Treating erectile dysfunction after prostate surgery

Prostate cancer is one of the most common cancers affecting men in Austria and Germany. However, if detected and treated early, the chances of recovery are good.

As many prostate cancers grow slowly and tumour growth is often hormone-dependent, the condition can be effectively controlled with medication.

However, certain types of prostate cancer grow faster and are more aggressive, and therefore require different treatment. Sometimes surgery is the only option.

During a radical prostatectomy, the entire prostate and surrounding tissue are removed to ensure that all affected tissue is eliminated.
However, a common side effect of prostate surgery is erectile dysfunction (ED).

Impotence after prostate surgery

The nerves responsible for erections are located close to the prostate. Since prostate removal surgery involves the complete or partial removal of this nerve tissue, erectile dysfunction is often the result.
Up to 90 percent¹ of men who undergo prostate surgery suffer from erectile dysfunction after the operation.

There is a high risk of nerve or blood vessel damage associated with erection during surgery for benign prostate enlargement (prostatic hyperplasia) and other pelvic surgical procedures, such as those on the bladder or intestine.

Limited treatment options

However, if parts of the nerve bundles responsible for erections can be spared during the procedure, erectile function can be improved with the administration of PDE-5 inhibitors. If the nerve fibers have been completely removed or severed, Viagra, Cialis, and other similar drugs are ineffective.

Sometimes, prostaglandin E1 can be administered to induce an erection. This medication can either be dripped into the urethra or injected into the erectile tissue using a syringe.

Penile prosthesis as a solution after prostate removal

The most promising method for treating erectile dysfunction after prostate cancer is the implantation of a penile prosthesis.

During the procedure, two silicone cylinders are inserted into the erectile tissue, which will take over the erection mechanism.

The hydraulic penile prostheses primarily used today consist of several interconnected components and imitate the natural erection mechanism: A small pump, which is “hidden” in the scrotum, allows saline solution to be pumped from a small fluid reservoir in the abdomen into the cylinders in the penis. This causes the penis to become erect.

After sexual intercourse, the saline solution is simply released back into the reservoir and the erection subsides.

A penile prosthesis is not a prosthesis in the conventional sense. It does not replace the penis itself, but only the erectile tissue. The implant is inserted into the erectile tissue, so the entire system is hidden inside the body and is therefore not visible or detectable to outsiders.

Studies examining patient and partner satisfaction with various treatment options for erectile dysfunction have shown that penile prosthesis implantation has the highest satisfaction rate of all the treatment options. Hydraulic erectile tissue implants achieved satisfaction rates of up to 98%.

Penile prostheses can also treat erectile dysfunction and impotence following radical prostatectomy, prostate surgery, or other pelvic surgeries.