel through the ducts are absorbed and eliminated by our bodies.

Penile therapy after radical prostacetomy

Although 60-75% of patients regain erectile function with nerve-sparing robotic prostatectomy, the remaining patients require various methods of penile rehabilitation to restore erectile function. This typically involves medications called PDE-5 inhibitors, vacuum devices, injections, and penile shock wave therapy (ESWT). If severe erectile dysfunction persists despite this therapy, especially after one year, patients are recommended penile prosthesis implantation.

Penile Injection Therapy

Injection therapies administered to the penis are among the treatment options for erectile dysfunction that develops after prostatectomy. In this context, alprostadil, papaverine, phentolamine, or a combination of these are effective agents used for penile rehabilitation.

ESWT (shockwave therapy) after prostatectomy

Low-intensity electroshock wave therapy (Li-ESWT),used for penile rehabilitation in urology, leads to penile revascularization, nerve regeneration, and a reduction in fibrotic processes, thus positively contributing to erectile capacity in affected patients. Scientific studies have emphasized the therapeutic properties of ESWT for impotence following prostate cancer surgery, as well as for erectile dysfunction of organic origin.

Vacuum pump after prostate surgery?

A vacuum pump, also known as a vacuum erection device, aids penile rehabilitation by trapping blood in the corpus cavernosum, the erectile tissue in the penis, during erection physiology. It is recommended to use it twice a week for an average of 10 minutes after radical prostatectomy.

How can a wife help her husband after prostate removal?

Penile rehabilitation for erectile dysfunction following vascular and nerve damage following prostate cancer surgery involves the presence of stimulation. While treatment methods such as PDE-5 inhibitors and ESWT are often used to achieve rehabilitation, these alone are meaningless without visual and physical stimulation. Therefore, it's important for women to support their partners in this regard. Furthermore, men experiencing this condition may delay the problem due to the fatigue brought on by cancer treatment. In this case, it's also crucial for women to support their partners in providing timely urological consultations and referrals to treatment options to address the issue.

Does Viagra work after prostate removal?

Drugs such as sildenafil (Viagra) and tadalafil (Cialis) from the PDE-5 inhibitor group are an effective treatment method for erectile dysfunction that develops after radical prostatectomy surgery, as well as for other causes. There are articles recommending the use of tadalafil (Cialis),particularly at a daily dose of 5 mg, immediately after or even before penile rehabilitation surgery. This method is a successful treatment method used both to restore erection and to prevent penile length shortening.

Penile implant after prostate surgery

Penile implants are the most effective treatment option for severe erectile dysfunction following prostatectomy. Patients experiencing erection problems even after one year of prostatectomy are particularly suitable candidates for penile implant surgery. This is because the vascular and nerve structures damaged by prostatectomy are no longer expected to improve after one year.

Best penile implant

The decision is made by first assessing the patient's expectations and evaluating the options of malleable or inflatable penile implants. If there are no financial concerns or any factors (such as neurological disorders) that limit the use of inflatable implant pumps, inflatable penile implants are more comfortable prostheses. When evaluated at the brand level, each brand has various advantages. For example, antibiotic-coated implants offer the advantage of preventing infection. Some brands offer lifetime warranties and offer good rigidity, which are advantageous features.

For more information WhatsApp: +905324850016