Prostate Cancer Rehabilitation And Recovery

What causes erection problems after prostate cancer treatment?

Prostate cancer treatments, such as surgery, radiation therapy, and hormone therapy, can affect nerves, blood vessels, and neighboring tissues crucial for erectile function, causing ED. Although experts often spare or save nerves during surgery, this is not always a guarantee that the ability to maintain an erection will be preserved. If nerves are damaged, the brain can no longer send a clear signal to the penis for an erection. Some men receive hormone therapy and may notice changes in their libido (sex drive) and/or orgasms due to the loss of testosterone.

How long can ED last after treatment?

Most men will experience a significant decrease in erectile function after prostate cancer treatment. Some will “return to baseline” meaning their erection will return to its original form. However, most men will suffer from some degree of ED. Although it is true that erectile function can improve over time, most of the improvement will occur within the first 1-2 years after prostate cancer treatment.

Is it possible for my penis to shorten after prostate cancer surgery?

Penile shortening is a potential side effect that some men may experience after prostate cancer treatment, particularly after undergoing a radical prostatectomy (surgical removal of the prostate gland). The reasons for penile shortening (on average 1 cm) are multifactorial and can include the following factors: surgical trauma, nerve damage, changes in blood flow, and scar tissue formation. Penile rehabilitation can provide the best chance for improving length.

Is it possible for my penis to curve after prostate cancer surgery?

Penile curvature after prostatectomy is a potential side effect that may occur in up to 16% of men following the surgical removal of the prostate. This curvature is often referred to as Peyronie's disease. Several factors contribute to the development of penile curvature after prostatectomy: surgical trauma, and scar tissue formation. Several treatment options exist to reduce the curvature.

What is penile rehabilitation after prostate cancer treatment?

Penile rehabilitation refers to a series of interventions and strategies aimed at preserving or restoring erectile function and overall penile health after prostate cancer treatment, particularly after a radical prostatectomy. The goal of penile rehabilitation is to improve blood flow, maintain tissue health, support nerve recovery to enhance erectile function, and increase length through the use of oral medications, vacuum erection devices,  penile injections, and sexual counseling and education.

What causes urinary leakage after prostate cancer treatment?

Urinary incontinence is a common side effect that some men may experience after prostate cancer treatment, particularly after surgical removal of the prostate. The prostate is located near the bladder and surrounds the urethra, the tube through which urine passes. Prostate cancer treatment, including surgery, can impact the structures and mechanisms that control urinary function, leading to incontinence.

What is the most common type of urinary leakage after prostate cancer treatment?

Stress urinary incontinence (leakage with laughing coughing sneezing, walking, and physical activity) is the most common type of leakage which occurs after prostate cancer treatment, particularly after surgical removal of the prostate. Medications are not a good treatment option for stress urinary incontinence. Some men with stress urinary incontinence may benefit from strengthening their pelvic floor muscles with Kegel exercises, which are often best taught by a pelvic floor physical therapist. Some patients who are significantly bothered by their symptoms will proceed with a surgical treatment such as replacement of an artificial urinary sprinter or urethral sling. Although it is true that stress urinary incontinence can improve over time, most of the improvement will occur within the first year after prostate cancer treatment.

Dr. Chung is a fellowship-trained urologist who has advanced specialty training in the surgical treatment of both erectile dysfunction and urinary incontinence. Call the office of Paul H. Chung, MD, for erectile does function and urinary incontinence consultation in Philadelphia, Pennsylvania now.