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Written By THT Editorial Team

Dr. Asmita Pandey

Reviewed by Dr. Erena Pradhan, Consultant Urologist, MS, MCH

The Journey to Recovery

Prostate cancer treatments, especially the surgical procedure known as radical prostatectomy, have profound effects on a man’s sexual health. This operation can alter erectile function, ejaculation, and overall sexual contentment (Hyun 2012). Both patients and healthcare providers need to grasp the intricacies of sexual health following prostate surgery to tackle these challenges and discover successful recovery strategies effectively.

Sexual Health and Prostate Surgery

Radical prostatectomy, a gold standard method for treating localized prostate cancer, may cause a range of postoperative sexual health concerns. One of the most common issues is erectile dysfunction caused by damage to the nerves that control erections (Bratu et al. 2017). While nerve-sparing surgeries are designed to reduce this risk, they’re not suitable for everyone, and some men may face persistent erectile dysfunction that necessitates continued support for fulfilling sexual activity. (Cancer Research UK, 2023).

Post-surgery, men might also encounter ejaculation issues, most commonly retrograde ejaculation, which is caused by destruction of the natural mechanism of preventing the backflow of semen into the urinary bladder. Also in radical prostatectomy, lack of seminal fluid production, leads to what’s known as dry orgasms (orgasm without ejaculation), which can alter the physical sensation of climax (Koren & Koren, 2020). Additionally, the removal of the prostate gland can change sexual sensations during anal intercourse, potentially affecting sexual pleasure and intimacy, particularly in same-sex relationships. (Alexis & Worsley, 2018).

Pathways to Sexual Health Recovery

Addressing the sexual health challenges after prostate surgery involves a variety of strategies and interventions to aid patients in reclaiming sexual function and satisfaction. Penile rehabilitation programs are vital in fostering erectile recovery by preserving the oxygenation of penile tissue and muscle health, as well as aiding nerve healing. (Müller et al., 2008) (Elliott & Matthew, 2017)

Medical treatments, including oral medications like sildenafil and tadalafil, can improve blood flow to the penis, aiding in achieving erections. For cases where more conservative treatments don’t yield results, vacuum devices and penile implants provide alternative solutions for erectile dysfunction (Wang et al., 2023). These methods are geared towards restoring penile erection and enhancing sexual performance after surgery.

A Holistic Approach to Sexual Well-being: 

Confronting the sexual health changes following prostate surgery which is often an unspoken aspect demands a holistic strategy that considers both the physical and psychological facets of sexual wellness. With an understanding of the potential complexities introduced by prostate cancer treatments and the implementation of personalized recovery plans, patients can improve their quality of life and rediscover gratifying sexual experiences.

In summary, active management of sexual health problems after prostate surgery through counselling, rehabilitation, and medical treatments is crucial in aiding patients on their path to restoring sexual function.  Healthcare providers can combine their medical knowledge with comprehensive care practices to help individuals effectively navigate the complexities of sexual health following prostate cancer therapy.


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  2. Bratu O, Oprea I, Marcu D, Spinu D, Niculae A, Geavlete B, Mischianu D. Erectile dysfunction post-radical prostatectomy – a challenge for both patient and physician. J Med Life. 2017 Jan-Mar;10(1):13-18. PMID: 28255370; PMCID: PMC5304365.
  3. Cancer Research UK. (2023). Sex and erection problems after treatment for prostate cancer. Retrieved from https://www.cancercenter.com/community/blog/2023/06/sex-after-prostate-cancer
  4. Koren G, Koren D. Retrograde Ejaculation-a Commonly Unspoken Aspect of Prostatectomy for Benign Prostatic Hypertrophy. Am J Mens Health. 2020 Mar-Apr;14(2):1557988320910870. doi: 10.1177/1557988320910870. PMID: 32146870; PMCID: PMC7065283.
  5. Alexis O, Worsley AJ. The Experiences of Gay and Bisexual Men Post-Prostate Cancer Treatment: A Meta-Synthesis of Qualitative Studies. Am J Mens Health. 2018 Nov;12(6):2076-2088. doi: 10.1177/1557988318793785. Epub 2018 Aug 16. PMID: 30112965; PMCID: PMC6199434.
  6. Müller, A., Tal, R., Donohue, J. F., Akin-Olugbade, Y., Kobylarz, K., Paduch, D., Cutter, S. C., Mehrara, B. J., Scardino, P. T., & Mulhall, J. P. (2008). The effect of hyperbaric oxygen therapy on erectile function recovery in a rat cavernous nerve injury model. The Journal of Sexual Medicine, 5(3), 562-570. https://doi.org/10.1111/j.1743-6109.2007.00727.x
  7. Elliott, S., & Matthew, A. (2017). Sexual Recovery Following Prostate Cancer: Recommendations From 2 Established Canadian Sexual Rehabilitation Clinics. Retrieved from https://pcscprogram.ca/wp-content/uploads/2022/01/Sexual-Recovery-after-Prostate-Cancer-Elliott-Matthews.pdf
  8. Wang CM, Wu BR, Xiang P, Xiao J, Hu XC. Management of male erectile dysfunction: From the past to the future. Front Endocrinol (Lausanne). 2023 Feb 27;14:1148834. doi: 10.3389/fendo.2023.1148834. PMID: 36923224; PMCID: PMC10008940.