For many men, facing prostate surgery, or a prostatectomy, brings up questions about how this will impact their sex life. It’s a topic that carries both physical and emotional weight. The effects of prostate surgery can vary depending on the type of procedure, the extent of cancer or other issues, and individual health factors. This article explores what you can expect and offers insight into recovery and resources.

What Is a Prostatectomy?

A prostatectomy is a surgical procedure in which part or all of the prostate gland is removed. This is typically done as a treatment for prostate cancer but may also be recommended for other health concerns like benign prostatic hyperplasia (BPH). There are different types of prostatectomies:

Radical Prostatectomy: Removes the entire prostate gland and some surrounding tissue.
Laparoscopic Prostatectomy: A minimally invasive procedure done through small incisions.
Transurethral Resection of the Prostate (TURP): removes a portion of the prostate to relieve symptoms of urinary issues, often for men with BPH.

Effects of Prostate Surgery on Sexual Health

Several factors can influence post-surgery sexual function. Since the prostate and surrounding nerves play a role in erections and ejaculation, prostatectomy can result in certain side effects. Here’s what men can generally expect:

1. Erectile Dysfunction (ED)

Erectile dysfunction is a common outcome following prostate surgery. The nerves surrounding the prostate, responsible for achieving an erection, can be affected during the procedure. While “nerve-sparing” surgery may help preserve erectile function, some men will experience temporary or even long-term erectile issues.

Recovery Tip: Many men find improvement over time, and medications or treatments such as oral ED medications, penile injections, or vacuum devices can assist in regaining function.

2. Changes in Orgasm

After a prostatectomy, the experience of orgasm often changes. Because the prostate and seminal vesicles are removed, there will be no ejaculation, a condition known as “dry orgasm.” Although the sensation of orgasm is still possible, it may feel different in intensity or duration.

3. Reduced Libido

The emotional and psychological impact of prostate surgery can also affect libido. The stress of surgery, coupled with concerns about sexual performance, can impact desire. Additionally, hormonal changes due to cancer treatment (if applicable) may lower testosterone levels, impacting libido.

Will sexual function recover?

Sexual recovery is possible for many men, but it may take time and patience. Recovery rates depend on age, overall health, and whether nerve-sparing techniques were used during surgery. Generally, the recovery of erectile function can take anywhere from 6 to 18 months, with gradual improvements.

Strategies for Managing Sexual Health Post-Prostatectomy

While recovery varies, there are ways to manage and improve sexual health after prostate surgery. Here are some practical strategies:

1. Medications for Erectile Dysfunction

Medications like Viagra, Cialis, and Levitra are often effective for men after a prostatectomy. These drugs help increase blood flow to the penis and can be taken as a regular treatment or on an as-needed basis.

2. Penile Rehabilitation

Some doctors recommend penile rehabilitation, which involves using medication, devices, or exercises to maintain blood flow and encourage healing in penile tissues. This can help improve erectile function over time.

3. Counseling and therapy

Emotional wellness is just as crucial as physical recovery. Working with a therapist or counselor, especially one who specializes in sexual health, can be beneficial. Couples therapy may also help manage expectations and communicate openly about changes in intimacy.

4. Pelvic Floor Exercises

Strengthening pelvic floor muscles through exercises like Kegels can support recovery and improve sexual health by enhancing blood flow and control over erections. 

Tips for Couples Navigating Intimacy Post-Surgery

Maintaining intimacy after a prostatectomy can be a journey that both partners undertake together. Here are some ways couples can nurture intimacy:

Open Communication: Honest conversations about fears, expectations, and feelings can reduce stress and bring partners closer.
Exploration and Patience: Trying new ways to experience pleasure can help couples find alternative means of connection. Physical closeness doesn’t always require penetration.
Set realistic expectations. Recovery takes time, so set achievable goals and focus on progress rather than perfection.

Alternative Treatments for Erectile Dysfunction Post-Prostatectomy

If oral medications aren’t effective, there are other options available:

Vacuum Erection Devices: A vacuum device can help draw blood into the penis, aiding in achieving an erection.
Penile Injections: Self-administered penile injections can produce an erection and are often used when oral medications don’t work.
Surgical Implants: In cases of severe ED, penile implants offer a permanent solution for achieving erections.

When to Seek Help

If sexual issues persist, don’t hesitate to reach out for help. Many specialists, including urologists and sexual health therapists, are skilled in helping men manage post-prostatectomy sexual challenges. Addressing any ongoing issues for both physical and emotional well-being is essential.

Conclusion

A prostatectomy can change your sexual life, but it doesn’t have to end it. While some effects are unavoidable, many men find ways to adapt and enjoy intimacy in new ways. Open communication, support from partners, and a willingness to explore different treatment options can make a world of difference. Remember that recovery is a journey, and with the right tools and patience, a fulfilling sexual life is still within reach.

FAQs

Q1: Can I still have sex after a prostatectomy?
Yes, many men continue to have an active sex life after a prostatectomy, though there may be adjustments, especially regarding erections and ejaculation.

Q2: How long does it take to regain erectile function after prostate surgery?
A: Recovery varies, but it typically takes 6 to 18 months. Some men may regain function earlier, while others may need more time and additional treatments.

Q3: Are there treatments for ED after prostate surgery?
A: Yes, options include medications, vacuum devices, penile injections, and, in severe cases, penile implants.

Q4: What is a “dry orgasm”?
A dry orgasm is an orgasm without ejaculation, which commonly occurs after a prostatectomy since the glands responsible for semen production are removed.

Q5: Can pelvic floor exercises help with recovery?
A: Absolutely. Pelvic floor exercises, like Kegels, can support erectile function by enhancing blood flow and muscle strength in the pelvic area.