When you experience erectile dysfunction and impotence after prostate surgery

Erectile dysfunction after prostate surgery doesn’t mean the end of your sex life

Many men will experience changes in their ability to achieve and maintain an erection after prostate surgery. However, this is also commonly seen after back surgery and cancer surgery in general.

This can come as a shock, since there’s often little focus on the potential for erectile problems or impotence after surgery. And especially if your sex life was going well before, it can really hit a man’s self-esteem hard.

Erections and potency may weaken, become unreliable, or perhaps disappear entirely. Sexual desire may also be negatively affected, and sometimes masturbation is possible, but not sexual intercourse. Your sex life just isn’t the same as before!

The problem isn’t you or your sexuality—it’s the physical and neurological changes that affect your erectile function after prostate surgery.

On this page, I’ll describe what happens to erectile function after prostate surgery, as well as after cancer and spinal surgeries. I’ll also explain why this is common and what can be done about it if you act in time.

Here you can focused shockwave and EMTT treatment can be an invaluable part of the rehabilitation process after prostate surgery for your penis and erectile function.

Michael Strøm

International expert in shockwave and EMTT therapy for erectile dysfunction and Peyronie's disease.

Erectile Dysfunction / Impotence After Prostate Surgery

A strong, firm erection requires coordination between blood vessels, nerves, hormones, and the brain. Any factor that affects these systems can also interfere with the ability to achieve and maintain a strong erection.

After prostate surgery, it is not uncommon to experience impotence or incontinence. This is because even during nerve-sparing prostate surgeries, damage can occur to nerves, blood vessels, and the surrounding tissue.

The pelvic floor is particularly vulnerable, as it acts as a hammock for the organs and is part of the body’s center of balance. Consequently, there is a great deal of connective tissue, nerves, blood vessels, and muscles in this area that interact with one another.

In particular, the pudendal nerve, which runs from the spine and through the large muscles of the buttocks, is particularly vulnerable. If it is damaged, it can lead to erectile dysfunction, as it supplies the pelvic floor and penis with nerve signals.

Finally, it’s inevitable that inflammation will occur, leading to scar tissue formation in the area after surgery—whether in the pelvic floor, the back, or elsewhere in the body. The scar tissue contributes to increased stiffness and reduced elasticity in the tissue and can diminish sensation in the area.

Symptoms of erectile dysfunction and incontinence after prostate surgery

will vary from man to man. It depends on how the surgery went and what the man’s sexual function was like beforehand. However, typical symptoms include

Weak or absent morning erections
Delayed or absent erection during sexual activity
An erection that begins but quickly disappears or subsides.
Lack of firmness in the penis; penetration is not possible
Lack of sensation in the penis or groin
No reaction to stimulation
A feeling of a disconnect between desire and physical response
Lack of response to erectile dysfunction medication, even though it has worked in the past.
Development of Peyronie’s disease

In many cases, this leads to greater frustration because the desire is still there, but the body does not respond as it used to.

Psychological Effects and Erectile Dysfunction Following Prostate Surgery or Other Illnesses

One thing that can be really difficult after prostate surgery or another serious illness is that your self-image as a man changes. Erectile dysfunction can lead to low self-esteem and raise questions such as:

Am I still a real man if I can’t get an erection?
Can a partner love me if I’m impotent?
Can I still satisfy my partner despite my lack of potency?
Why am I the one experiencing erectile dysfunction after prostate surgery?
Will I have to wear diapers or pads for the rest of my life?
If I can’t do it now, I’ll never be able to!
My partner thinks I’m not attracted to him or her anymore!
I HAVE to be able to—otherwise, I’m not man enough!

You’re not alone in experiencing erectile dysfunction after prostate surgery

All the thoughts that can arise, along with the physical changes, can lead to anxiety about sex and intimacy, a feeling of being “less of a man,” and generally result in a lower quality of life due to erectile dysfunction after prostate surgery.

It’s about how you see yourself as a sexual being.

In addition, all those thoughts activate the sympathetic nervous system (increasing stress and arousal in the body) and inhibit all the functions necessary for achieving a good erection.

At the clinic, as a shockwave specialist and sexologist , I have the opportunity to help you with a comprehensive, 360-degree solution to your problem, so you can continue to feel like a man after prostate surgery.

Here, I’ll help you crack the code on how to feel like a real man again.

Common diseases and conditions associated with an increased risk of erectile dysfunction

Erectile dysfunction associated with prostate cancer and radical prostatectomy/prostate surgery

Surgery for prostate cancer typically involves removal of the entire prostate and carries a risk of impotence. This is because there is a high risk that the small nerves running along the prostate—which are responsible for controlling erections and sexual function—will be damaged.

Even with robot-assisted nerve-sparing surgery, up to 80% of men experience erectile dysfunction and incontinence for months or years after prostate surgery. This does not mean you have to live with incontinence or that you cannot regain your sexual function.

But it requires the right treatment and rehabilitation after surgery. I’ll explain this in more detail further down the page. Especially if your surgery also involved radiation therapy, it’s even more important to be aware of this, as large amounts of scar tissue can form after treatment.

In addition, anxiety, incontinence, reduced morning erections, and changes in body image can play a role.

Why Do Erectile Dysfunction Problems Occur with Bladder Cancer and Pelvic Surgery?

