Photo: Julia Volk

How much length do you lose after prostatectomy?

Most men are quite surprised early in the recovery after surgery and often wonder where their penis has gone. However this is a common experience as research finds most men report a 1-3cm length loss even after 12 months.

onlineprostate.physio - Lesser Known Sexual Complications of Prostate Cancer Treatment

Does spinach increase uric acid?

Because spinach is a vegetable containing high levels of purines, when entering the body, it will convert to uric acid, when the concentration of...

Last updated Jun 13, 2021

What can I take instead of turmeric for inflammation?

9 Herbs and Spices That Fight Inflammation Ginger. Ginger (Zingiber officinale) is a delicious spice with a peppery yet sweet flavor. ... Garlic....

Last updated Feb 8, 2021

Promotion

There is a wide range of complications and side-effects that can result from prostate cancer treatment. Common issues such as erectile dysfunction and urinary incontinence are usually well known and managed. However many men are left wondering when their issues differ to those that are well reported during sexual recovery. This article further discusses these less known sexual complications of prostate cancer treatment.

Penile Deformities

Peyronie’s Disease

Peyronie’s disease is a condition that results in curvature of the penis causing excessive upwards bend. Hardened tissue forms on the upper surface of the penis, changing its curve or size during erections. The causes of Peyronie’s remains relatively unknown at this stage and higher rates are observed in men after prostate cancer treatment. Although this is not a common condition and reportedly occurs in less than 10% of men. Sexual health is greatly affected physically and psychologically from the abnormal appearance and function of the penis. Peyronie’s often puts physical limitations on achieving sex, taking the enjoyment out of it for men and their partners. Additionally, it is common for men to report penile pain and erectile dysfunction. Fortunately there are a large range of treatment options that exist. The scale of treatment types depends on the severity of the condition, usually combining pharmacological and stretching based treatments before considering surgery.

Penile Length Loss

Penile length loss is another common sexual complication resulting from prostate cancer treatment and occurs after a radical prostatectomy. This is obviously a real concern for men as it hits on a very touchy subject! Most men are quite surprised early in the recovery after surgery and often wonder where their penis has gone. However this is a common experience as research finds most men report a 1-3cm length loss even after 12 months. The mechanism involved is thought to be related to nerve damage and recovery resulting in overactivity rather than changes to penile muscles. Therefore it’s usually at its most severe after catheter removal and continues to a lesser degree with greater healing. To avoid significant penile length loss it is important to complete adequate penile rehabilitation. Using a vacuum erectile device daily has been shown to reduce the likelihood of ongoing penile length loss. Whilst also using PDE5 inhibitor medications (Cialis & Viagra) and some good old fashioned elbow grease helps.

5 TIPS TO IMPROVE YOUR ERECTIONS

BLOG: Learn how to improve erectile function after prostate cancer treatment

Ejaculatory & Orgasm Dysfunctions

Change in Orgasms

The apparatus controlling normal ejaculatory and orgasmic functions can be disrupted and dysfunctional after prostate cancer treatment. Anatomical features for normal ejaculatory function involve the prostate, seminal vesicles and ejaculatory ducts. Removing the prostate is an obvious contributing factor owing to sexual change, however radiation can lead to widespread stiffening of these structures. Up to 35% of men report either a reduction in orgasm intensity or an absence of orgasms after surgery. Whilst a smaller number of men (~15%) report painful orgasms occurring. Additionally, it’s extremely common to have reduced ejaculate volumes or dry ejaculations as the prostate gland primarily produces semen.

Why do older men pee so much?

As men age, their prostates often enlarge. This puts pressure on their urethras. An enlarged prostate is also known as benign prostatic hyperplasia...

Last updated Jun 25, 2021

Can I spray onion juice on hair daily?

It's fine to use onion juice daily in a bid to boost hair growth. However, the trick is to avoid applying plain onion juice directly to your hair...

Last updated May 28, 2019

Promotion

Climacturia

Climacturia is the phenomenon of experiencing urine leakage at the point of orgasm. This is a known complication of prostatectomy surgery and can occur in 10-60% of men throughout recovery. Although for men treated with radiotherapy this is less common as it only occurs in 5% of cases. Urine leakage can also occasionally occur during foreplay or other acts of intimacy. Such symptoms appear mostly between 6-12 months post surgery, as both continence and erectile function are slowly returning. Fortunately in most cases this will resolve although few men still experience symptoms up to 2 years. Completing an individualised rehabilitation program for the pelvic floor often accelerates the improvement of climacturia. This is due to the primary mechanism believed to involve relaxation of the muscles surrounding the bladder neck at the point of climax, allowing urine to enter the urethra. Therefore developing control of the pelvic floor muscles that inappropriately relax at the point of orgasm helps overcome this symptom. For a lot of men and their partners this is not a significantly stressful issue but it can still be bothersome. Emptying the bladder before sexual activity and the use of a condom are strategies that can be adopted if required.

Sexual Relationship Dynamics

Among all the sexual complications of prostate cancer the changes experienced within oneself and partners are often overlooked. Treatment outcomes regularly cause significant psychological distress, feelings of low self-esteem and sense of masculinity. Major hurdles contributing to these sensations include erectile dysfunction, loss of libido, and anxiety regarding sexual performance. Hence it’s no surprise that men and their partners report low levels of sexual satisfaction, high rates of depression and reduced overall life satisfaction. Undergoing psychotherapy or counselling is helpful for couples to manage cancer together. This establishes healthy communication techniques and addresses the needs of the individual and partners. Open and constructive discussions around sexual complications helps to relieve stigma built up around these sensitive and complex issues.

References

Chung E, Brock G. Sexual rehabilitation and cancer survivorship: a state of art review of current literature and management strategies in male sexual dysfunction among prostate cancer survivors. The journal of sexual medicine. 2013 Feb;10:102-11. Kirages DJ, Johnson EV. Pelvic floor muscle rehabilitation to improve sexual function in geriatric men. Topics in Geriatric Rehabilitation. 2016 Jul 1;32(3):174-81.

onlineprostate.physio - Lesser Known Sexual Complications of Prostate Cancer Treatment

Does Mila Kunis have blue eyes?

During the beginning of her acting career, Mila Kunis had one hazel eye while the other had a blue tint. What many people don't know is that Mila...

Last updated Apr 11, 2021

Does melatonin block DHT?

Hormones such as adrenaline, testosterone, and DHT are observed and held during sleep while the body generates melatonin. The DHT hormone binds to...

Last updated Mar 7, 2019

Promotion

Can Apple cider vinegar remove plaque from arteries?

Although we're not sure where this claim originated from, we do know there is no scientific evidence proving apple cider vinegar clears clogged...

Last updated Jan 6, 2019

Promotion

What is stonewalling in a relationship?

Stonewalling, one of the Four Horsemen, is Dr. John Gottman's term for one or both partners shutting down when feeling overwhelmed during conflict....

Last updated Mar 11, 2019