Prostate cancer is one of the most common cancers among men, and treatment options can include surgery, radiation therapy, cryotherapy, high intensity focused ultrasound and chemotherapy. One of the common side effects of prostate cancer treatment, especially surgery, is erectile dysfunction (ED). ED can have a significant impact on the quality of life of prostate cancer patients, leading to depression, anxiety, and a reduced sense of well-being. Fortunately, there are effective ED therapies available that can help improve sexual function in post-surgery prostate cancer patients.
Types of Prostate Cancer Surgery
Prostate cancer surgery involves removing the entire prostate gland, including the surrounding tissue. The two most typical prostate cancer surgical procedures are:
- Radical Prostatectomy – This involves removing the entire prostate gland, including the surrounding tissue, through an incision in the lower abdomen.
- Robot-Assisted Radical Prostatectomy – This involves the use of a robot to perform the surgery through several small incisions in the abdomen. This technique is less invasive than the traditional radical prostatectomy and has a faster recovery time.
Both types of surgery can cause ED due to nerve damage that occurs during the procedure. The nerves that control erections run alongside the prostate gland, and any damage to these nerves can lead to ED.
ED Therapy after Prostate Cancer Surgery
There exist a lot of ED treatments after prostate cancer surgery for patients. These treatments or therapies can be classified into three categories:
- Medical Therapy – These are medications that are taken orally, injected directly into the penis, or applied as a cream or gel to the penis. These medications work by increasing blood flow to the penis, which helps to achieve and maintain an erection. Some commonly prescribed medications include:
- PDE5 inhibitors (sildenafil, tadalafil, vardenafil)
- Alprostadil (injected or suppository)
- TRT (Testosterone Replacement Therapy)
- Mechanical Therapy – These are devices that are used to create an erection. These devices work by creating a vacuum around the penis, which causes blood to flow into the penis and create an erection. Some commonly used devices include:
- Vacuum erection devices (VEDs)
- Penile implants (semi-rigid or inflatable)
- Psychological Therapy – These therapies aim to address any psychological issues that may be contributing to ED. Some commonly used therapies include:
- Cognitive-behavioral therapy (CBT)
- Sex therapy
- Couples therapy
- Shockwave therapy
- EMTT therapy
- Tesla Chair
The most popular treatment options to treat ED caused by prostate cancer surgery are PDE5 inhibitors. These drugs function by boosting blood flow to the penis, which might aid in obtaining and maintaining an erection. By blocking this enzyme, the medication helps to maintain an erection. Sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) are the most commonly prescribed PDE5 inhibitors. The efficacy of these medications varies from man to man. The tablets are quick, simple, and don’t get in the way of foreplay. Beginning to take them shortly after prostate cancer treatment is recommended. These drugs may aid a patient’s rehabilitation and enable him to achieve erections on his own in the future.
Alprostadil is another medication that is used to treat ED. It can be placed as a suppository into the urethra or administered directly into the penis. Alprostadil works by increasing blood flow to the penis, which helps to achieve and maintain an erection.
TRT may be recommended if the patient has low testosterone levels. The hormone testosterone is in charge of promoting sex desire and the maturation of male sexual features. Low testosterone levels can contribute to ED, and TRT can help to improve sexual function. TRT is very dangerous if the patient is suffering from prostate cancer. So, it has to be made sure that the patient who is about to receive TRT, doesn’t possess any cancer cell in his body. If the patient doesn’t have prostate cancer or his prostate cancer has been treated completely, then TRT is safe to undergo.
VEDs or also known as vacuum pumps for Erectile Dysfunction, are non-invasive devices that can be used to create an erection. An erection is produced by placing a plastic cylinder over the penis and using a vacuum pump to create a vacuum, which sucks blood into the penis. The erection is then kept in place by placing a constriction ring at the base of the penis. If the patient has a bleeding issue, takes medication to thin his blood, or has Peyronie’s disease, the vacuum pump might not be appropriate for him. Thus, if somebody is thinking about receiving vacuum pump treatment, then it’s vital to talk to the doctor first.