Erectile dysfunction can also occur after surgeries to remove the bladder, for rectal cancer, or for inguinal hernia repairs. As with prostate cancer surgeries, there is a risk of damage to the nerve tissue and blood vessels in the area. This can contribute to both mild and severe erectile dysfunction.

In addition, it’s important to consider that scar tissue and disruptions in the connective tissue structures—through which blood vessels and nerves run—can contribute to reduced sensation in the testicles and the penis as a whole.

How can a herniated disc and back surgery affect sexual function and cause erectile dysfunction?

In cases of disc herniations in the lower back, it is not uncommon to see erectile dysfunction and problems achieving an erection. This is due to mechanical compression of the nerves, particularly the pudendal nerve. This is the nerve that controls erections and a large part of pelvic floor function.

So if you experience a herniated disc or undergo back surgery, it cannot be ruled out that you may experience temporary erectile dysfunction or incontinence.

The link between a herniated disc and erectile dysfunction is often overlooked, as it can be a taboo subject to discuss. But there is a clear connection, due to the nervous system’s role in erectile function.

In addition to pain, symptoms of a herniated disc may include reduced sensation in the groin and an inability to achieve an erection. They can also include severe pain and incontinence, where you cannot control urination or bowel movements. If you experience the latter symptoms, you should see a doctor as soon as possible, as this can be dangerous.

Why can erectile dysfunction occur after a stroke?

A stroke can cause erection problems by affecting the brain’s ability to send signals related to desire, stimulation, and erection.

In many cases, it can also lead to incontinence, since the nerves that control erections and the pelvic floor muscles are the same.

In Denmark, more and more men are having strokes, and this is most often due to an unhealthy lifestyle characterized by low physical activity, high stress levels, and other underlying conditions, such as cardiovascular disease and diabetes.

If you’d like more information about strokes, read more at hjernesagen.dk

How can you avoid erectile dysfunction after prostate surgery?

Before prostate surgery, you can do the following

The key here is to maintain good erectile function by engaging in regular sexual intercourse or masturbation. This helps ensure the best possible blood circulation and healthy nerve function in the penis and erectile tissues. The better your starting point is before surgery, the easier it will be to maintain satisfactory erectile function afterward.

In addition, it’s also recommended to start pelvic floor exercises for men. This is both to help maintain erections and to build strong muscles that can compensate for the removal of the prostate. This is particularly important in reducing incontinence following prostate surgery.

Finally, maintain a generally high level of physical activity leading up to the surgery so that your body has the best possible conditions for recovery and healing.

How can MS Insight help you with erectile dysfunction after prostate surgery?

At the clinic, I have a variety of options for helping you regain your ability to achieve an erection.

I use the following tools to help you regain your potency and self-esteem

Magnetolith EMTT therapy, which can stimulate the deep nerves and structures in the pelvic floor following prostate surgery. It also accelerates tissue healing.

Focused shockwave therapy, which stimulates blood vessel formation in the penis and pelvic floor, makes the tissue more elastic, and reduces scar tissue formation
Counseling on your lifestyle and the things you should focus on yourself, including pelvic floor exercises and the use of a penis pump.
Sexual therapy focused on helping you regain your self-esteem.

How can you manage erectile dysfunction after prostate surgery?

After prostate surgery, the goal is to restore sexual function. There are several options available, and recent studies have shown that early intervention after surgery (within a few weeks) using focused shockwave therapy can reduce erectile dysfunction and increase sexual desire in the long term.

Shockwave Therapy for Erectile Dysfunction After Prostate Surgery

Shockwave therapy reduces the amount of scar tissue and allows the tissue to move more freely. It helps nerves and blood vessels regenerate and grow after the damage that surgery can cause. A typical course of treatment lasts about 3 months.

The treatment also contributes to the regeneration of tissue in the erectile bodies, which may have been inactive for an extended period following prostate surgery—a time when the inability to achieve an erection has often been a significant factor.

Erectile dysfunction medications as a supplement to shockwave therapy

Various erectile dysfunction pills can help improve blood flow and increase the frequency of erections. When combined with shockwave therapy, this has proven to be an effective solution, as the two treatment methods complement each other. I’d be happy to advise you on which pills might be right for you.

Kegel exercises for erectile dysfunction after prostate surgery

It is still recommended that men focus on Kegel exercises after prostate surgery. These exercises strengthen blood flow and nerve signals to the area, which can improve erectile function. At the same time, Kegel exercises are important for preventing incontinence.

Penis pump after prostate surgery

In addition to focusing on a healthy lifestyle, a penis pump can be an effective part of rehabilitation. The pump increases blood flow to the penis and creates an erection, which can be maintained with a cock ring so that sexual intercourse can take place. As an added bonus, it can increase elasticity and help reduce the risk of Peyronie’s disease.

Results after prostate surgery

With targeted and effective efforts, around 40-50% of men will regain much of their potency and erectile function within 1-2 years after prostate surgery, especially if they were younger and in good physical shape before the procedure. The greater the focus on lifestyle and rehabilitation, the better the results can be achieved.

Not sure? Get a clear picture of your options

I will get back to you within 12-24 hours.

Schedule a no-obligation consultation about treating erectile dysfunction today

If you’re interested in learning more about how we can help you, feel free to contact us by phone at 41 40 08 58 or by email at michael@msinsight.dk. Alternatively, you can fill out the contact form with your information and a brief description of your problem. I’ll get back to you quickly with a customized proposal for a solution so that together we can find the best way forward.