Sexual Function Post-Robotic-Assisted Radical Prostatectomy
Robotic-assisted radical prostatectomy (RARP) can impact sexual function, but recovery strategies exist.
What percentage of men suffer from impotence after prostate removal?
Studies show that the rate of erectile dysfunction (ED) after radical prostatectomy, surgery to remove the prostate, varies widely. Some studies show that 25% to 75% of men may experience some level of impotence after surgery, depending on age, sexual function before surgery, and nerve-sparing surgical techniques used.
It's important to note that recovery can improve over time and with medical interventions.
How does a man feel after prostate removal?
After undergoing prostate removal surgery, men may experience a variety of physical and emotional reactions. While it can provide relief from cancer, it can also lead to concerns over side effects such as erectile dysfunction, urinary incontinence, and changes in sexual function, which can affect their emotional well-being and sense of masculinity. Additionally, many men may experience anxiety about the possibility of cancer recurrence and may require support to manage these complex emotions.
Can a man climax after prostate removal?
Men who have had a prostatectomy will no longer ejaculate because the prostate gland and seminal vesicles have been removed. These are the parts of the body that make most of the semen fluid.
Individuals can still experience the joyful sensation of orgasm, albeit without the emission of seminal fluid.
The volume of ejaculate fluid experiences a significant decrease after radiation therapy.
What is recommended after prostate removal?
Mindset and Approach to regain sexual function
Remember the three Ps: Proactivity, Positivity, and Patience
The brain plays a vital role as a sexual organ, particularly in the recovery process of RARP. It may take several months to determine the return of erectile function, so being optimistic and persistent is crucial. It is essential to prioritize sexual health recovery without giving in to negativity to achieve success.
Open and honest communication
Effective communication between partners is essential. There has frequently been a misunderstanding of the idea that erections are the only indicator of sexual desire or psychological health. It is crucial to acknowledge that the achievement of sexual enjoyment and orgasm can occur independently of an erection, as this understanding is vital for the preservation of closeness.
Physical Strategies to regain sexual function
Stimulation
Mental and physical stimulation are fundamental for encouraging blood flow and erectile function. The use of sex toys, erotic material, and other aids can be beneficial in stimulating sexual desire and arousal, which is crucial for confidence and libido.
Pelvic Floor Muscle Training
Improved bladder control exercises can also potentially boost sexual function.
Medical Interventions
Medication
After undergoing a radical prostatectomy, medications like tadalafil (Cialis) can be taken to improve blood flow to the penis and promote erections. These medications are generally well-tolerated, but it's important to speak with a medical professional to ensure compatibility, especially if there are any allergies or concurrent nitrates usage. In clinical practice, the majority of patients (87%) follow their doctor's advice and continue taking the medication.
Vacuum Devices
Vacuum erection devices can maintain penile length, improve tissue health, and support erection quality. They should be used cautiously, particularly regarding urinary continence, and should never cause discomfort or pain.
Direct Medication
Prostaglandins administered via injections, urethral pellets, or penile creams directly to the penis can induce erections by dilating blood vessels. These should be initially used under medical supervision due to risks such as priapism.
Surgical Options
Penile Implant Surgery
As a last resort, penile implants offer a solution for those who do not benefit from other methods. This requires careful consultation with specialists and consideration of the irreversible changes it entails.
Do men change after prostate removal?
Although the impact of RARP on sexual function is considerable, as evidenced by the fact that around one-third of patients do not regain spontaneous erections and many discontinue sexual intercourse, informed decision-making and the availability of diverse therapeutic interventions can aid in the restoration and improvement of sexual health. Patients must engage in thorough discussions with their healthcare professionals regarding these options and the potential consequences associated with them.