Devices that are put surgically into the penis are known as penile implants. Penile implants usually come in two varieties: semi-rigid and inflatable. Semi-rigid penile implants consist of two rods that are inserted into the penis, and the patient can manually bend the penis into the desired position for intercourse. Inflatable penile implants consist of a fluid-filled reservoir that is implanted in the abdomen and a pump that is implanted in the scrotum. To achieve an erection, the patient squeezes the pump, which fills the cylinders in the penis with fluid. Inflatable implant lasts for about 12 years. After this time period it needs to be changed. Though, in some men it needs to be changed after 6 or 7 years. Semi-rigid implant doesn’t have this issue however. Because it doesn’t require to be changed.
Psychological therapies aim to address any psychological factors that may be contributing to ED. CBT is a type of therapy that helps patients identify and change negative thought patterns that may be contributing to ED. Another sort of therapy that focuses particularly on sexual concerns is called “sex therapy”. Sex therapists can work with patients to develop new sexual skills, improve communication with their partner, and address any emotional or psychological issues that may be contributing to ED. Couples therapy involves both partners and can help to improve communication and intimacy in the relationship.
Shockwave therapy is a viable Erectile Dysfunction treatment option in men who have undergone prostate cancer surgery. By generating new blood vessels, regenerating those that already exist, and significantly enhancing the nerve and other nearby tissues, shockwave therapy for ED enables the patient to have a greater and stronger erection.
EMTT therapy or Electromagnetic Transduction Therapy is capable of beating Erectile Dysfunction in patients who have undergone prostate cancer surgery. The microscopic cell level is where electromagnetic transduction therapy operates. The endothelial cells found inside the millions of blood arteries of the penis are exposed to a strong magnetic field. These cells support the patient’s overall environment to facilitate speedier healing and the restoration of sexual function to normal levels. They also provide energy, transport nutrients, and aid in cell regeneration.
Functional magnetic stimulation is employed by the ground-breaking new piece of medical equipment known as the Tesla Chair. The TESLA Chair’s Functional Magnetic Stimulation delivers electro-magnetic energy that stimulates the targeted deep muscle structures, activating the body’s motor nervous system and causing the muscles to contract, growing bigger, stronger, and tighter as a result. Furthermore, this special apparatus somehow accomplishes this without making direct touch with the skin. Although the Tesla Chair sends the potent electromagnetic waves into the pelvic region, the patient sits in it fully dressed. The painless and cozy Tesla Chair provides a magnetic field strength of up to 1.7 TESLA.
According to Shockwave Clinics Ltd, which is the leading non-invasive treatment provider for ED in the Europe, this therapy is particularly beneficial for men who developed ED as a result of prostate surgery that injured the nerves in the penis, the prostate, and the perineum.
Choosing the Right Therapy
The type of therapy that is best for a post-surgery prostate cancer patient with ED depends on several factors, including the patient’s age, overall health, and the severity of their ED. Medical therapy is often the first-line treatment for ED, but it may not be effective for all patients. Mechanical therapy may be a good option for patients who cannot take medications or who have not had success with medications. Psychological therapy can be useful for patients who have psychological factors contributing to their ED.
It is essential to consult with a healthcare provider before starting any ED therapy, as some therapies may not be safe for certain patients. For example, patients who are taking nitrate medications for chest pain should not take PDE5 inhibitors, as this can lead to a dangerous drop in blood pressure. On the other hand, in some cases simultaneous use multiple therapies can bring a lot of success as well.
In addition to ED therapies, making certain lifestyle changes can also help to improve sexual function in post-surgery prostate cancer patients. These lifestyle changes include:
- Exercise – Regular exercise can help to improve blood flow and overall cardiovascular health, which can improve sexual function.
- Diet – A diet rich in fruits, vegetables, whole grains, and lean protein can help to improve overall health and may improve sexual function.
- Quitting smoking – Smoking can contribute to ED by damaging blood vessels and reducing blood flow to the penis. Smoking cessation can enhance sexual performance.
- Managing stress – Stress can contribute to ED, so managing stress through techniques like meditation, yoga, or therapy can help to improve sexual function.
ED is a common side effect of prostate cancer treatment, especially surgery. However, there are several effective therapies available to improve sexual function in post-surgery prostate cancer patients. Medical therapy, mechanical therapy, and psychological therapy can all be effective, depending on the patient’s individual needs. In addition to these therapies, making certain lifestyle changes can also help to improve sexual function. The appropriate treatment strategy for each patient should be discussed with their healthcare provider.