Sex after prostate surgery

Sexual disorders after radical removal of the prostate often but little noticed

Many patients fear the loss of a fulfilled sex life after prostate cancer surgery. A justified concern, as a significant proportion of men undergoing surgery suffer from sexual dysfunction, as a recent Danish study has shown. But often patients are only informed about the impotence before a radical intervention.

The maintenance of potency is by no means a guarantee for a fulfilled sex life, says Dr. Pedram Derakhshani. Even if the erectile function should be retained after radical prostatectomy, the sex life of men is often severely impaired, according to the urologist at the Westdeutsche Prostatazentrum in Cologne. Involuntary urination during orgasm and sexual stimulation, a painful climax or shortening of the penis can considerably disturb sexuality - shame and unwillingness are often the result.

Unpleasant consequences of the operation

While such problems are usually not discussed by many urologists, a Danish team of researchers has compiled a systematic review1 of all the sexual disorders that can lead to radical removal of the prostate gland. Up to 93 percent of men suffer from incontinence during orgasm or sexual stimulation. Nearly 80 percent of men undergoing orgasmic surgery perceive a reduction in their sensation. Pain during orgasm also occurs in almost a quarter of the patients after surgery. And depending on the study, 15 to 68 percent of men find out after the operation that their penis has become shorter, and 16 percent also experience penile distortion as a result of the operation.

The frequent occurrence of sexual problems after the operation is all the more serious because many men with prostate cancer are still operated unnecessarily,"emphasizes Dr. Derakhshani. According to the recommendation of the guidelines, for example, in men with a low risk prostate carcinoma, it can often be sufficient to closely monitor the tumor (Active Surveillance). If treatment should nevertheless become necessary, it is important to steer the focus more towards achieving optimal healing rates with minimal side effects, according to the urologist from Cologne. It is therefore our duty to draw the patient's attention to effective but gentle treatment methods such as brachytherapy (internal radiation) in the run-up to therapy.

Literature:

Frey AU, Sønksen J, Fode M.: Neglected Side Effects After Radical Prostatectomy: A Systematic Review. J Sex Med. 2013 Nov 25. doi. J Sex Med. 2013 Nov 25. doi: 10.1111/sm. 12403. 

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