Impotence results when the line of communication is disrupted between the brain – your primary sex organ – and your penis. Sexual desire is born in the brain, which then orders the penis to fill itself with blood and create an erection.
Unfortunately, the line of communication between brain and groin runs past the prostate. Prostate-cancer treatment, whether surgical or non-surgical, often damages or destroys the nearby nerves, thus blocking communications. If the order doesn’t get through, the erection doesn’t occur.
Raising the odds against ED
Non-surgical treatments, such as radioactive seeds (brachiatherapy), and cryotherapy (freezing the tumor) decrease the likelihood of ED. Surgical techniques, such as the so-called nerve-sparing technique, improve chances of post-surgery sexual function. Robotic surgery offers a level of precision that may enable the surgeon to zap the cancer cells without zapping the nerve cells. But not all cancer patients are candidates for these methods, and there’s no guarantee that the patient will return to full sexual function.
So what are the options if you find yourself impotent after surgery?
Using the Vacuum Pump
Patients who undergo nerve-sparing surgery may recover their sexual functions within a year. In the meantime, there’s the vacuum pump. It’s relatively inexpensive and may be covered by Medicare or your health-insurance policy.
The device consists of a plastic tube with a pump inserted into one end. You simply slide a plastic pressure ring over the open end, apply a water-soluble lubricant such as KY to the rim and to a couple of inches inside the tube, and insert the penis. The pump creates a vacuum inside the tube, causing blood to flow into the penis and create an erection. Once the erection is obtained, you slide the pressure ring off the end of the cylinder and around the base of the penis. This will hold the erection long enough to allow intercourse.
Viagra, Cialis, Levitra et al
In many men, the remedy for ED may be as simple as taking Viagra, Cialis, Levitra or another oral medication. Brian Miles, M.D., one of the authors of a study at the Baylor College of Medicine in Houston, Texas, recommended that patients begin taking the medication around six months after surgery.
Penile Injections for More Natural Erections
Penile injections are another option. This method requires that you inject a serum into the side of your penis, using a thin needle. The pain is minimal, and most men adjust to it quickly. The injection provides something close to a natural erection within a few minutes, and it may last for an hour or more.
The surgical penile implant
If none of these works, medical technology offers the penile implant. This requires surgery, but it produces quick, convenient and reliable erections. It uses a pump in the scrotum to force a solution from a reservoir in the abdomen into tubes up the sides of the penis. The surgery leaves no visible evidence of the implant.
Different, but Still Enjoyable
Without the prostate, you will not secrete semen. You will experience orgasms, but there will be no ejaculation. The climax will be less intense, but enjoyable anyway.
If you’re considering riding out the cancer rather than risking a diminution of your sex life, remember this: As you approach old age, your potency is likely to wane anyway. Artificially restored potency may be preferable to age-induced ED. And untreated prostate cancer can lead to the ultimate impotency: death.
