Does prostate removal affect sperm?

Once the prostate is removed a man no longer has the ability to make semen or ejaculate semen, so infertility is an unavoidable and permanent consequence of surgery. Radiation may also damage the prostate's ability to produce semen or damage the sperm cells in the testicles.

zerocancer.org - Infertility | ZERO - The End of Prostate Cancer

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What is infertility?

Infertility is the inability to father children through sexual intercourse. Some men do not know that the loss of fertility is a common side effect of prostate cancer treatment.

What causes infertility?

Many types of prostate cancer treatment cause infertility. The prostate produces the fluid that helps keep semen liquid. Once the prostate is removed a man no longer has the ability to make semen or ejaculate semen, so infertility is an unavoidable and permanent consequence of surgery. Radiation may also damage the prostate’s ability to produce semen or damage the sperm cells in the testicles.

What if I have prostate cancer and want to have children?

If maintaining the possibility of fatherhood is important to you, be sure to discuss that with your doctor. Men with low-risk, slow-growing prostate cancer may be able to avoid infertility by choosing active surveillance. However, if your cancer requires treatment, there are some options you can pursue to maintain the possibility of fathering children:

Sperm Banking

Freezing (cryopreservation) of sperm is the most successful way for men to preserve fertility before cancer treatment. The most common way to collect the semen sample is through masturbation. Men who cannot ejaculate may have vibrational or electrical stimulation to help them do so. The sperm will stay frozen, or “banked,” until you need them. Freezing—even for many years—does not damage sperm.

Testicular Sperm Extraction

Even if a man cannot ejaculate sperm, he may still have sperm in the testicles. In testicular sperm extraction, a surgeon removes small pieces of testicular tissue (biopsy) while the patient is sedated or under local or general anesthesia. If the tissue contains sperm, the sperm are either frozen or used to fertilize a female partner’s eggs. This technique may be an option before or after cancer treatment.

Where can I learn more?

If you are interested in fertility preservation, ask for a referral to a physician who specialized in treating male fertility. This may be an endocrinologist, andrologist, or urologist.

Visit the following links to learn more:

LIVESTRONG Fertility for Men

American Society for Reproductive Medicine

Oncofertility Consortium

Save My Fertility

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Do men need stimulation to get hard?

An erection begins with sensory and mental stimulation. During sexual arousal, nerve messages begin to stimulate the penis. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces.

my.clevelandclinic.org - Erection & Ejaculation: How Does It Work - Cleveland Clinic

What is the anatomy of the penis?

The penis is made up of:

Two chambers called the corpora cavernosa, which run the length of the organ and contain a maze of blood vessels shaped like cavernous spaces (like a sponge). The urethra, or channel for urine and sperm, which runs along the underside of the corpora cavernosa. Erectile tissue, which surrounds the urethra, two main arteries and several veins and nerves.

The shaft, the longest part of the penis.

The head (glans), which is at the end of the shaft.

The meatus, or opening at the tip of the head where urine and semen are discharged.

How does an erection occur?

When the blood vessels of the corpora cavernosa relax and open up, blood rushes in through the cavernosus arteries to fill them. The blood then gets trapped under high pressure, creating an erection. An erection begins with sensory and mental stimulation. During sexual arousal, nerve messages begin to stimulate the penis. Impulses from the brain and local nerves cause the muscles of the corpora cavernosa to relax, allowing blood to flow in and fill the open spaces. The blood creates pressure in the corpora cavernosa, making the penis expand and creating an erection. The tunica albuginea (the membrane surrounding the corpora cavernosa), helps to trap the blood in the corpora cavernosa, sustaining the erection. Erection is reversed when muscles in the penis contract, stopping the inflow of blood and opening outflow channels.

How does ejaculation occur?

Sexual stimulation and friction provide the impulses that are delivered to the spinal cord and into the brain. Ejaculation is a reflex action controlled by the central nervous system. It is triggered when the sexual act reaches a critical level of excitement. It has two phases.

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