Can I Have An Orgasm Without An Erection
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.
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Nerve Damage From Chemotherapy
Some chemo drugs like cisplatin, vincristine, paclitaxel, bortezomib, and thalidomide can damage parts of the nervous system, usually the small nerves of the hands and feet. These drugs have not been found to directly injure the nerve bundles that allow erection. But some people have concerns because the drugs are known to affect nerve tissue, and there are many nerves involved in sexual function.
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How To Manage Erectile Dysfunction During And After Prostate Cancer Treatment
The ultimate goal of both surgery and radiation therapy for prostate cancer is to remove as much of the cancer as possible while maintaining a patients desired quality of life.
Remember: your ideal treatment plan should be unique to your situation. Thats why its so important to get a second opinion and consult with an expert team of medical professionals including urology, radiation oncology, and other specialists.
If you want to learn more about potential treatment options for erectile dysfunction, or just have a lot of questions youd like answered, click here for resources from EDCure.org.
If youre looking for a doctor and want to discuss your options for treatment as well as possible side effects you can expect, feel free to use our free doctor finder tool below:
Nerve Damage From Surgery
The most common way surgery affects erections is by removing or causing injury to the nerves that help cause an erection. All of the operations listed above can damage these nerves. The nerves surround the back and sides of the prostate gland between the prostate and the rectum, and fan out like a cobweb around the prostate, which makes it easy to damage them during an operation.
When possible, nerve-sparing methods are used in radical prostatectomy, radical cystectomy, AP resection, or TME. In nerve-sparing surgery, doctors carefully try to avoid these nerves. When the size and location of a tumor allow for nerve-sparing surgery, more men recover erections than with other techniques. But even if the surgeon is able to spare these nerves, they might still be injured during the operation and need time to heal.
Even when the nerves are spared, research has shown that the healing process takes up to 2 years for most men. We dont know all the reasons some men regain full erections and others do not. We do know that men are more likely to recover erections when nerves on both the left and right sides of the prostate are spared.
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High Intensity Focused Ultrasound Or Cryotherapy
Treatments such as High Intensity Focused Ultrasound or cryotherapy may cause fewer erection problems. Researchers are still looking into these treatments and their long term side effects. There is still a risk of erection problems with these treatments. For example, to treat your cancer properly, the doctor may not be able to avoid the nerves.
Cancer Treatments And Erectile Dysfunction
Following surgery, many men experience erectile dysfunction , but for many, the disruption is temporary. Nerves damaged during surgery may result in erectile dysfunction. A nerve-sparing prostatectomy may reduce the chances of nerve damage. Another factor is the surgeons skill level for performing the nerve-sparing technique, which if done correctly, may improve patients likelihood of retaining erectile function, says Dr. Shelfo.
Prostate cancer may also be treated with various types of radiation therapybrachytherapy, external beam radiation or stereotactic body radiation therapy. Each type of therapy causes somewhat different side effects. About half of all prostate cancer patients who undergo any of these types of radiation therapy are likely to develop erectile dysfunction, according to a 2016 article published in Advances in Radiation Oncology.
When you compare surgery with radiation, both may affect erections, says Dr. Shelfo. Surgery is usually more immediate, and sexual dysfunction has the potential with time to improve. With radiation, erections are usually less affected in the beginning, but over timemonths or, sometimes, yearssexual dysfunction may develop. Both treatments may affect sexual function, resulting in no ejaculate or the ability to attain erections.
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How Soon After Prostate Cancer Treatment Can I Be Sexually Active Again
This will depend on what type of treatment you have had and how you feel. It could be several weeks, for others it may be a lot longer for erections to return. Some men will never be able to keep an erection without the help of artificial methods like medicines or medical devices . If you were having problems having erections before treatment, this will not get better after treatment.
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When Can Erectile Dysfunction Occur After Treatment
- Surgery. Some degree of erectile dysfunction usually occurs right after surgery to remove the prostate, regardless of whether the technique is performed that tries to spare the nerve that controls erections.
The severity of the erectile dysfunction depends on the type of surgery, stage of cancer, and skill of the surgeon.
If the nerve-sparing technique is used, recovery from erectile dysfunction may occur within the first two years following the procedure. Recovery of erectile function after a non-nerve-sparing surgery is unlikely, but possible.
The use of vacuum devices or erectile dysfunction drugs after the body has healed from surgery may improve the quality of erections and speed the return of normal sexual function .
