Erectile dysfunction, also called impotence, is the inability to develop or sustain an erection.
Why it happens: Prostate cancer treatments can cause trauma to the nerves and blood vessels that control an erection. These include:
- Surgery to remove the entire prostate gland
- Radiation therapy, either by external beam or radioactive seed implants
- Hormone therapy, due to the testosterone-reducing action of drugs
What are your options?
- Oral medications relax muscles in the penis, letting blood rapidly flow in
- Injections of medicine into the penis before intercourse (intracavernous injection therapy)
- Vacuum constriction device to draw blood into the penis
- Penile implant, which requires an operation to place implant in the penis
Loss of libido, or sexual desire
Why it happens: Sometimes, it’s a result of certain hormone therapy. Other times, it may occur because of treatment side effects, such as fatigue or weight gain.
What you can do:
- Maintain good communication. Rather than avoid the topic, address it with your partner. Say something like: “I’m sorry I haven’t been in the mood lately. I hope you know it’s because of my treatment. But I still want to feel close to you, so let’s cuddle.” Relaying your concerns will help you two stay connected.
- Consider joint counseling. Speaking with a third-party professional can help you and your partner open up with each other, and provide ways to cope.
- Determine if it’s depression. If you think your loss of libido may be due to depression, which is common after diagnosis and surgery, speak with your healthcare professional.
Urinary incontinence, which ranges from leaking to complete loss of bladder control, and increased urinary urgency
Why it happens: After therapy, these symptoms are usually caused by damage to the nerves and muscles that manage urinary control.
What are your options?
Following radiation therapy, some urinary symptoms are often a problem—so drugs that improve urinary flow may be prescribed and are gradually withdrawn as symptoms improve.
Following surgery, leakage is a common problem. Treatment options include:
- Kegel exercises. It strengthens the pelvic floor muscles, which support the uterus, bladder, small intestine and rectum.
- Cunningham claps. This V-shaped device is covered with foam and fits over the penis. It can apply pressure to the urethra, preventing leakage.
- Injection of collagen into the urethra, which tightens the passageway, and makes it more difficult for urine to leak through. This is the least invasive procedure but its effects only last for a short time.
- Sling insertion. In this surgical procedure, a sling made from silicone is slipped under the urethra, where it relieves buildup as urine increases.
- Artificial urinary sphincter. This device uses a pressure-sensitive valve to replace the damaged urinary valves and is opened with a mechanical system that is implanted into the pelvis and controlled by a device in the scrotum.
Talk with your healthcare provider about your sexual concerns
These tips can make it easier:
- List your questions and concerns. Ask the most important ones first. This way, if you get nervous, you won’t forget something.
- Let your doctor know about any symptoms or side effects. This information will help your healthcare provider better plan your treatment.
- Keep important health information on you. Things like insurance information and the names and numbers of other members of your healthcare team.
Remember that you’re not the first person with a certain concern or symptom. Your healthcare provider has likely heard it before. So be honest and don’t be embarrassed!