You may have trouble getting or keeping an erection firm enough for intercourse or other sexual activity after treatment. This is called erectile dysfunction (ED) or impotence. While erection problems become more common with age, they can also be affected by health conditions such as diabetes and heart disease; certain medicines for blood pressure or depression; previous surgery to the bowel or abdomen; smoking or heavy drinking; or emotional concerns.
The prostate lies close to nerves and blood vessels that help control erections. These can be damaged during treatment:
- After surgery – problems with erections occur immediately.
- After radiation therapy – erection problems develop slowly over time.
Erectile function can continue to improve for up to three years after treatment has finished. Sometimes, erection problems may be permanent.
Before and after treatment, various methods can help keep your penis healthy (penile rehabilitation). These may include:
- engaging in foreplay and other sexual intimacy with your partner
- trying to get erections, starting a month after surgery
- taking prescribed medicines to maintain blood flow in the penis
- using a vacuum erection device to stop the penis shortening or losing flexibility
- injecting prescribed medicine into the penis.
Dr Amy Hayden, Radiation Oncologist, Westmead and Blacktown Hospitals, and Chair, Faculty of Radiation Genito-Urinary Group (FROGG), The Royal Australian and New Zealand College of Radiologists, NSW; Prof Shomik Sengupta, Professor of Surgery and Deputy Head, Eastern Health Clinical School, Monash University, and Visiting Urologist and Uro-Oncology Lead, Urology Department, Eastern Health, VIC; A/Prof Arun Azad, Medical Oncologist, Urological and Prostate Cancers, Peter MacCallum Cancer Centre, VIC; Ken Bezant, Consumer; Dr Marcus Dreosti, Radiation Oncologist, GenesisCare, and Clinical Strategy Lead, Oncology Australia, SA; A/Prof Nat Lenzo, Nuclear Physician, Specialist in Internal Medicine, Group Clinical Director, GenesisCare Theranostics and The University of Western Australia, WA; Jessica Medd, Senior Clinical Psychologist, Department of Urology, Concord Repatriation General Hospital, and HeadwayHealth Clinical and Consulting Psychology Services, NSW; Caitriona Nienaber, 13 11 20 Consultant, Cancer Council Western Australia; Graham Rees, Consumer; Kerry Santoro, Prostate Cancer Specialist Nurse, Southern Adelaide Local Health Network, SA; A/Prof David Smith, Senior Research Fellow, Cancer Research Division, Cancer Council NSW; Matthew Starr, Consumer. We also thank the health professionals, consumers and editorial teams who have worked on previous editions of this title. This booklet is funded through the generosity of the people of Australia.
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