If an erection can be achieved after surgery, one does not lose the ability to have an orgasm. However, they may be “dry” orgasms in which little ejaculate is produced. This results in infertility for most men, although most men are older when they are diagnosed for prostate cancer and may not be concerned. If desired, you could talk to your doctor about “banking” sperm before the procedure.
- Radiation therapy. The onset of erectile dysfunction following radiation therapy is gradual and usually begins about six months following the treatment.
Radical Prostatectomy And Sexual Function
Radical prostatectomy is the standard treatment method selected for the treatment of local prostate cancer limited to the intraprostate region. As endourological treatments using an endoscope or robot have been used more frequently recently, the frequency of radical prostatectomy has been decreasing. It is, however, still the most important treatment method for local prostate cancer.
Previous studies using animal models reported that cavernosal nerve injury caused increased collagen in the corpus cavernosum, apoptosis in the cavernosal smooth muscle, and cavernosal fibrosis. Additionally, due to increased transforming growth factor-1 and decreased prostaglandin E1 and cyclic adenosine monophosphate in the corpus cavernosum, and the secretion of cytokines and endothelin-1 from injured nerves, veno-occlusive erectile dysfunction may then occur as a result of structural changes in the corpus cavernosum . Direct injury of the neurovascular bundle during radical prostatectomy may also cause arterial erectile dysfunction due to injuries to the cavernosal artery.
Pathophysiology of erectile dysfunction following radical prostatectomy. ROS: reactive oxygen species, TGF-: transforming growth factor-beta, ET-1: endothelin-1, PGE1: prostaglandin E1, iNOS: inductible nitric oxide synthase.
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How Are Prostate Cancer And Erectile Dysfunction Related
If you have issues with your prostate, a general workup can include urine tests, bloodwork, and a physical exam. This exam usually consists of a digital rectal exam , where a doctor will feel your prostate from inside your anal cavity. If the prostate feels smooth and round, thats generally a sign that you probably only have BPH. Otherwise, you may need to undergo further testing, and cancer may be a concern. Men who are diagnosed with prostate cancer worry about many areas of their health. I have heard many of these questions over the years: How bad is it?, What options do I have?, and What are possible complications of treatment?
Currently, the mainstays of treatment for prostate cancer are anti-testosterone therapy, surgery, and radiation therapy. Each of these has pros and cons related to treatment success and long-term effects on the body. However, one of the most common complications for all three of these options is erectile dysfunction. We talked about how anti-testosterone therapy can affect erections when we discussed BPH treatments above. Lets now look at prostate surgery and radiation therapy.
Management Of Erectile Dysfunction By Prostate Cancer Patients
There are numerous types of treatments to address erectile dysfunction and improve patients quality of life. According to the Prostate Cancer Foundation, these include oral medications for erectile dysfunction, sildenafil , tadalafil , and vardenafil , relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin working the erection helping effects of sildenafil and vardenafil last for about 8 hours and tadalafil about 36 hours. About 75% of men who undergo nerve-sparing prostatectomy or more precise forms of radiation therapy have reported successfully achieving erections after using these drugs.
Men with heart problems are, however, recommended not to take these type of drugs. Surgery is also an option, but it tends to be a final option. To address erectile dysfunction, a penile implant, which is a narrow flexible plastic tube, is surgically inserted along the length of the penis. Then, surgeons attach a small balloon-like structure filled with fluid in the abdominal wall and a small button is released into the testicle. The button can later be pressed and the fluid rushes from the ballon into the plastic tube, resulting in an erection.
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Your Thoughts And Feelings
Changes to your body and your sex life can have a big impact on you. You may feel worried, unsatisfied, angry and some men say they feel like they’ve lost a part of themselves. There are ways to tackle these issues and find solutions that work for you.
Getting support
If you are stressed or down about changes to your sex life, finding some support may improve how you feel. There are lots of different ways to get support.
You are not alone. A lot of men, with and without prostate cancer have sexual problems. Talking to other men who have had similar experiences can help.
- Our sexual support service is a chance for you, or your partner, to talk to one of our Specialist Nurses with an interest in helping with sexual problems.
- Our one-to-one support service is a chance to speak to someone who’s been there. They can share their experiences and listen to yours.
- Our online community is a place to deal with prostate cancer together. You can talk about whatever’s on your mind. Anyone can ask a question or share an experience.
- Our Specialist Nurses can answer questions and explain your treatment options. You can also email or chat online with our nurses.
- Get in touch with your local prostate cancer support group.
