As people get older, the body can’t handle surgeries and treatments the way it once did. Because of this, some people end up with unrelated short-term or long-term side effects because of those surgeries. If you’re a man over 50, one of those side effects could be erectile dysfunction (ED).
“In order to get an erection you need five things,” urologist Justin Dubin, M.D. exclusively told Health Digest, explaining that if any of the five things have been compromised due to surgery or treatments, ED can occur. The five things? Good blood flow, good nerves, good testosterone, arousal, and a good state of mind. “Surgery like a prostatectomy can compromise blood flow to your penis, making it difficult to get or maintain an erection,” said Dubin, adding that other surgeries can damage nerves, impacting penile function. “We know that men who have a history of cancer and/or have been treated for cancer have higher risks of having low testosterone,” said Dublin, noting that testosterone is also necessary for an erection.
As for arousal and a good state of mind, these may be impacted by surgery or treatment, not in a physical way, but in emotional or mental ways. “Sometimes after surgery and cancer your relationship with your partner may change,” said Dubin, pointing out that stress and anxiety come into play if there’s cancer involved. “Oftentimes after cancer surgeries your body changes and it’s possible your confidence in yourself [and] your body can change,” said Dubin. In other words, there are a lot of components that can cause ED in men after some surgeries, none of which should cause shame or embarrassment. But, just how common is ED after surgery?
The prevelence of ED after surgery is variable
When trying to determine just how common erectile dysfunction is after surgery, it’s hard to give an exact number or percentage, because there are so many things at play: what type of surgery, the stage of the disease that’s resulted in the surgery, what treatments might be necessary and for how long, as well as one’s baseline erectile function. If your ability to get and maintain an erection is already on shaky ground, you can’t expect any surgery or treatment to not affect that part of the body in a negative way.
“In general, ED is a common complication following prostate cancer treatment, with prevalence rates ranging from 20% to 90% and, in general, impacts the majority of patients after prostatectomy,” said Dubin, adding that while recovery is definitely possible, it can take several months (roughly 12 to 18) to get back to a new normal of functioning. “Fortunately, there are several strategies you can do for penile rehabilitation,” said Dubin. “They include daily medications like Cialis or Viagra, vacuum erection devices, pelvic floor physical therapy, and intracavernosal injections in your penis.”
According to a 2003 study published in the International Journal of Andrology, while certain surgeries and/or treatments can cause erectile dysfunction, in some cases, the ED can take years to develop. But the same study also found that nerve-sparing surgery can get erections back.
If you want to be sexually active, you will be
If your doctor diagnoses you with something that needs surgery or treatment and, in the same breath, they say that erectile dysfunction may be a side effect, it’s important to not stress yourself out over the possible ED. If anything, you should focus on doing what you need to do and preparing for the surgery — if ED happens to you afterward, you can worry about it then.
You’re lucky enough to live in a day and age where there are numerous options to remedy erectile dysfunction. If pills like Viagra don’t work for you, then there’s always another surgery — but this one is aimed at making your penis function properly. “We can perform penile implant surgery if all other options don’t work, which is an excellent procedure with very high satisfaction rates that allows men to get hard erections with full sensation and full orgasm,” said Dubin. So take a deep breath and relish in that fact. “At the end of the day, if you want to be sexually active you will be,” he added. “But we cannot help you unless you go talk with your local urologist. Cancer sucks. Life after cancer should not.”