Does surgery for prostate cancer cause ED?

Erectile dysfunction (ED) is common after prostate cancer surgery. Up to 75 percent of men after prostate cancer surgery have some degree of erectile dysfunction. It depends on what the pre-surgery function was, age of the patient, extent of the cancer, and whether the surgery spared the nerves that allow for erectile function or not. Treatments such as Viagra, Cialis or Levitra may help. Penile prostheses can be used if other treatments fail.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

If you have prostate cancer, surgery to remove the diseased gland is one option for treatment. During the procedure, there's a chance that nerves needed to produce an erection may be damaged. Erectile dysfunction could be the result. You are more likely to develop erectile dysfunction following surgery for prostate cancer if:

  • You are 60 or older
  • You had some evidence of erectile dysfunction before surgery
  • You are in poor health

However, if you develop erectile dysfunction after undergoing surgery for prostate cancer, the problem isn't necessarily permanent. Many men regain full sexual function over time, usually within a year or so. For those who don't, medications such as sildenafil (Viagra), vardenafil (Levitra) and tadalafil (Cialis) can help men cope with erectile dysfunction.

Dr. Marc B. Garnick, MD
Hematologist & Oncologist

Surgery for prostate cancer can sever some of the nerves and arteries that are necessary for an erection. About three-quarters of men who have had a radical prostatectomy, including the nerve-sparing operation, experience erectile dysfunction (ED). The specific risk for surgery-induced ED depends on a number of variables, including the patient's age and the surgeon's skill. And regardless of the type of prostatectomy performed, men who do regain potency usually do so about six to 12 months following surgery, though for some it can take a few years.

Surgery for prostate cancer can cause erectile dysfunction. Nerves that carry signals from the spine to the penis run very close to the prostate. Sometimes during surgery to remove cancer in and around the prostate, these nerves are damaged or destroyed. Although it is usually possible to avoid the nerves during surgery, surgeons may remove the nerves intentionally for fear that they may contain cancer cells that have spread from the prostate. Removing the nerves may prevent the cancer from spreading.

Because the most common and troubling harms of surgery have to do with two basic bodily functions, the ability to control one's bladder and to have sex, there is a good possibility of suffering at least some erectile dysfunction (impotence) or urinary incontinence as a result of the surgery.

Erectile problems are almost inevitable unless a nerve-sparing technique is successfully used. Whether or not this technique can be used, however, is usually not known going into the surgery. It depends on the location and characteristics of the tumor that are found during surgery, however; there is a chance that a planned nerve-sparing approach will have to be converted into the more-damaging wide excision during the procedure to make sure that the entire tumor is removed.

Of all men who have adequate erectile function prior to surgery, regardless of age or stage, over half can expect some erectile difficulties after surgery. The range of probability is about 25 to 85 out of 100 men experiencing problems. Younger (under 60), healthy men who have nerve-sparing surgery have the best chance of maintaining sexual function—about 75 out of 100 will regain sexual function, although recovery may take a year. The chance of having persisting erectile problems increases with age and the extent of disease, but there are medical and surgical treatments available to induce erections, and erectile difficulties do not interfere with libido or the sensation of orgasm.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.