Trained counsellors
Counsellors are trained to listen and can help you find your own ways to deal with things. Many hospitals have counsellors or psychologists who specialise in helping people with cancer – ask your doctor or nurse if this is available.
How Will Treatment Affect My Ability To Orgasm Or My Fertility
Surgery for prostate cancer can affect both your orgasms and your ability to have children. The prostate gland normally adds a fluid called semen to sperm to nourish and protect it. Youll no longer make semen after surgery, which means your orgasms will be dry. Radiation therapy can also reduce the amount of fluid you ejaculate. Without semen, you wont be able to father children. If youre concerned about fertility, you can bank your sperm before your surgery.
After surgery, orgasms will also feel different. You wont have that normal buildup of sensation before you have an orgasm. Youll still be able to feel pleasure, though.
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Why Does It Take So Long To Recover Erections After The Very Best Surgery
A number of explanations have been proposed for this phenomenon of delayed recovery, including mechanically induced nerve stretching that may occur during prostate retraction, thermal damage to nerve tissue caused by electrocoagulative cautery during surgical dissection, injury to nerve tissue amid attempts to control surgical bleeding, and local inflammatory effects associated with surgical trauma.
Erectile Dysfunction After Cancer Treatment
Many men may have difficulty obtaining or maintaining erections after cancer treatment. Surgery and radiation therapy to the pelvic area, hormonal therapy, chemotherapy, and some medications may impact a man’s ability to obtain or maintain an erection. Erectile dysfunction can cause angst and anxiety for the man and his partner.
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Management Of Erectile Function
Whats the secret to having a good sex life after prostate cancer? In an interview with the Prostate Cancer Foundation Johns Hopkins urologist Trinity Bivalacqua, M.D., Ph.D. summed it up this way You use prescription erection pills. If they dont work, you move to injectable medications. If they dont work, you get a penile prosthesis. Theres also the vacuum pump.
Erectile Dysfunction Medications Viagra® , Cialis® , and Levitra® work by relaxing the muscles in the penis which allows blood to rapidly flow to achieve an erection. About 75% of men who undergo nerve-sparing prostatectomy or radiation therapy can successfully achieve erections with these medications.
Muse® is a medicated pellet about half the size of a grain of rice that when inserted into the urethra through the opening at the tip of the penis stimulates blood flow into the penis. About 40% of men have reported successfully achieving erections after using this drug.
End to End nerve grafting is a new technique recently reported to be effective in improving erectile function.
Injection therapy requires sticking a tiny needle into the base of the penis so Tri-mix which contains three drugs can be injected. The success rate is between 70 and 80% and each shot costs about $7. The specific formulation of drugs is based on the type of erection achieved with test dosages in the doctors office and the doctor teaches the patient how to self-inject.
References:
Can Erection Rehabilitation Be Applied To Improve Erection Recovery Rates
A relatively new strategy in clinical management after radical prostatectomy has arisen from the idea that early induced sexual stimulation and blood flow in the penis may facilitate the return of natural erectile function and resumption of medically unassisted sexual activity. There is an interest in using oral PDE5 inhibitors for this purpose, since this therapy is noninvasive, convenient, and highly tolerable. However, while the early, regular use of PDE5 inhibitors or other currently available, “on-demand” therapies is widely touted after surgery for purposes of erection rehabilitation, such therapy is mainly empiric. Evidence for its success remains limited.
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Surgery Effects On Erections
Some types of cancer surgery can affect erections. If any of these surgeries are part of your treatment plan, talk to your doctor before the procedure. Ask doctor about how your erections might be affected by surgery and what may be the best way to manage the problem.
- Radical prostatectomy: Removal of the prostate and seminal vesicles for prostate cancer
- Radical cystectomy: Removal of the bladder, prostate, upper urethra, and seminal vesicles for bladder cancer. Removal of the bladder requires a new way of collecting urine, either through an opening into a pouch on the belly or by building a new bladder inside the body.
- Abdominoperineal resection: Removal of the lower colon and rectum for colon cancer. This surgery may require an opening in the belly where solid waste can leave the body.
- Total mesorectal excision : Removal of the rectum as well as the tissues that support it for treating rectal cancer
- Total pelvic exenteration: Removal of the bladder, prostate, seminal vesicles, and rectum, usually for a large tumor of the colon, requiring new openings for both urine and solid waste to leave the body.
Most men who have these types of surgeries will have some difficulty with erections . Some men will be able to have erections firm enough for penetration, but probably not as firm as they were before. Others may not be able to get erections. There are many different treatments for ED that can help many men get their erections back.